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Purpose Gamification elements have been increasingly used in online weight-loss communities to help users lose weight. The purpose of this paper is to systemically examine whether and how social interactions influence users’ continued participation in the context of online weight-loss competitions (OWCs). Design/methodology/approach This study empirically investigated sustained involvement in OWCs using a Cox proportional hazards model. Additionally, the research utilized a text-mining technique to identify various types of social support and explored their roles in sustaining participation behavior in OWCs. Findings Community response both within and outside OWCs positively influence users’ continued participation in OWCs. Moreover, whereas emotional support and companionship received within OWCs have a greater impact on users’ continued participation than informational support received within OWCs, informational support received outside OWCs has a greater impact on users’ continued participation than emotional support and companionship received outside OWCs. Originality/value This paper highlights users’ social needs in OWC engagement and provides empirical evidence on how different types and sources of social support influence continued participation behavior in OWCs. The research additionally provides management implications for online health community service providers.

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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.

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.

PurposeAlthough 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/approachBased 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.FindingsBoth 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/valueThis 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.