JMIR Publications

ABSTRACT

Background:

Tuberculosis (TB) remains one of the world’s leading deadly infectious diseases. Yet, despite the growing role of online health communities (OHCs) as key sources of social support, research on TB-related online communities remains scarce. Network analysis has been increasingly used to study OHCs and identify opinion leaders, offering a valuable approach to advancing knowledge of TB-related online communities.

Objective:

This study aimed to provide insights into the types of social support and the influence of opinion leaders in a prominent TB-related online forum in China, based on 438 posts recommended by the forum’s administrator (admin) and the 150,570 replies they received, collected over 18 years from the forum’s launch in 2004 to 2021.

Methods:

This study employed content analysis to examine the types of social support in admin-recommended posts, which are commonly considered high-quality. It then applied social network analysis to these posts and their replies to identify opinion leaders based on their degree centrality—measured by replies received and sent—after which, their identities and number of self-created posts were examined. Finally, semantic network analysis was used to explore the topics discussed in the opinion leaders’ posts and replies.

Results:

The content analysis showed a high prevalence of informational and emotional support in the admin-recommended posts. Of the 438 posts, 296 (67.5%) contained social support, with 150 containing informational support and 136 containing emotional support. Social support varied by post theme and whether the intent was to provide or seek it. Among disease knowledge posts, 74 out of 75 provided informational support. Emotional support was most frequently provided in non-treatment sharing posts (28 out of 113) and most frequently sought in treatment experience posts (47 out of 129). The social network analysis identified two opinion leaders with the highest centrality, measured by replies received and sent. The first was a former TB patient, and the second a pulmonary TB doctor. Together, they contributed 30.4% (133/438) of all posts. In their posts and replies, while both focused on TB treatment and the importance of doctors, the former patient covered a wider range of topics and provided more emotional support, whereas the doctor offered more informational support based on professional expertise.

Conclusions:

The findings suggest that the examined TB-related online forum served as an important source of social support for people affected by TB in China, fostering an environment for both informational and emotional support. Opinion leaders played an important role by contributing posts and establishing a central position through reply interactions with users.