Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

In online support groups (OSGs), individuals build social connections in order to grant social support, especially reciprocal social support. Much research has been done around the support exchange behaviors and the content of support. Few have investigated the formation of reciprocal social support, especially in the context of social embedding where the social networks evolve. In this article, we aim to explain how reciprocal social support forms by testing and integrating the social science hypotheses into the modeling of the outside social networks. A series of simulation experiments have been conducted to test our hypotheses and the proposed models. The results show that our proposed models can well capture the reciprocal properties observed in real-world social networks, and our hypotheses can collectively explain the formation of reciprocal social support. By hypothesizing user behaviors of support exchange and modeling the outside social networks, our study advances the understanding of how users participate in online groups, either to give more or to receive more support.

Background: Studies have shown that the phenomenon of fetal malformations can cause serious psychological problems and even depressive symptoms of pregnant women during their perinatal period. Psychological studies have shown that involving these women into appropriate interventions and treatments can effectively alleviate their depressed symptoms. With the prevalence of mobile technologies and online social networks, practitioners and researchers have been dedicating to move the offline intervention strategies to online platforms for the treatment of depression caused by fetal malformations.System Design: We design an online DEPression INterVention system (DEPINV), suitable for the online intervention of depressed woman suffering from fetal malformations. There are three main features in the design of DEPINV. First, it intends for the effective coordination and interaction among three types of user roles in order to reach a tripartite synergistic therapy effect. Second, it focuses on the assessment and monitoring of users’ psychological state, and the Accept Cognition Theory (ACT) is introduced into the design of the system for the intervention. Third, various communication channels are provided to assist users’ coordination and ACT-based intervention. System Implementation: To make the access easy and flexible, we adopt the WeChat applet as the development and deploying technical framework. Therefore, DEPINV is a WeChat applet that can be accessed by simply scanning the Quick Response (QR) code. It cooperates three types of users, the healthcare providers, depressed women and their family members. That is, DEPINV helps healthcare providers to maintain and manage the psychological states of depressed women with the involvement of their family members. There are six successive stages in the core function of the ACT-based intervention and each target for the accomplishment of one specific psychological state. Through the comprehensive management of treatment procedure, DEPINV applet helps healthcare providers record and monitor the dynamic change of patients' affections. To cope with the negative emotions of depressed women, various channels of information support, social support and emotional support are also provided for instant communication between healthcare providers and family members.Conclusion: The DEPINV applet provides effective online interventional strategies and treatments for depressed women with the help of both healthcare providers and their family members. When more interventional features and functions are included, it is necessary to extend the applet into a mental health app.

BACKGROUND Internet hospitals, or e-hospitals, as one kind of e-health platforms in China, provided novel channels through which physicians present their medical or health-care knowledge to patients and provide online counseling services. The sustainable development of Internet hospitals and e-health platforms relied on the participation of both the patients and the physicians, especially on the provision of health consultation services by the physicians. OBJECTIVE The objective of our study was to explore the factors motivating Chinese physicians to provide online health counseling services from the perspectives of their online reputation and offline reputation. METHODS We collected the data of 141,030 physicians from 6,173 offline hospitals and 350 cities on WeDoctor, an Internet hospital platform authorized by the China Health and Family Planning Committee. We selected the physicians’ online consultation volume, the total amount of counseling conversations from all channels of the platform, as the investigated dependent variable, reflecting the actual online counseling behaviors of the physicians in the platform. Based on the reputation theories and prior study, we incorporated patients’ feedback as the physicians’ online reputation (i.e. patients’ comments and their satisfaction scores), and incorporated the physicians’ offline professional status as the offline reputation (i.e. professional titles and the rankings of their offline working hospitals). We also delved the moderated effects of the city levels where the physicians lived offline and the number of patients who were watching the physicians online. Eight research hypotheses were proposed. Step-wise linear regression models were used to test our hypotheses. Durbin-Watson test and robustness tests were also conducted to ensure the fitness and reliability of our models. RESULTS As a result of the regression models, we found that, 1) physicians’ online reputation, including the number of comments written by the patients (beta=0.588, P<0.001), the satisfaction scores (beta=0.034, P<0.01), significantly and positively influence physicians’ online counseling behaviors; 2) Physicians’ offline reputation, including their professional titles (beta=-0.084, P<0.001) and the hospital rankings (beta=-0.163, P<0.001), significantly and negatively influence physicians’ online counseling behaviors; 3) the city levels where the physicians lived strengthen the negative effect between their offline hospital rankings and their online consulting services (beta=-0.177, P<0.001), indicating that physicians of higher offline reputation spend less time on online counseling, possibly due to the relative heavier offline workload; 4) the number of watching patients weakens the positive effect between patients’ comments and physicians’ online consulting services (beta=-0.216, P<0.001), indicating that the watching patients may switch the channels from online consultation to offline hospital visits after using the Internet hospitals. CONCLUSIONS This study contributed to the literature on physicians online counseling behaviors in Internet hospitals by verifying the contrasting effects of the online reputation and the offline reputation. It then contributed to the motivation theory by separating the online reputation from the offline reputation when the acting entities have constraints of limited time and effort. This study can also provide practical insights for the hospital managers to better arrange for the online counseling services and for the policy makers to consider the patients’ online feedback into the overall evaluation of the physicians’ reputation.