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A multilevel analysis of sociability, usability, and community dynamics in an online health community

Published:01 June 2005Publication History
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Abstract

The aim of this research is to develop an in-depth understanding of the dynamics of online group interaction and the relationship between the participation in an online community and an individual's off-line life. The 2½-year study of a thriving online health support community (Bob's ACL WWWBoard) used a broad fieldwork approach, guided by the ethnographic research techniques of observation, interviewing, and archival research in combination with analysis of the group's dynamics during a one-week period. Research tools from the social sciences were used to develop a thick, rich description of the group. The significant findings of this study include: dependable and reliable technology is more important than state-of-the-art technology in this community; strong community development exists despite little differentiation of the community space provided by the software; members reported that participation in the community positively influenced their offline lives; strong group norms of support and reciprocity made externally-driven governance unnecessary; tools used to assess group dynamics in face-to-face groups provide meaningful information about online group dynamics; and, membership patterns in the community and strong subgroups actively contributed to the community's stability and vitality.

References

  1. Abras, C. 2003. Determining success in online education and health communities: Developing usability and sociability heuristics. Unpublished Doctoral Dissertation, University of Maryland Baltimore County, Baltimore, MD.Google ScholarGoogle Scholar
  2. Abras, C., Ozok, A., and Preece, J. 2004. Heuristics for designing and maintaining online health and academic support communities (draft available from the authors).Google ScholarGoogle Scholar
  3. Bales, R. F. 1951. Interaction Process Analysis: A Method for the Study of Small Groups. Addison-Westley Press, Inc, Cambridge, MA.Google ScholarGoogle Scholar
  4. Bales, R. F. 1958. Task roles and social roles in problem-solving groups. In Readings in Social Psychology, E. E. Maccoby, T. M. Newcomb, and E. L. Hartley, Eds. Holt, Rinehart and Winston, New York, 437--458.Google ScholarGoogle Scholar
  5. Bales, R. F. 1970. Personality and interpersonal behavior. Holt, Rinehart and Winston, New York.Google ScholarGoogle Scholar
  6. Baym, N. 1997. Interpreting soap operas and creating community: Inside an electronic fan culture. In Culture of the Internet. S. KiesleR, Ed. Lawrence Erlbaum Associates, Mahwah, NJ. 103--119.Google ScholarGoogle Scholar
  7. Baym, N. K. 2000. Tune In, Log On: Soaps, Fandom, and Online Community. Sage Publications, Thousand Oaks, CA.Google ScholarGoogle Scholar
  8. Benne, K. D. and Sheats, P. 1948. Functional roles of group members. J. Social Iss. 4, 2, 41--19.Google ScholarGoogle Scholar
  9. Bos, N., Olson, J., Gergel, D., Olson, G., and Wright, Z. 2002. Confidence and trust: Effects of four computer-mediated communications channels on trust development. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems: Changing Our World, Changing Ourselves. (April) Minneapolis, MI. 135--140. Google ScholarGoogle Scholar
  10. Braithwaite, D. O., Waldron, V. R., and Finn, J. 1999. Communication of social support in computer-mediated groups for people with disabilities. Health Comm., 11, 2, 123--151.Google ScholarGoogle Scholar
  11. Brennan, P., Moore, S., and Smyth, K. 1991. ComputerLink: Electronic support for the home caregiver. Advances Nursing Sciences 13, 4, 14--27.Google ScholarGoogle Scholar
  12. Brennan, P. F. and Ripich, S. 1994. Use of a home-care computer network by persons with aids. Int. J. Tech. Assess. Health Care 10, 2, 258--272.Google ScholarGoogle Scholar
  13. Brown, R. 2000. Group Process, 2nd Ed. Blackwell Publishers, Malden, MA.Google ScholarGoogle Scholar
  14. Cosley, D., Ludford, P., and Terveen, L. 2003. Social browsing: Studying the effect of similarity in online task-focused interactions. In Proceedings of 2003 International ACM SIGGROUP Conference on Supporting Group Work (April). Sanibel Island, FL. 321--329. Google ScholarGoogle Scholar
  15. Cotton, S. R. 2001. Implications of Internet technology for medical sociology in the new millennium. Sociolog. Spect. 21, 319--340.Google ScholarGoogle Scholar
  16. Crabtree, B. and Miller, W., Eds. 1992. Doing Qualitative Research, Vol. 3. Sage Publications, Inc., Newbury Park, CA.Google ScholarGoogle Scholar
  17. Culnan, M. J. and Markus, M. L. 1987. Information Technologies. In Handbook of Organizational Communication: An Interdisciplinary Perspective. F. M. Jablin, L. L. Putnam, K. H. Roberts and L. W. Porter Eds. Sage, Newbury Park, CA.Google ScholarGoogle Scholar
  18. Cummings, J. N., Butler, B., and Kraut, R. 2002. The quality of online social relationships. Comm. ACM 45, 1 (July), 103--108. Google ScholarGoogle Scholar
  19. Cummings, J., Kiesler, S. B., and Sproull, L. 2002. Beyond hearing: Where real world and online support meet. Group Dynamics: Theory, Res. Prac. 6, 1, 78--88.Google ScholarGoogle Scholar
  20. Davison, K., Pennebaker, J., and Dickerson, S. 2000. Who talks? The social psychology of illness support groups. Amer. Psychol. 55, 2, 205--217.Google ScholarGoogle Scholar
  21. Erickson, T., Halverson, C., Kellog, W. A., Laff, M., and Wolf, T. 2002. Social translucence: Designing social infrastructures that make collective activity visible. Comm. ACM 45, 4, 40--44. Google ScholarGoogle Scholar
  22. Farnham, S., Cheng, L., Stone, L,. Zaner-Godsey, M., and Hibbeim, C. 2002. HutchWorld: Clinical study of computer-mediated social support for cancer patients and their caregivers. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems: Changing Our World, Changing Ourselves (April). Minneapolis, MI. 375--382. Google ScholarGoogle Scholar
  23. Ferguson, T. 1996. Health Online. Addison-Wesley Publishing Co., Reading, MA.Google ScholarGoogle Scholar
  24. Fetterman, D. M. 1998. Ethnography: Step by Step, 2nd Ed. Sage Publications, Thousand Oaks, CA.Google ScholarGoogle Scholar
  25. Finn, J. 1998. An exploration of helping processes in an online self-help groups focusing on issues of disability. Available at http://www.unh.edu/social-work/SW810/disabl3.html.Google ScholarGoogle Scholar
  26. Forsyth, D. R. 1999. Group Dynamics, 3rd Ed. Wadsworth Publishing Company, Belmont, CA.Google ScholarGoogle Scholar
  27. Fox, S. and Rainie, L. 2002. Vital decisions: How Internet users decided what information to trust when they or their loved ones are sick. Pew Internet & American Life Project. (Dec. 15, 2002). Available at www.pewinternet.org.Google ScholarGoogle Scholar
  28. Fussell, S. and Setlock, L. 2003. Informal communication in an online volunteer community: Implications for supporting virtual relationships. Carnegie Mellon University, Pittsburgh, PA.Google ScholarGoogle Scholar
  29. Garton, L., Haythornthwaite, C., and Wellman, B. 1999. Studying online social networks. In Doing Internet Research, S. Jones, Ed. Sage Publications, London, UK, 75--105.Google ScholarGoogle Scholar
  30. Gustafson, D. H., Hawkins, R. P., Boberg, E. W., Bricker, E., Pingree, S., and Chan, C. 1994. The use and impact of a computer based support system for people with AIDS and HIV infection. In Proceedings of the American Medical Informatics Association, JAMIA Symposium Supplement, Hanley and Belfus, Inc., Philadelphia, PA.Google ScholarGoogle Scholar
  31. Hare, A. 1976. Handbook of Small Group Research 2nd Ed. Free Press, New York.Google ScholarGoogle Scholar
  32. Haythornthwaite, C. and Wellman, B. 2002. The internet in everyday life: An introduction. In The Internet in Everyday Life. C. Haythornthwaite and B. Wellman, Eds. Blackwell Publishers Ltd., Malden, MA. 3--41.Google ScholarGoogle Scholar
  33. Herring, S. C. 1996. Two variants of an electronic message schema. In Computer-Mediated Communication: Linguistic, Social and Cross-Cultural Perspectives, S. Herring, Ed. John Benjamins Publishing Company, Philadelphia, PA. 81--106.Google ScholarGoogle Scholar
  34. Hiltz, S. R., Johnson, K., and Turoff, M. 1986. Experiments in group decision making; Communication process and outcome in face to face versus computerized conferencing. Hum. Comm. Res. 13, 225--252.Google ScholarGoogle Scholar
  35. Hine, C. 2000. Virtual Ethnography. Sage Publications, Thousand Oaks, CA.Google ScholarGoogle Scholar
  36. Jacobs, M. K. and Goodman, G. 1989. Psychology and self-help groups: Predictions on a partnership. American Psychologists 44, 536--545.Google ScholarGoogle Scholar
  37. Jacko, J. A., Sears, A., and Borella, M. S. 2000. Toward a characterization of the usability of distributed multimedia documents. Behav. Infor. Tech.Google ScholarGoogle Scholar
  38. Kim, A. J. 2000. Community Building on the Web: Secret Strategies for Successful Online Communities. Peachpit Press, Berkeley, CA. Google ScholarGoogle Scholar
  39. King, S. A. and Moreggi, D. 1998. Internet therapy and self help groups-the pros and cons. In Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Implications. J. Gackenbach, Ed. Academic Press, San Diego, CA. 77--109.Google ScholarGoogle Scholar
  40. Korenman, J. and Wyatt, N. 1996. Group dynamics in an e-mail forum. In Computer-Mediated Communication: Linguistic, Social and Cross-Cultural Perspectives. S. Herring, Ed. John Benjamins Publishing Company, Philadelphia, PA. 225--242.Google ScholarGoogle Scholar
  41. Larson, K. and Czerwinski, M. 1998. Web page design: Implications of memory, structure and scent for information retrieval. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (Jan.). Los Angeles, CA. 25--32. Google ScholarGoogle Scholar
  42. LeCompte, M. D. and Schensul, J. 1999. Analyzing and Interpreting Ethnographic Data, Vol. 5. AltaMira Press, Walnut Creek, CA.Google ScholarGoogle Scholar
  43. Lieberman, M. A. 1993. Self-help groups. In Comprehensive Group Psychotherapy, 3rd Ed. H. I. Kaplan and M. J. Sadock, Eds. Williams and Wilkins, Baltimore, MD. 292--304.Google ScholarGoogle Scholar
  44. Lynch, P. J. and Horton, S. 1999. Web Style Guide (Preliminary Version). Yale University Press, New Haven, CT.Google ScholarGoogle Scholar
  45. Maloney-Krichmar, D., Eckert, K., and Preece, J. 2003. A critique of an ethnographic approach to the study of an online health support community: Advantages, disadvantages, and lessons learned. The 15th Annual Conference on Ethnographic and Qualitative Research in Education (June). Duquesne University, Pittsburg, PA.Google ScholarGoogle Scholar
  46. Maloney-Krichmar, D. and Preece, J. 2003. An ethnographic study of an online health support community. The 15th Annual Conference on Ethnographic and Qualitative Research in Education (June). Duquesne University, Pittsburg, PA. Google ScholarGoogle Scholar
  47. Maloney-Krichmar, D. 2003. The Impact of an online community on its members: Group dynamics, usability and sociability. Unpublished Doctoral Dissertation, University of Maryland Baltimore County, Baltimore, MD.Google ScholarGoogle Scholar
  48. Marshall, C. and Rossman, G. B. 1999. Designing Qualitative Research, 3rd Ed. Sage Publications, Thousand Oaks, CA.Google ScholarGoogle Scholar
  49. McGrath, J. E. 1984. Groups: Interaction and Performance. Prentice Hall, Englewood Cliffs, NJ.Google ScholarGoogle Scholar
  50. Miles, M. B. and Huberman, A. M. 1994. Qualitative Data Analysis. Sage Publications Ltd., Thousand Oaks, CA.Google ScholarGoogle Scholar
  51. Millen, D. and Patterson, J. F. 2002. Stimulating social engagement in a community network. In Proceedings of the 2002 ACM Conference on Computer Supported Cooperative Work. New Orleans, LA. 306--313. Google ScholarGoogle Scholar
  52. Mudrack, P. and Farrell, G. 1995. An examination of functional role behavior and its consequences for individuals in group settings. Small Group Behav. 26, 542--571.Google ScholarGoogle Scholar
  53. Nardi, B. A. 1997. The use of ethnographic methods in design and evaluation. In Handbook of Human-Computer Interaction (Second Ed.). M. G. Helander, T. K. Landauer and P. Prabhu, Eds. Elsevier Science B. V., Amsterdam, Netherlands, 361--366.Google ScholarGoogle Scholar
  54. Nielsen, J. 1993. Usability Engineering. AP Professional, Boston, MA. Google ScholarGoogle Scholar
  55. Nielsen, J. 1998. About Jakob Nielsen {WWW}. Available at http://www.useit.com/jakob/.Google ScholarGoogle Scholar
  56. Nonnecke, B. and Preece, J. 2000. Lurker demographics: Counting the silent, In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (April). Hague, The Netherlands. 73--80. Google ScholarGoogle Scholar
  57. Nonnecke, B. and Preece, J. 2000a. Persistence and lurkers in discussion lists: A pilot study. In Proceedings of the 33rd Hawaii International Conference on System Sciences (Jan.). 3031. Google ScholarGoogle Scholar
  58. Powazek, D. M. 2002. Design For Community: The Art of Connecting Real People in Virtual Places. New Riders, Indianapolis, IN. Google ScholarGoogle Scholar
  59. Preece, J. and Ghozati, K. 2001. Observations and explorations of empathy online. In The Internet and Health Communication: Experience and Expectations. R. R. Rice and J. E. Katz, Eds. Sage Publications Inc., Thousand Oaks, CA. 237--260.Google ScholarGoogle Scholar
  60. Preece, J. and Maloney-Krichmar, D. 2003. Online communities: Focusing on sociability and usability. In Handbook of Human-Computer Interaction, J. Jacko and A. Sears, Eds. Laurence Erlbaum, Mahwah, NJ. 596--620. Google ScholarGoogle Scholar
  61. Preece, J. 1998. Empathic communities: Reaching out across the web. Interact. 32--43. Google ScholarGoogle Scholar
  62. Preece, J. 1999. Empathic communities: Balancing emotional and factual communication. Interacting with Computers, Interdiscipl. J. Hum.-Comput. Interact. 12, 1, 63--77.Google ScholarGoogle Scholar
  63. Preece, J. 1999a. Empathy online. Virtual Reality 4, 1--11.Google ScholarGoogle Scholar
  64. Preece, J. 2000. Online Communities: Designing Usability, Supporting Sociability. John Wiley and Sons, Chichester, England. Google ScholarGoogle Scholar
  65. Preece, J. 2001. Sociability and usability: Twenty years of chatting online. Behav. Inform. Tech. J. 20, 5, 347--356.Google ScholarGoogle Scholar
  66. Putnam, R. D. 2000. Bowling Alone: The Collapse and Revival of American Community. Simon and Schuster, New York.Google ScholarGoogle Scholar
  67. Quan-Haase, A., Wellman, B., Witte, J., and Hampton, K. 2002. Capitalizing on the net: Social contact, civic engagement, and sense of community. In The Internet in Everyday Life. B. Wellman and C. Haythornthwaite, Eds. Blackwell Publishers Ltd., Malden, MA. 291--324.Google ScholarGoogle Scholar
  68. Rafaeli, S., Sudweeks, F., Konstan, J., and Mabry, E. A. 1998. ProjectH overview. A collaborative quantitative study of computer mediated communication. In Network and Netplay. Virtual Groups on the Internet. F. Sudweeks, M. McLaughlin and S. Rafaeli, Eds. AAAI/MIT Press, Menlo Park, CA. 265--282. Google ScholarGoogle Scholar
  69. Rheingold, H. 1994. A slice of life in my virtual community. In Global Networks: Computers and International Communication. L. M. Harasim, Ed. MIT Press, Cambridge, MA. 57--80. Google ScholarGoogle Scholar
  70. Rheingold, H. 2002. Smart Mobs: The Next Social Revolution. Perseus Publishing, Cambridge, MA. Google ScholarGoogle Scholar
  71. Rice, R. and Love, G. 1987. Electronic emotion: Socioemotional content in computer-mediated communication network. Comm. Res. 14, 1, 85--108.Google ScholarGoogle Scholar
  72. Sampson, E. E. and Marthas, M. 1990. Group Process for the Health Professional, 3rd Ed. Delmar, Albany, NY.Google ScholarGoogle Scholar
  73. Schoch, N. A. and White, M. D. 1997. A study of the communication patterns of participants in consumer health electronic discussion groups. In Proceedings of the 60th ASIS Annual Meeting, Washington, DC.Google ScholarGoogle Scholar
  74. Shaw, B. R., McTavish, F., Hawkins, R., and Gustafson, D. H. 1999. Experiences of women with breast cancer: Exchanging social support over the CHESS computer network. Health Communication Division of the International Communication Association, San Francisco, CA.Google ScholarGoogle Scholar
  75. Shneiderman, B. 1998. Designing the User Interface: Strategies for Effective Human-Computer Interaction, 3rd Ed. Addison-Wesley, Reading, MA. Google ScholarGoogle Scholar
  76. Silver, D. 1999. Localizing the Global Village: Lessons from the Blacksburg Electronic Village. In The Global Village: Dead or Alive? R. B. Browne and M. W. Fishwick, Eds. Popular Press, Bowling Green, OH. 79--92.Google ScholarGoogle Scholar
  77. Sondheimer, N. 1979. On the fate of software enhancements. In Proceedings of the National Computer Conference, 48. AFIPS Press, Nontvale, NJ.Google ScholarGoogle Scholar
  78. Spears, R. and Lea, M. 1992. Social Influence and the Influence of ‘Social’ in Computer Mediated Communication. In Contexts of Computer Mediated Communication. M. Lea, Ed. Harvest Wheatsheaf, Hemel Hempstead, UK.Google ScholarGoogle Scholar
  79. Sproull, L. and Keisler, S. 1986. Reducing social context cues; Electronic mail in organizational communication. Manag. Science 32, 1492--1512. Google ScholarGoogle Scholar
  80. Torres, C., Fairbanks, D., and Roe, R. (Eds.) 1996. The ASTD Trainer's Sourcebook: Teambuilding. McGraw-Hill Professional Publisher, New York.Google ScholarGoogle Scholar
  81. Turner, J. W., Grube, J., and Meyers, J. 2001. Developing an optimal match within online communities: An exploration of CMC support communities and traditional support. J. Comm. 51, 2, 231--251.Google ScholarGoogle Scholar
  82. van Manen, M. 1977. Linking ways of knowing with knowing with ways of being practical. Curric. Inq. 6, 3, 205--228.Google ScholarGoogle Scholar
  83. Walther, J. B. and Boyd, S. 2002. Attraction to computer-mediated social support. In Communication Technology and Society: Audience Adoption and Uses. C. A. Lin and D. Atkin, Eds. Hampton Press, Cresskill, NJ. 153--188.Google ScholarGoogle Scholar
  84. Walther, J. B. 1992. Interpersonal effects in computer-mediated interaction: A relational perspective. Comm. Res. 57, 52--90.Google ScholarGoogle Scholar
  85. Walther, J. B. 1993. Impression development in computer-mediated interaction. West. J. Comm. 57, 381--398.Google ScholarGoogle Scholar
  86. Walther, J. B. 1994. Anticipated ongoing interaction versus channel effects on relational communication in computer-mediated interaction. Hum. Comm. Res. 20, 4, 473--501.Google ScholarGoogle Scholar
  87. Wellman, B. and Frank, K. 2001. Getting support from personal communities. In Social Capital: Theory and Research. N. Lin, R. Burt, and K. Cook, Eds. Aldine De Gruytere, Chicago, IL.Google ScholarGoogle Scholar
  88. Wellman, B. 1982. Studying personal communities. In Social Structure and Network Analysis. P. M. N. Lin, Ed. Sage Publications, Beverly Hills, CA.Google ScholarGoogle Scholar
  89. Wellman, B. 1992. Which types of ties and networks give what kinds of social support? Advances in Group Processes 9, 207--235.Google ScholarGoogle Scholar
  90. Wolcott, H. 1999. Ethnography: A Way of Seeing. AltaMira Press, Walnut Creek, CA.Google ScholarGoogle Scholar
  91. Zheng, J., Bos, N., Olson, J. S., and Olson, G. M. 2001. Short talks: Trust, credibility, community: Confidence and trust: Trust without touch: Jump-start trust with social chat. In Chi'2001 Extended Abstract on Human Factors in Computing Systems (March). Minneapolis, MI. 293--294. Google ScholarGoogle Scholar

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        Caroline Merriam Eastman

        What makes an online community work__?__ What makes it at least viable and hopefully vital__?__ Sharp focus and reliable systems are two of the answers, according to this report on an extended and comprehensive research study of one such community, Bob's ACL WWWBoard. If you don't know what ACL stands for, you would likely pass this board by. However, if you are suffering from a knee injury to your anterior cruciate ligament, you might check out this online self-help community, also known as the Kneeboard. Maloney-Krichmar and Preece report on a multiyear ethnographic study of this community. Their research combined observation of the Kneeboard, detailed analysis of messages in a one-week period, various forms of social network analysis, and online interviews with selected members. The results are clearly presented, with extensive references to related literature. Kneeboard is a text-based online community with minimal structure. There are some organized subgroups, and a modest level of moderation. The participant group is largely self-organizing and self-moderating, however. Members of Kneeboard join for further information on ACL injuries and treatment, and for emotional and social support; most of the messages support these goals. The software used does not have the kinds of bells and whistles often proposed as components of online community systems, such as visualization and filters. However, participants appeared to be quite satisfied with the system as is. The extended research study and insightful analysis in this paper make it an important contribution to our understanding of online communities, especially those within the self-help category. Those involved in research and development in this area should read it. It will also be of interest to anyone with a knee injury. Online Computing Reviews Service

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