Self-management behavioural change as a result of engagement with online peer support: Insights from a qualitative analysis of a UK asthma online community

Problem

Background:Patients with long term conditions take part in online health communities (OHCs) for advice and guidance from peers (other patients with similar conditions). Engagement with these communities may prompt changes in self-management behaviour. Limited information, however, exists on determinants of behavioural change as a result of engagement with an OHC.Aim:To understand factors that might drive changes in self-management behaviour following engagement with an asthma OHC.

Approach

Design & setting:Qualitative and sentiment analysis of posts written between December 2022 and August 2023 in the OHC of the Asthma + Lung UK (ALUK) charity. Method:OHC posts were identified using the search term ‘helped’ with Google search engine and collected for analysis, together with all other posts within the same threads. Thematic analysis was applied to posts driving a change in behaviour using the Behaviour Change Technique (BCT) Taxonomy. Sentiment analysis was used to explore the sentiment (positive, neutral and negative) accompanying behaviour change.

Findings

Results:Thirty-five threads were identified, of which 17 (48.6%) showed self-management behaviour change as a result of users’ interactions. The 17 threads included a total of 362 posts by 18 users (9 female, 1 male, 8 not stated). Intention to change behaviour was declared in 32/362 posts, actual change in 6/362 posts, and both in 1 post. Behaviours and intentions to change behaviour included: contacting primary care services, trying on other users’ recommendations, asking to change medication, and purchasing equipment. 52 posts were identified as driving the behaviour change, using 12 BCTs. Common BCT were: Demonstration of behaviour (n=30), Action planning (n = 26), Instruction on how to perform the behaviour (n=17), Adding objects to the environment (n=15), and Pharmacological support (n= 10). In all cases, a combination rather than a single BCT were used in each post that led to change. In 66.7% of these threads, the sentiment of participants showing behaviour change shifted from negative to positive.Conclusion:Online peer support can be associated with self-management behavioural change among individuals with chronic health conditions such as asthma. ‘Demonstrating behaviour’ and ‘action planning’ by users might be successful techniques in fostering both intention and actual behavioural change in patients taking part in the OHC.

Consequences

- Patients with chronic illnesses engage with OHCs for support and advice.- We found that online peer support is associated with self-management behavioural change, like seeking further pharmacological support from healthcare services, over-the-counter/self-supportive advice, and contacting medical professionals.- By applying the behaviour change technique taxonomy BCTs we identified ‘Action planning’, ‘Instruction on how to perform the behaviour’, ‘Adding objects to the environment’, and ‘Pharmacological support’ as the active ingredients driving patient self-management behavioural change as result of engagement with asthma OHCs.