JMIR Publications

ABSTRACT

Background:

Patients and caregivers have been widely using Online Health Communities (OHCs) to acquire knowledge from peers. Questions posed in OHCs reflect the participant's learning objectives and are known to differ in the level of cognitive complexity. However, little is known about the topics and levels of participant learning objectives and the corresponding support they receive from other members of the OHC.

Objective:

This study aims to investigate patients' and caregivers’ knowledge acquisition in an OHC. Specifically, we investigate: 1) the distribution and topics of posts with learning objectives at different cognitive complexity levels; 2) the type and amount of social support provided to meet users’ learning objectives at different cognitive complexity levels; and 3) the influence of social support on the change in learning objectives.

Methods:

We collected 10-years of discussion threads from one of the most active OHCs for ovarian cancer (OvCa). A mixed-method approach was employed, including qualitative content analysis and quantitative statistical analysis. Initial posts with questions were manually classified into one of three learning objectives with increasing cognitive complexity levels, from low to high, using Anderson and Krathwohl’s taxonomy: Understand, Analyze, and Evaluate. Manual content analysis and automatic classification models were performed to identify the types of social support in the comments, including emotional support and five types of informational support (i.e., Advice, Referral, Fact, Personal Experience, and Opinion)

Results:

The original dataset contains 909 initial posts and 14,816 comments, and the final dataset for the analysis contains 560 posts with questions and 3,998 comments. Our results show that OvCa patients and their caregivers mainly used the OHC to acquire knowledge for low- to medium-level learning objectives. 82.3% (461/560) of the questions were either Understand or Analyze questions, in which users are seeking to learn basic facts and medical concepts or draw connections among different situations and conditions. Only 17.7% (99/560) of the questions were at the Evaluate level, in which the users asked other OHC members to help them make decisions or judgments based on their specific conditions. Notably, OvCa treatment was the most popular topic of interest among all the questions, regardless of levels of learning objectives. Regarding the social support received for different levels of learning objectives, significant differences were found in the Advice (F(2,437.84) = 9.69, P < .001), Opinion (F(2,418.18) = 11.56, P < .001), and Emotional Support (F(2,395.88) = 3.24, P = .01), as determined by one-way ANOVA whereby questions at the Evaluate level were more likely to receive Advice, Opinion, and Emotional Support than for questions at the lower levels of learning objectives. In addition, receiving more social support tends to drive the users to increase the cognitive complexity of the learning objective in the next post.

Conclusions:

Our study establishes that OHCs are promising resources for acquiring knowledge of OvCa. Our findings provide implications for designing better OHCs that serve the growing OvCa community.