Moment or Momentum? Examining the Effectiveness of the Ecosystem in Online Healthcare Communities

Patient-centric online platforms for seeking peer support and engaging in health activities have become increasingly popular among social media users. Although there is an increasing number of online healthcare communities (OHCs), most struggle to remain operative. In this study, we draw from attract-select-attrition theory to examine various functional components offered by OHCs for user participation. By analyzing users’ activities in a weight-loss community over a 3-year period, we find that users are likely to self-monitor their weight management progress and to participate in structured programs for promoting healthier behavior changes. Our findings provide evidence for OHCs as an effective means of patient health management and indicate that the massive amount of social interaction involved in knowledge sharing and opinion exchange does not necessarily attract users’ active participation, although there is an indirect impact. Together, the functional components in OHCs create a reinforced ecosystem. Once we differentiate users in terms of newcomers and continuous participants, our analysis reveals that, although structured programs and self-monitoring are effective in attracting new OHC participants, returning users are more likely to be attracted by self-monitoring features and opt for attending behavior changes. Again, social support is found to be insignificant in exhibiting a direct impact, albeit indirect pathways exist. Because online platforms depend primarily on users’ voluntary participation, and OHCs need to have enough social resources to remain sustainable and continue to provide services for participants, our findings provide important practical guidance for service providers to design better ecosystems for online healthcare platforms