Online Peer-to-Peer Healthcare: Exploring Push-Pull Factors of Engagement
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Abstract
Background: Recent estimates suggest that a quarter of people who go online for health or medical information are drawn to content posted by their peers. This trend towards peer-to-peer healthcare raises a number of questions: What are the processes through which patients engage with online peer experiences? How do they decide what peer information to trust? What kinds of experiences do they find compelling? What health conditions are best supported by peer-to-peer healthcare?
Objective: This paper presents a series of related studies designed to better understand peer-to-peer healthcare interaction online with the aim of identifying key factors that attract users to online patient experiences and that drive continued engagement or disengagement with peer content.
Methods: Three studies were conducted between 2011 and 2012 in the UK. Each study adopted a similar research design allowing data to be pooled from 74 participants across three different health conditions, including 29 asthma sufferers, 25 smokers considering quitting, and 20 personal carers of people with multiple sclerosis (MS). These three patient groups were chosen carefully to reflect three very different health challenges: (i) patients with a chronic health condition (asthma), (ii) individuals consideringa health behaviour change (smoking), and (iii) individuals supporting someone with a serious health condition (MS carers). Each health group varied both in terms of population demographics and in the severity and nature of the condition. This intentionally diverse selection ensured that any systematic differences between the groups groups would not overly bias the results. A multi-method toolkit approach (including focus groups, log books, data logging and interviews) allowed us to explore participant behaviour in an unrestricted online search for information as well as study more protracted engagement with a fixed set of websites chosen to reflect different types of patient-generated content each with different credibility markers.
Results: Following qualitative thematic analysis of the data we were able to develop a framework that captured a three-stage process of patient engagement with their peers and allowed us to identify the key factors at play at each stage of the process. Firstly, the quality of the website, the accessibility of good peer-to-peer information and the nature of the health condition under investigation influenced an early gating process where patients decided whether peer information was superficially credible, available and appropriate and made the choice about whether to engage further with the site. Secondly, participants engaged in a more probing, comparator process - where they measured themselves against their peers, often questioning the extent to which the peer contributions were directly relevant to their own situation and needs. Finally, they were influenced by the perceived value of the information they found in terms of how it might affect attitude and behavior and shape their longer-term outlook.
Conclusions: The research has highlighted several key factors that influence online peer-to-peer communication at different stages of the engagement process. Different patient groups have different needs and we have developed an engagement framework that allows us to explore these differences more precisely. The framework has also helped us identify a set of website design guidelines for successful peer-to-peer interaction.
Objective: This paper presents a series of related studies designed to better understand peer-to-peer healthcare interaction online with the aim of identifying key factors that attract users to online patient experiences and that drive continued engagement or disengagement with peer content.
Methods: Three studies were conducted between 2011 and 2012 in the UK. Each study adopted a similar research design allowing data to be pooled from 74 participants across three different health conditions, including 29 asthma sufferers, 25 smokers considering quitting, and 20 personal carers of people with multiple sclerosis (MS). These three patient groups were chosen carefully to reflect three very different health challenges: (i) patients with a chronic health condition (asthma), (ii) individuals consideringa health behaviour change (smoking), and (iii) individuals supporting someone with a serious health condition (MS carers). Each health group varied both in terms of population demographics and in the severity and nature of the condition. This intentionally diverse selection ensured that any systematic differences between the groups groups would not overly bias the results. A multi-method toolkit approach (including focus groups, log books, data logging and interviews) allowed us to explore participant behaviour in an unrestricted online search for information as well as study more protracted engagement with a fixed set of websites chosen to reflect different types of patient-generated content each with different credibility markers.
Results: Following qualitative thematic analysis of the data we were able to develop a framework that captured a three-stage process of patient engagement with their peers and allowed us to identify the key factors at play at each stage of the process. Firstly, the quality of the website, the accessibility of good peer-to-peer information and the nature of the health condition under investigation influenced an early gating process where patients decided whether peer information was superficially credible, available and appropriate and made the choice about whether to engage further with the site. Secondly, participants engaged in a more probing, comparator process - where they measured themselves against their peers, often questioning the extent to which the peer contributions were directly relevant to their own situation and needs. Finally, they were influenced by the perceived value of the information they found in terms of how it might affect attitude and behavior and shape their longer-term outlook.
Conclusions: The research has highlighted several key factors that influence online peer-to-peer communication at different stages of the engagement process. Different patient groups have different needs and we have developed an engagement framework that allows us to explore these differences more precisely. The framework has also helped us identify a set of website design guidelines for successful peer-to-peer interaction.
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