Enhancing social support: Role of professional capital in shaping identity-driven participation in online patient communities

Abstract

An online patient support community (OPSC) facilitates information exchange and emotional support among patients with shared health conditions. While the benefits of OPSCs for patients’ physical and mental well-being are well-documented, the antecedent factors that drive patients to provide informational and emotional support remain underexplored. This study extends social identity theory to investigate how professional capital—comprised of human capital, decisional capital, and social capital—affects the provision of social support in OPSCs. The study also examines how identity rights, representing community status and privileges, moderate this relationship. An empirical study was conducted on one of the largest diabetes OPSCs in China, analyzing 227,901 text interactions from 5,977 members. Using text mining analytics (i.e., text classifiers and latent Dirichlet allocation models), we measured professional capital and examined its influence on social support provision. The results reveal that professional capital significantly impacts the provision of both informational and emotional support. Specifically, the human and decisional dimensions of professional capital exert a stronger influence than the social dimension. Additionally, identity rights positively moderate the effects of professional capital on social support provision, showing that members with higher status and privileges contribute more actively. These findings have important implications for both management theory and practice.

Graphical abstract

Keywords

online patient support community / social support / professional capital / text mining

References

[1] Alemu E N, Huang J, (2020). HealthAid: Extracting domain targeted high precision procedural knowledge from on-line communities. Information Processing & Management, 57( 6): 102299

[2] Andrews K M, Delahaye B L, (2002). Influences on knowledge processes in organizational learning: The psychosocial filter. Journal of Management Studies, 37( 6): 797–810

[3] Ardichvili A, Page V, Wentling T, (2003). Motivation and barriers to participation in virtual knowledge-sharing communities of practice. Journal of Knowledge Management, 7( 1): 64–77

[4] ArgyleM (1978). The Psychology of Interpersonal Behaviour. United Kingdom: Penguin Press

[5] Barak A, Boniel-Nissim M, Suler J, (2008). Fostering empowerment in online support groups. Computers in Human Behavior, 24( 5): 1867–1883

[6] Blank T O, Schmidt S D, Vangsness S A, Monteiro A K, Santagata P V, (2010). Differences among breast and prostate cancer online support groups. Computers in Human Behavior, 26( 6): 1400–1404

[7] Brashers D E, Neidig J L, Goldsmith D J, (2004). Social support and the management of uncertainty for people living with HIV or AIDS. Health Communication, 16( 3): 305–331

[8] Brown J S, Duguid P, (2001). Knowledge and organization: A social-practice perspective. Organization Science, 12( 2): 198–213

[9] Butler B S, (2001). Membership size, communication activity, and sustainability: A resource-based model of online social structures. Information Systems Research, 12( 4): 346–362

[10] Carron-Arthur B, Ali K, Cunningham J A, Griffiths K M, (2015). From help-seekers to influential users: A systematic review of participation styles in online health communities. Journal of Medical Internet Research, 17( 12): e271

[11] Cassell J, Tversky D, (2005). The language of online intercultural community formation. Journal of Computer-Mediated Communication, 10( 2): JCMC1027

[12] Chang H H, Chuang S S, (2011). Social capital and individual motivations on knowledge sharing: Participant involvement as a moderator. Information & Management, 48( 1): 9–18

[13] Chen L, Baird A, Straub D, (2020a). A linguistic signaling model of social support exchange in online health communities. Decision Support Systems, 130: 113233

[14] Chen S, Guo X, Wu T, Ju X, (2020b). Exploring the online doctor-patient interaction on patient satisfaction based on text mining and empirical analysis. Information Processing & Management, 57( 5): 102253

[15] Chen Y, Feeley T H, (2014). Social support, social strain, loneliness, and well-being among older adults: An analysis of the health and retirement study. Journal of Social and Personal Relationships, 31( 2): 141–161

[16] ChildS (2016). Social Capital and Social Networks: The Importance of Social Ties for Health among Residents of Disadvantaged Communities. Dissertation for the Doctoral Degree. University of South Carolina, USA

[17] Chiu C M, Hsu M H, Wang E T, (2006). Understanding knowledge sharing in virtual communities: An integration of social capital and social cognitive theories. Decision Support Systems, 42( 3): 1872–1888

[18] Chuang K Y, Yang C C, (2010). Helping you to help me: Exploring supportive interaction in online health community. Proceedings of the American Society for Information Science and Technology, 47( 1): 1–10

[19] Cobb S, (1976). Social support as a moderator of life stress. Biopsychosocial Science and Medicine, 38( 5): 300–314

[20] CohenSUnderwoodL GGottliebB H (2000). Social support measurement and intervention: A guide for health and social scientists. New York: Oxford University Press

[21] CoulsonN S (2013). How do online patient support communities affect the experience of inflammatory bowel disease? An online survey. JRSM Short Reports, 4(8): 2042533313478004

[22] Dang Y, Guo S, Guo X, Vogel D, (2020). Privacy protection in online health communities: Natural experimental empirical study. Journal of Medical Internet Research, 22( 5): e16246

[23] Dang Y, Guo S, Guo X, Wang M, Xie K, (2021). Privacy concerns about health information disclosure in mobile health: Questionnaire study investigating the moderation effect of social support. JMIR mHealth and uHealth, 9( 2): e19594

[24] Dang Y, Guo S, Song H, Li Y, (2024). Setting goal difficulty in monetary incentives to physicians: Evidence from an online health knowledge-sharing platform. Information Technology & People, 37( 2): 605–634

[25] Davis J L, Love T P, Fares P, (2019). Collective social identity: Synthesizing identity theory and social identity theory using digital data. Social Psychology Quarterly, 82( 3): 254–273

[26] Dinev T, Hart P, (2006). An extended privacy calculus model for e-commerce transactions. Information Systems Research, 17( 1): 61–80

[27] Dutton J E, Dukerich J M, Harquail C V, (1994). Organizational images and member identification. Administrative Science Quarterly, 39( 2): 239–263

[28] Ellemers N, De Gilder D, Haslam S A, (2004). Motivating individuals and groups at work: A social identity perspective on leadership and group performance. Academy of Management Review, 29( 3): 459–478

[29] Ellemers N, Kortekaas P, Ouwerkerk J W, (1999). Self-categorisation, commitment to the group and group self-esteem as related but distinct aspects of social identity. European Journal of Social Psychology, 29( 2–3): 371–389

[30] Frost J H, Massagli M P, (2008). Social uses of personal health information within PatientsLikeMe, an online patient community: What can happen when patients have access to one another’s data. Journal of Medical Internet Research, 10( 3): e15

[31] Fullan M, Rincón-Gallardo S, Hargreaves A, (2015). Professional capital as accountability. Education Policy Analysis Archives, 23: 15–15

[32] Galegher J, Sproull L, Kiesler S, (1998). Legitimacy, authority, and community in electronic support groups. Written Communication, 15( 4): 493–530

[33] Granovetter M, (1985). Economic action and social structure: The problem of embeddedness. American Journal of Sociology, 91( 3): 481–510

[34] Guo S, Chen Y, Dang Y, Li X, (2025). Individual protective actions with social support seeking in an online health community: Two observational cross-sectional studies during public health emergencies. Humanities & Social Sciences Communications, 12( 1): 550

[35] Guo S, Guo X, Fang Y, Vogel D, (2017). How doctors gain social and economic returns in online health-care communities: A professional capital perspective. Journal of Management Information Systems, 34( 2): 487–519

[36] Guo S, Guo X, Zhang X, Vogel D, (2018). Doctor–patient relationship strength’s impact in an online healthcare community. Information Technology for Development, 24( 2): 279–300

[37] Guo X, Guo S, Vogel D, Li Y, (2016). Online healthcare community interaction dynamics. Journal of Management Science and Engineering, 1( 1): 58–74

[38] Håkansson J, Montgomery H, the HåKansson J, (2003). Empathy as an interpersonal phenomenon. Journal of Social and Personal Relationships, 20( 3): 267–284

[39] Hale B J, Gonzales A L, Richardson M, (2018). Vlogging cancer: Predictors of social support in YouTube cancer vlogs. Cyberpsychology, Behavior, and Social Networking, 21( 9): 575–581

[40] Hargreaves A, Fullan M, (2013). The power of professional capital. Learning Professional, 34( 3): 36

[41] HargreavesAFullanM (2015). Professional Capital: Transforming Teaching in Every School. Teachers College Press

[42] Helgeson V S, (2003). Social support and quality of life. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 12( S1): 25–31

[43] Hogg M A, Terry D I, (2000). Social identity and self-categorization processes in organizational contexts. Academy of Management Review, 25( 1): 121–140

[44] HuangKChengalur-SmithIRanW (2013). Engagement in healthcare virtual support communities: Social support, companionship activities, and gender differences. Communications of the Association for Information Systems: 34

[45] Huang K Y, Chengalur-Smith I, Pinsonneault A, (2019). Sharing is caring: Social support provision and companionship activities in healthcare virtual support communities. Management Information Systems Quarterly, 43( 2): 395–423

[46] Huang K Y, Chengalur-Smith I, Ran W, (2014). Not just for support: Companionship activities in healthcare virtual support communities. Communications of the Association for Information Systems, 34( 1): 29

[47] Jiang L C, Bazarova N N, Hancock J T, (2011). The disclosure–intimacy link in computer-mediated communication: An attributional extension of the hyperpersonal model. Human Communication Research, 37( 1): 58–77

[48] Jin X L, Yin M, Zhou Z, Yu X, (2021). The differential effects of trusting beliefs on social media users’ willingness to adopt and share health knowledge. Information Processing & Management, 58( 1): 102413

[49] Kawachi I, Berkman L F, (2001). Social ties and mental health. Journal of Urban Health, 78( 3): 458–467

[50] Kazmer M M, Lustria M L A, Cortese J, Burnett G, Kim J H, Ma J, Frost J, (2014). Distributed knowledge in an online patient support community: Authority and discovery. Journal of the Association for Information Science and Technology, 65( 7): 1319–1334

[51] Kim H W, Zheng J R, Gupta S, (2011). Examining knowledge contribution from the perspective of an online identity in blogging communities. Computers in Human Behavior, 27( 5): 1760–1770

[52] King G, Willoughby C, Specht J A, Brown E, (2006). Social support processes and the adaptation of individuals with chronic disabilities. Qualitative Health Research, 16( 7): 902–925

[53] Kingod N, Cleal B, Wahlberg A, Husted G R, (2017). Online peer-to-peer communities in the daily lives of people with chronic illness: A qualitative systematic review. Qualitative Health Research, 27( 1): 89–99

[54] Knippenberg A D, (1991). Social identifications: A social psychology of intergroup relations and group processes. British Journal of Social Psychology, 30( 3): 271–272

[55] Koetsenruijter J, van Eikelenboom N, van Lieshout J, Vassilev I, Lionis C, Todorova E, Portillo M C, Foss C, Gil M S, Roukova P, (2016). Social support and self-management capabilities in diabetes patients: An international observational study. Patient Education and Counseling, 99( 4): 638–643

[56] Lekwijit S, Terwiesch C, Asch D A, Volpp K G, (2024). Evaluating the efficacy of connected healthcare: An empirical examination of patient engagement approaches and their impact on readmission. Management Science, 70( 6): 3417–3446

[57] Liao G Y, Huang T L, Dennis A R, Teng C I, (2024). The influence of media capabilities on knowledge contribution in online communities. Information Systems Research, 35( 1): 165–183

[58] Liu C, Marchewka J T, Lu J, Yu C S, (2005). Beyond concern—A privacy-trust-behavioral intention model of electronic commerce. Information & Management, 42( 2): 289–304

[59] Liu J, Zhang X, Meng F, Lai K, (2020). Deploying gamification to engage physicians in an online health community: An operational paradox. International Journal of Production Economics, 228: 107847

[60] Mao J Y, Benbasat I, (2000). The use of explanations in knowledge-based systems: Cognitive perspectives and a process-tracing analysis. Journal of Management Information Systems, 17( 2): 153–179

[61] McCaig D, Elliott M T, Siew C S, Walasek L, Meyer C, (2019). Profiling commenters on mental health–related online forums: A methodological example focusing on eating disorder–related commenters. JMIR Mental Health, 6( 4): e12555

[62] Mpinganjira M, (2019). Willingness to reciprocate in virtual health communities: The role of social capital, gratitude and indebtedness. Service Business, 13( 2): 269–287

[63] Nahapiet J, Ghoshal S, (1998). Social capital, intellectual capital, and the organizational advantage. Academy of Management Review, 23( 2): 242–266

[64] NonneckeBPreeceJ (2003). Silent Participants: Getting to Know Lurkers Better. London: Springer London

[65] O’Neill B, Ziebland S, Valderas J, Lupiáñez-Villanueva F, (2014). User-generated online health content: A survey of Internet users in the United Kingdom. Journal of Medical Internet Research, 16( 4): e118

[66] Ommen O, Thuem S, Pfaff H, Janssen C, (2011). The relationship between social support, shared decision-making and patient’s trust in doctors: A cross-sectional survey of 2,197 inpatients using the Cologne Patient Questionnaire. International Journal of Public Health, 56( 3): 319–327

[67] Panzarasa P, Griffiths C J, Sastry N, De Simoni A, (2020). Social medical capital: How patients and caregivers can benefit from online social interactions. Journal of Medical Internet Research, 22( 7): e16337

[68] Pavlou P A, Gefen D, (2004). Building effective online marketplaces with institution-based trust. Information Systems Research, 15( 1): 37–59

[69] Rains S A, (2016). Language style matching as a predictor of perceived social support in computer-mediated interaction among individuals coping with illness. Communication Research, 43( 5): 694–712

[70] Rains S A, Peterson E B, Wright K B, (2015). Communicating social support in computer-mediated contexts: A meta-analytic review of content analyses examining support messages shared online among individuals coping with illness. Communication Monographs, 82( 4): 403–430

[71] Rains S A, Young V, (2009). A meta-analysis of research on formal computer-mediated support groups: Examining group characteristics and health outcomes. Human Communication Research, 35( 3): 309–336

[72] Reynolds R, Dennis S, Hasan I, Slewa J, Chen W, Tian D, Bobba S, Zwar N, (2018). A systematic review of chronic disease management interventions in primary care. BMC Family Practice, 19( 1): 11

[73] Roland B, Tirole J, (2006). Incentives and prosocial behavior. American Economic Review, 96( 5): 1652–1678

[74] Ryan V D, Agnitsch K A, Zhao L, Mullick R, (2005). Making sense of voluntary participation: A theoretical synthesis. Rural Sociology, 70( 3): 287–313

[75] Sarason I G, Levine H M, Basham R B, Sarason B R, (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44( 1): 127–139

[76] Shaw B R, McTavish F, Hawkins R, Gustafson D H, Pingree S, the Bret R. Shaw, Fiona McTavish, (2000). Experiences of women with breast cancer: Exchanging social support over the CHESS computer network. Journal of Health Communication, 5( 2): 135–159

[77] Shensa A, Sidani J E, Escobar-Viera C G, Switzer G E, Primack B A, Choukas-Bradley S, (2020). Emotional support from social media and face-to-face relationships: Associations with depression risk among young adults. Journal of Affective Disorders, 260: 38–44

[78] Shinn M, Lehmann S, Wong N W, (1984). Social interaction and social support. Journal of Social Issues, 40( 4): 55–76

[79] Shumaker S A, Brownell A, (1984). Toward a theory of social support: Closing conceptual gaps. Journal of Social Issues, 40( 4): 11–36

[80] Song X, Liu Y H, Jin J, Zhao J, (2018). Factors driving continued use of online health promotion competitions. Online Information Review, 42( 6): 802–820

[81] StaubEBar-TalDKarylowskiJReykowskiJ (1984). Development and Maintenance of Prosocial Behavior: International Perspectives on Positive Morality. New York: Plenum Publishing Corporation

[82] Stewart S A, Abidi S S R, (2012). Applying social network analysis to understand the knowledge sharing behaviour of practitioners in a clinical online discussion forum. Journal of Medical Internet Research, 14( 6): e170

[83] Stewart Loane S, Webster C M, (2017). Social capital and consumer value co-created within an online health community. Journal of Nonprofit & Public Sector Marketing, 29( 3): 317–345

[84] Suhay E, (2015). Explaining group influence: The role of identity and emotion in political conformity and polarization. Political Behavior, 37( 1): 221–251

[85] Tajfel H, (1974). Social identity and intergroup behaviour. Social Sciences Information. Information Sur les Sciences Sociales, 13( 2): 65–93

[86] Tamjidyamcholo A, Baba M S B, Shuib N L M, Rohani V A, (2014). Evaluation model for knowledge sharing in information security professional virtual community. Computers & Security, 43: 19–34

[87] Tsai W, Ghoshal S, (1998). Social capital and value creation: The role of intrafirm networks. Academy of Management Journal, 41( 4): 464–476

[88] Turner J W, Robinson J D, Tian Y, Neustadtl A, Angelus P, Russell M, Mun S K, Levine B, (2013). Can messages make a difference? The association between e-mail messages and health outcomes in diabetes patients. Human Communication Research, 39( 2): 252–268

[89] Vahtera P, Buckley P J, Aliyev M, Clegg J, Cross A R, (2017). Influence of social identity on negative perceptions in global virtual teams. Journal of International Management, 23( 4): 367–381

[90] Van Dick R, (2001). Identification in organizational contexts: Linking theory and research from social and organizational psychology. International Journal of Management Reviews, 3( 4): 265–283

[91] Van Dick R, Wagner U, Stellmacher J, Christ O, (2005). Category salience and organizational identification. Journal of Occupational and Organizational Psychology, 78( 2): 273–285

[92] Wang J J, Liu H, Ye J, (2023). The impact of individual and team professional capital on physicians’ performance in online health-care communities: a cross-level investigation. Internet Research, 33( 1): 152–177

[93] Wang Q, Qiu L, Xu W, (2024). Informal payments and doctor engagement in an online health community: An empirical investigation using generalized synthetic control. Information Systems Research, 35( 2): 706–726

[94] Wang W T, Wei Z H, (2011). Knowledge sharing in wiki communities: An empirical study. Online Information Review, 35( 5): 799–820

[95] Wasko M M, Faraj S, (2005). Why should I share? Examining social capital and knowledge contribution in electronic networks of practice. Management Information Systems Quarterly, 29( 1): 35–57

[96] Wellman B, Wortley S., (1989). Brothers’ keepers: Situating kinship relations in broader networks of social support. Sociological Perspectives, 32( 3): 273–306

[97] Wright K B, (2016). Communication in health-related online social support groups/communities: A review of research on predictors of participation, applications of social support theory, and health outcomes. Review of Communication Research, 4: 65–87

[98] Wright K B, Bell S B, Wright K B, Bell S B, (2003). Health-related support groups on the Internet: Linking empirical findings to social support and computer-mediated communication theory. Journal of Health Psychology, 8( 1): 39–54

[99] Wu B, (2018). Patient continued use of online health care communities: Web mining of patient-doctor communication. Journal of Medical Internet Research, 20( 4): e126

[100] Wu J, Hou S, Jin M, (2017). Social support and user roles in a chinese online health community: A LDA based text mining study. In: International Conference on Smart Health. Cham: Springer International Publishing, 10347: 169–176

[101] Wu L, (2013). Social network effects on productivity and job security: Evidence from the adoption of a social networking tool. Information Systems Research, 24( 1): 30–51

[102] Yan L, Tan Y, (2014). Feeling Blue? Go online: An empirical study of social support among patients. Information Systems Research, 25( 4): 690–709

[103] Yang F, Zhong B, Kumar A, Chow S M, Ouyang A, (2018). Exchanging social support online: A longitudinal social network analysis of irritable bowel syndrome patients’ interactions on a health forum. Journalism & Mass Communication Quarterly, 95( 4): 1033–1057

[104] Yang H, Yan Z, Jia L, Liang H, (2021). The impact of team diversity on physician teams’ performance in online health communities. Information Processing & Management, 58( 1): 102421

[105] Yang Y, Zhang X, Lee P K C, (2019). Improving the effectiveness of online healthcare platforms: An empirical study with multi-period patient-doctor consultation data. International Journal of Production Economics, 207: 70–80

[106] Yli-Renko H, Autio E, Sapienza H J, (2001). Social capital, knowledge acquisition, and knowledge exploitation in young technology‐based firms. Strategic Management Journal, 22( 6–7): 587–613

[107] ZaphirisPAngC S (2009). Social Computing and Virtual Communities. New York: CRC Press

[108] ZhangNJiaQYinKDongLGaoFHuaN (2020a). Conceptualized representation learning for chinese biomedical text mining. arXiv preprint arXiv: 10813

[109] Zhang X, Liu S, Deng Z, Chen X, (2017a). Knowledge sharing motivations in online health communities: A comparative study of health professionals and normal users. Computers in Human Behavior, 75: 797–810

[110] Zhang Y, Li X, Fan W, (2020b). User adoption of physician’s replies in an online health community: An empirical study. Journal of the Association for Information Science and Technology, 71( 10): 1179–1191

[111] Zhang Y, Sun Y, Kim Y, (2017b). The influence of individual differences on consumer’s selection of online sources for health information. Computers in Human Behavior, 67: 303–312

[112] Zhao Y, Da J, Yan J, (2021). Detecting health misinformation in online health communities: Incorporating behavioral features into machine learning based approaches. Information Processing & Management, 58( 1): 102390

[113] Zhou J, Zhang Q, Zhou S, Li X, Zhang X M, (2023). Unintended emotional effects of online health communities: A text mining-supported empirical study. Management Information Systems Quarterly, 47( 1): 195–226

[114] Zhou T, (2020). Understanding users’ participation in online health communities: A social capital perspective. Information Development, 36( 3): 403–413

[115] Zhu P, Shen J, Xu M, (2020). Patients’ willingness to share information in online patient communities: Questionnaire study. Journal of Medical Internet Research, 22( 4): e16546

RIGHTS & PERMISSIONS

Higher Education Press