A multilevel investigation of participation within virtual health communities

Virtual health communities are a major channel through which health consumers share health-related know ledge and/or exchange social support with their peers. These virtual environments can be a form of, or a potential component of, integrated Patient-centered e-Health (PCEH) applications, which represent emerging healthcare information systems that emphasize the role of patients and revolve around providing patient-focus, patient-activity, and patient-empowerment services. Because of the collaborative nature of virtual health communities, user participation is a critical factor for community grow th and prosperity. In this study, we examine user participation at the individual and group (thread) levels. At the individual level, we investigate the impact of reciprocity and homophily (similarity of user characteristics such as age, gender, and tenure) on user participation within virtual health communities. At the thread level, we study the role of highly active users (power users) as thread initiators as well as the role of thread initiators' participation on the overall thread vibrancy. To do so, we analyzed 2,176 threads initiated by 130 users and 1,947 messages exchanged between these users and their peers. Our results support short-term reciprocity, but refute the positive relationship associated with long-term reciprocity. Among homophily hypotheses, our results support gender homophily, but not age or tenure homophily. At the thread level our findings suggest that a discussion thread is vibrant if the thread initiator is a power user or participates actively within the thread. These findings have important implications for future research and practice in PCEH applications.