Patient Problem-Solving on the Web: How do Patients Use Web Forums to Cope with Chronic Disease? [4 1530 Aud Billman]

Billman, D. et al.: Patient Problem-Solving on the Web: How do Patients Use Web Forums to Cope with Chronic Disease? ,[object Object],[object Object],[object Object]

Patient Problem-Solving on the Web: How do Patients Use Web Forums to Cope with Chronic Disease? Dorrit Billman CSLI Stanford & Palo Alto Research Corp Diane Schiano Palo Alto Research Corp Lee Gugerty Clemson, Psychology Medicine2.0 Sept 4, 2008

Overall Goals of Research ,[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Approach ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Related work re: peer-generated content about health conditions ,[object Object],[object Object],Medicine2.0 Sept 4, 2008 Study content with focus on topics discussed Blank &Adams-Biodnieks 07 (breast & prostate cancer) Kenen et al 07(cancer risk) Lasker et al 05 (cirrhosis) Meier et al 07 (cancer survivors) Study activity through content What about a message increases chance of reply to first-postings (Kraut et al) How do people use types of information: shared health variables (Frost & Massagli, 08)

This study ,[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Design sample: DISEASES, sites, threads, messages. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Design sample: DISEASES, sites, threads, messages. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Design sample: diseases, sites, threads, messages. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Code Development ,[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Code Development ,[object Object],Medicine2.0 Sept 4, 2008 Form What illocutionary force/speech acts are people using? Assumed asking for information and telling information. Codes= TELL, ASK, GREET, and OTHER Topic of Content What are people talking about? Physiological= disease mechanisms, treatments; personal or general. Pragmatic= interacting with health care, daily living, financial Social- Emotional= direct expressions: offering or requesting emotional support or advice. NonHealth=personal life, stories, public events, activities without One message can include multiple forms and topic types. Intent- significant part.

Code Development ,[object Object],Medicine2.0 Sept 4, 2008 Schema We observed frequent, structured types of messages. -Give Information: post of general information relevant to health or condition. Not personal, not questioning . -Problem & Question: tells background circumstances about individual (usually but not necessarily self) about an undesired situation or problem; then asks explicitly for helping information, typically about what to do. -Status: Reports about individual’s status (usually self); may be evaluated positively, negatively, or neutral. No questions or requests. Personal reporting . - None : all messages not fitting one schema. Mutually exclusive.

Code Development ,[object Object],Medicine2.0 Sept 4, 2008 Example Flags - causal: information about cause, mechanism, effects; general or personal -triggers: was there a clearly identified, health-relevant event in life of individual that prompted writing the message? -personal experience of others: does message ask for personal experience? -multiple diseases: comorbidity, alternative diseases, interactions.

PRELIMINARY Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Medicine2.0 Sept 4, 2008

Frequency of Topic Types (in 300 messages) Medicine2.0 Sept 4, 2008 Coding includes 1-3 prominence. Users include multiple topic types when initiating threads. Average of 1.4 topic-types/message. Physio most prevalent. .

Frequency of Topic Types Differ by Group Medicine2.0 Sept 4, 2008 Mult-Sclerosis message topics are heavily physio. RSD message topics are very diverse . Coding includes 1-2 prominence.

Form of 1 st Messages (in 300 messages) Medicine2.0 Sept 4, 2008 TELL predominates (89%). Bare questions are very rare. Long tail of illocutionary acts- important for community? “ other” includes {thanks, apology, message testing, group games}

Ask and Tell Codes by Group Medicine2.0 Sept 4, 2008 Groups TELLing has different focus: Diabetes very personal, little general; MS and RSD the reverse. STABLE difference???

Medicine2.0 Sept 4, 2008 Schema of 1 st -Message (Coding is mutually exclusive) Overall, the majority of messages fit into two schema, Prob+Quest and GiveInfo.

Chronic Condition 1 st -Message Types Medicine2.0 Sept 4, 2008 But patterns differ by group. Diabetes is problem-focused. RSD is varied.

1 st -Message Types by Site Medicine2.0 Sept 4, 2008

Problem & Question Examples Medicine2.0 Sept 4, 2008 Diabetes Impact of activities on blood glucose Whether to use specialist How to continue activities Multiple Sclerosis Diagnosis limbo, asking how people were diagnosed Asking whether problems are MS related (spasms) RSD Interaction with doctors, prep for nonexperts Symptom management Help interpreting test results

[object Object],[object Object],[object Object],[object Object],Hypotheses on Function Medicine2.0 Sept 4, 2008 ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Future and Design Medicine2.0 Sept 4, 2008

Patient Problem-Solving on the Web: How do Patients Use Web Forums to Cope with Chronic Disease? [4 1530 Aud Billman]

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Patient Problem-Solving on the Web: How do Patients Use Web Forums to Cope with Chronic Disease? [4 1530 Aud Billman]