From help-seekers to influential users: A systematic review of participation styles in online health communities

Bradley Carron-Arthur, Kathina Ali, John Alastair Cunningham, Kathleen Margaret Griffiths

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43 Citations (Scopus)
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Background: Understanding how people participate in and contribute to online health communities (OHCs) is useful knowledge in multiple domains. It is helpful for community managers in developing strategies for building community, for organizations in disseminating information about health interventions, and for researchers in understanding the social dynamics of peer support. Objective: We sought to determine if any patterns were apparent in the nature of user participation across online health communities. Methods: The current study involved a systematic review of all studies that have investigated the nature of participation in an online health community and have provided a quantifiable method for categorizing a person based on their participation style. A systematic search yielded 20 papers. Results: Participatory styles were classified as either multidimensional (based on multiple metrics) or unidimensional (based on one metric). With respect to the multidimensional category, a total of 41 different participation styles were identified ranging from Influential Users who were leaders on the board to Topic-Focused Responders who focused on a specific topic and tended to respond to rather than initiate posts. However, there was little overlap in participation styles identified both across OHCs for different health conditions and within OHCs for specific health conditions. Five of the 41 styles emerged in more than one study (Hubs, Authorities, Facilitators, Prime Givers, and Discussants), but the remainder were reported in only one study. The focus of the unidimensional studies was on level of engagement and particularly on high-engaged users. Eight different metrics were used to evaluate level of engagement with the greatest focus on frequency of posts. Conclusions: With the exception of high-engaged users based on high post frequency, the current review found little evidence for consistent participatory styles across different health communities. However, this area of research is in its infancy, with most of the studies included in the review being published in the last 2 years. Nevertheless, the review delivers a nomenclature for OHC participation styles and metrics and discusses important methodological issues that will provide a basis for future comparative research in the area. Further studies are required to systematically investigate a range of participatory styles, to investigate their association with different types of online health communities and to determine the contribution of different participatory styles within and across online health communities.

Original languageEnglish
Article numbere271
Number of pages15
JournalJournal of Medical Internet Research
Issue number12
Publication statusPublished - 1 Dec 2015
Externally publishedYes

Bibliographical note

©Bradley Carron-Arthur, Kathina Ali, John Alastair Cunningham, Kathleen Margaret Griffiths. Originally published in the
Journal of Medical Internet Research (, 01.12.2015. This is an open-access article distributed under the terms
of the Creative Commons Attribution License (, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet
Research, is properly cited. The complete bibliographic information, a link to the original publication on,
as well as this copyright and license information must be included.


  • Online health community
  • Participation inequality
  • Participation style
  • Social network
  • Systematic review


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