UNDERSTANDING USER INTERACTION PATTERNS IN HEALTH SOCIAL MEDIA A dissertation Submitted to the Faculty of Drexel University By Katherine Y. Chuang in partial fulfillment of the requirements for the degree of Doctor of Philosophy College of Information Science & Technology Drexel University May 2013 © Copyright 2013 Katherine Y. Chuang. All Rights Reserved. ii TABLE OF CONTENTS List of Tables ................................................................................................................................... v List of Figures ............................................................................................................................... vii Abstract .......................................................................................................................................... ix Chapter 1: Introduction to Problem ............................................................................................. 1 1.1 Motivation .......................................................................................................................... 2 1.2 Research Objectives ........................................................................................................... 4 Chapter 2: Literature Review ........................................................................................................ 9 2.1 Brief History of Social Networking Sites ......................................................................... 10 2.1.1 Computer Mediated Communication Software ........................................................ 10 2.1.2 Features in Text-Based Online Communication Tools ............................................. 16 2.2 Online Health Support Communities ............................................................................... 23 2.2.1 Social Support Types ................................................................................................ 24 2.2.2 Support in Online Health Communities .................................................................... 25 Chapter 3: Operational Concepts: Technical and Social aspects of an online community ..................................................................................................................................... 28 3.1 Data Selection .................................................................................................................. 30 3.2 Definitions of Operational Concepts ............................................................................... 31 3.3 Analyzing Messages Posted by Community Members ..................................................... 33 3.4 Preliminary Results – Social Support Patterns ................................................................ 34 3.5 Related Work – Social Support Patterns .......................................................................... 42 3.6 Related Work - Network Structure Patterns ..................................................................... 46 Chapter 4: Informational Support .............................................................................................. 49 4.1 Definitions of Informational Support Types ..................................................................... 49 4.2 Methods ............................................................................................................................ 50 4.3 Informational Support Patterns ....................................................................................... 51 iii 4.3.1.1 Informational Support Offered ........................................................................................ 54 4.3.1.2 Informational Support Requested .................................................................................... 55 Chapter 5: Nurturant Support Patterns ..................................................................................... 58 5.1 Definitions of Nurturant Support ..................................................................................... 58 5.2 Methods ............................................................................................................................ 59 5.3 Nurturant Support Patterns .............................................................................................. 59 5.3.1.1 Results: Nurturant Support Offered ............................................................................. 60 5.3.1.2 Nurturant Support Requested .......................................................................................... 62 Chapter 6: Network Structure of Communication .................................................................... 68 6.1 Definitions of Structural Metrics ..................................................................................... 69 6.2 Methods ............................................................................................................................ 70 6.3 Results - Structural Metrics ............................................................................................. 73 6.3.1 Informational vs Nurturant Exchanges ..................................................................... 79 6.3.1.1 Informational Networks ................................................................................................... 81 6.3.1.2 Nurturant Networks ......................................................................................................... 87 Chapter 7: Blockmodels ............................................................................................................... 91 7.1 Definitions: Positional Metrics ........................................................................................ 92 7.2 Definitions: Functions of Social Networks ...................................................................... 92 7.3 Methods ............................................................................................................................ 94 7.4 Results: Positional Analysis (Blockmodels) ..................................................................... 98 7.4.1.1 Forum Informational Network ....................................................................................... 100 7.4.1.2 Journal Informational Network ...................................................................................... 102 7.4.1.3 Notes Informational Network ........................................................................................ 104 7.4.1.4 Forum Nurturant Network ............................................................................................. 107 7.4.1.5 Journal Nurturant Network ............................................................................................ 109 7.4.1.6 Notes Nurturant Network ............................................................................................... 111 iv 7.4.2 Summary of Social Positions .................................................................................. 113 Chapter 8: Discussion ................................................................................................................. 115 8.1 Gaps in Previous Research ............................................................................................ 115 8.2 Findings .......................................................................................................................... 115 8.2.1 Content: Patterns of social support exchanged in the community across each CMC format ............................................................................................................ 116 8.2.2 Relationships: Patterns of social network structure emerged in this online supportive environment .......................................................................................... 117 8.3 What features of CMC format impact behavior? ........................................................... 119 8.3.1 Communicating with Intent .................................................................................... 119 8.3.2 Privacy Affordance in Networked spaces ............................................................... 122 8.3.3 Usability and User Experience ............................................................................... 122 8.3.4 Social Conventions, Community of Practice .......................................................... 123 8.4 Emerging issues for practice .......................................................................................... 124 8.5 Design Guidelines for Creating Online Support Communities ...................................... 126 8.6 Limitations ...................................................................................................................... 127 Chapter 9: Contributions & Future Work ............................................................................... 128 Chapter 10: List of References .................................................................................................. 133 APPENDIX A: Social Positions ................................................................................................. 140 APPENDIX B: Publications of this work ................................................................................. 142 Vita ............................................................................................................................................... 143 v LIST OF TABLES Table 1. Study Objectives for Modeling User Activity .................................................................. 5 Table 2. CMC formats