Social media might be taking precedence in our lives these days, but there is another form of online communication that we used to (and for some of us still) rely on for exchanging knowledge or receiving emotional support from strangers – the online forums or bulletin boards. For example, Stack Overflow features a Q&A platform for software developers to exchange coding knowledge. Slickdeals, a deal and promotion-sharing forum, on the other hand, has a typical forum structure that has threads, original posters, and responses to those original posters.
Various streams of research have been conducted on online communities, from motivations behind participants in contributing time and knowledge in helping strangers, to the economic value of such contribution. What is lacking is the social value of online communities. Scholars Goh, Gordon and Agarwal (2016) aim to bridge this gap by looking at how an online community addresses the health disparity of rural and urban populations. They are also the first to quantify the social value of online communities.
Their assumptions are as follows: there is limited access to resources such as specialized care, information, healthcare programs, and social support groups in rural areas, which creates significant disadvantages for rural patients. Therefore, rural patients tend to have decreased health status and health functioning, possess less health knowledge, and have lower health-seeking skills, beliefs and self-efficacy. Together with other health capability gaps, rural patients are more likely to have poorer health statuses and higher mortality rates than urban patients. Given rural patients’ disadvantage relative to the urban patients, these researchers suggest that online communities can reduce the health capabilities gap experienced by rural patients by enabling the exchange of social support, in the form of both health information exchange and emotional support. Moreover, to the degree that community interaction has a relatively more positive effect for rural patients, they hypothesize that online communities generate social value by reducing rural–urban health disparities.
To prove their hypothesis, they collected message data on a rare disease online forum posted by 111 rural patients and 527 urban patients from October 2005 through June 2009. They adopted a network methodology in studying the knowledge and emotional exchange among original posters and responses. To illustrate, each node in the network represents a patient who participated in the forum. There is directionality associated with support provisions such that a supportive tie between a patient who posts a thread and a response from another patient is represented by a directed dyadic tie, where the arrow points toward the originating poster and the arrow head terminating at the recipient (e.g., a patient whose initial post generates a reply in the thread would have a tie that is directed toward her). If their hypothesis is correct, it should show that the rural nodes are more likely to be recipients and urban nodes are more likely to be providers of social support.
Their findings suggest the following: the probability of a node with an incoming tie is 7 percent higher for a rural node as compared to an urban node. In other words, all else equal, a rural patient is more likely to receive support compared to their urban counterparts. They also find that rural patients are less likely than their urban counterparts to provide support.
Taken together, these results show that the likelihood of an urban patient responding to a rural patient is higher than the likelihood of responding to another urban patient, all else equal, and therefore providing support for the claim that there is a net surplus of social support flowing from urban to rural users.
Their results yield implications for policy makers and practitioners concerned with meeting patient needs and overcoming disparities in medical access. Entities responsible for resource allocation decisions, such as governments, community agencies, and public health facilities should leverage the powerful role that online collectives can play. Online communities can serve as a low cost alternative to or as a complement to existing health programs. For instance, healthcare entities can have professional nurses or doctors participate in these communities by providing information in addition to regular patients. Such information shouldn’t replace necessary office visits. Rather, it can guide the patients in the right direction and serve as a conduit towards further examination.
Goh, Jie Mein; Gao, Guodong (Gordon); and Agarwal, Ritu. 2016. “The Creation of Social Value: Can an Online Health Community Reduce Rural-Urban Health Disparities?” MIS Quarterly, (40: 1) pp.247-263.
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