How engagement with an online health community can influence self-management behavior: insights from a qualitative analysis of a UK asthma online community using behavior change techniques taxonomy

Abstract Background Patients with long-term conditions take part in online health communities (OHCs) for advice and guidance from peers. Engagement with OHCs may prompt changes in self-management behavior. Limited information exists on determinants of behavioral change resulting from engagement with an OHC. Aims Firstly, to identify posts in which users reported engagement with an OHC was associated with actual or intended self-management behaviour change. Secondly, to identify the behavior change outcomes, and whether specific behavior change technique were used. Design & Setting Qualitative analysis of posts written between December 2022 and August 2023 in the asthma OHC of the Asthma + Lung UK (ALUK) charity. Method The search term ‘helped’ was used in the Google search engine to highlight relevant posts and threads. Two researchers read through these posts to identify threads that reported behavior change following engagement with an OHC and classified them based on the specific actions taken or intentions expressed by users. Earlier posts in the same threads that encouraged behavior change were classified using Michie’s Behavior Change Technique (BCT) Taxonomy to identify potential contributing techniques. Results Thirty-five threads were identified, with 703 posts contributed from 200 users. Users’ characteristics were mostly hidden. Seventeen (48.6%) of these threads included posts where the users who started the thread went back to it to describe their behavior change reported following engaging with the OHC. Within these threads, 6 posts demonstrated actual behavior change, 32 posts intention to change behavior, and one post both intention and actual behavior change. Behavior change outcomes included: contacting primary care services; trying out other users’ recommendations; consulting a healthcare professional to change medication; and purchasing equipment.