Purpose: Although online health communities (OHCs) and online patient reviews can help to eliminate health information asymmetry and improve patients' health management, how patients write online reviews within OHCs is poorly understood. Thus, it is very necessary to determine the factors influencing patients' online review behavior in OHCs, including the emotional response and reviewing effort.Design/methodology/approach: Based on expectation-disconfirmation theory, this study proposes a theoretical model to analyze the effects of service quality perception (i.e. outcome quality and process quality perceptions) and disconfirmation (i.e. outcome quality and process quality disconfirmations) on patients' emotional response and reviewing effort. The authors test the research model by using empirical data collected from a popular Chinese OHC and applying ordinary least squares (OLS) regression and zero-truncated negative binomial (ZTNB) regression models.Findings: Both service quality perception and disconfirmation have a positive effect on patients' positive emotional intensity in textual reviews, and disease severity enhances these relationships of process quality. Moreover, there is an asymmetric U-shaped relationship among service quality perception, disconfirmation and reviewing effort. Patients who perceive low service quality have higher reviewing effort, while service quality disconfirmation has the opposite relationship. Specifically, patients' effort in writing textual reviews is lowest when perceived outcome quality is 3.5 (on a five-point scale), perceived process quality is 4 or outcome quality and process quality disconfirmations are −1.Originality/value: This study is the first to examine patients' online review behavior and its motivations and contributes to the literature on online reviews and service quality. In addition, the findings of this study have important management implications for service providers and OHC managers.

Background: With the rapid development of information technology and web-based communities, a growing number of patients choose to consult physicians in online health communities (OHCs) for information and treatment. Although extant research has primarily discussed factors that influence the consulting choices of OHC patients, there is still a lack of research on the effects of log-in behaviors and web reviews on patient consultation. Objective: This study aims to explore the impact of physicians’ log-in behavior and web reviews on patient consultation. Methods: We conducted a longitudinal study to examine the effects of physicians’ log-in behaviors and web reviews on patient consultation by analyzing short-panel data from 911 physicians over five periods in a Chinese OHC. Results: The results showed that the physician’s log-in behavior had a positive effect on patient consultation. The maximum number of days with no log-ins for a physician should be 20. The two web signals (log-in behavior and web reviews) had no complementary relationship. Moreover, the offline signal (ie, offline status) has different moderating effects on the two web signals, positively moderating the relationship between web reviews and patient consultation. Conclusions: Our study contributes to the eHealth literature and advances the understanding of physicians’ web-based behaviors. This study also provides practical implications, showing that physicians’ log-in behavior alone can affect patient consultation rather than complementing web reviews.

Purpose: Since the success of online communities depend on physicians' participation, understanding factors that influence community participation and content contribution are critical for online health communities (OHCs). Drawing on the self-determination theory (SDT), an empirical model was proposed to explore the effects of social returns and economic returns on physicians' community participation, private content contribution and public content contribution, and the moderating effect of their online seniority. This paper aims to address these issues.Design/methodology/approach: Empirical data of 4,343 physicians were collected from a Chinese OHC, and ordinary least squares (OLS) and negative binomial regression models were employed to verify the proposed theoretical model.Findings: The authors’ results indicate that both social and economic returns have a positive effect on physicians' community participation and private content contribution, and their online seniority strengthens the positive effects of economic returns on community participation and private content contribution.Originality/value: The authors’ research extends physicians' community participation by dividing content contribution into private and public, and enhances our understanding of the determinants of physicians' participation in OHCs by exploring the effects of social and economic returns, as well as the moderating effect of online seniority. Their findings contribute to the literature on e-Health and user participation, and provide management implications for OHC managers.Peer review: The peer review history for this article is available athttps://publons.com/publon/10.1108/OIR-11-2021-0615/

Purpose: Given the popularity of online health communities (OHCs) and medical question-and-answer (Q&A) services, it is increasingly important to understand what constitutes useful answers and user-adopted standards in healthcare domain. However, few studies provide insights into how health information characteristics, provider characteristics and recipient characteristics jointly influence user information adoption decisions. To fill this research gap, this study examines the combined effects of physicians' certainty tone as information characteristics, seniority as provider characteristics and disease severity as recipient characteristics on patients' health information adoption.Design/methodology/approach: Drawing on dual-process theory and information adoption model, an extended information adoption model is established in this study to examine the effect of attitude certainty on patients' health information adoption, and the moderating effects of online seniority and offline seniority, as well as patient motivation level—disease severity. Utilizing logit regression models, the authors empirically tested the hypotheses based on 4,224 Q&A records from a popular Chinese OHC.Findings: The results show that (1) attitude certainty has a significant positive impact on patients' health information adoption, (2) the relationship between attitude certainty and information adoption is negatively moderated by physicians' online seniority, but is positively moderated by offline seniority; (3) there is a negative three-way interaction effect of attitude certainty, online seniority and disease severity on patients' health information adoption.Originality/value: This study extends the information adoption model to examine the two-way interaction between argument quality and source reliability, as well as the three-way interaction with user motivation level, especially for health information adoption in the healthcare field. These findings also provide direct practical applications for knowledge contributors and OHCs.

Purpose: A question of interest is whether online social networks are effective in promoting behavioral changes and weight loss. The purpose of this paper is to examine the contagion effect of an online buddy network on individuals’ self-monitoring behavior. Design/methodology/approach: This study collects data from an online weight-loss community and constructs an online buddy network. This study compares the effects of the network structure of the buddy network and the actor attributes when predicting self-monitoring performance by employing the auto-logistic actor attribute models. Findings: This study confirms the contagion effect on weigh-in behavior in the online buddy network. The contagion effect is significantly predictive when controlling for actor attribute and other network structure effects. Originality/value: There is limited evidence that one’s weight-related behavior can be affected by online social contacts. This study contributes to the literature on peer influence on health by examining the contagion effect on weight-related behavior between online buddies. The findings can assist in designing peer-based interventions to harness influence from online social contacts for weight loss.

Purpose: The success of online health communities (OHCs) depends on maintaining long-term relationships with physicians and preventing churn. Even so, the reasons for physician churn are poorly understood. In this study, an empirical model was proposed from a social influence perspective to explore the effects of online social influence and offline social influence on physician churn, as well as the moderating effect of their online returns.Design/methodology/approach: The empirical data of 4,145 physicians from a Chinese OHC, and probit regression models were employed to verify the proposed theoretical model.Findings: The results suggest that physicians' churn intention is influenced by online and offline social influences, and the offline social influence is more powerful. Physicians' reputational and economic returns could weaken the effect of online social influence on churn intention. However, physicians' economic returns could strengthen the effect of offline social influence on churn intention.Originality/value: This research study is the first attempt to explore physician churn and divides the social influence into online and offline social influences according to the source of social relationship. The findings contribute to the literature on e-Health, user churn and social influence and provide management implications for OHC managers.