جوامع سلامت دیجیتال: اثر مکانیسم های انگیزش آن ها

Health-related online social networks are starting to play a role in many people's daily lives by enabling them to monitor their diet and motivating them to change their lifestyles. These social networks provide different motivation mechanisms. However, little research has been done on the effectiveness of these motivation mechanisms. This research analyzes data collected from a digital health community to examine what mechanisms can help motivate people. The results suggest that there is a high level of correlation between users' exercise activities and their participation in these digital health communities. This research benefits the digital health communities by providing insights into the design of motivation mechanisms.

Healthcare is one of the most important industries in the U.S. With the development of electronic commerce, we have seen incredible transformations in banking, music, travel, and many other industries. The healthcare industry, however, still mostly runs on paper [21]. But in recent years, there has been a big push by the government, major healthcare organizations, and consumer advocacy groups to invest more in healthcare-related information technology and to move healthcare online. The federal government has invested a lot of money to encourage hospitals and physicians to automate their processes. Implementing modern information systems is expected to improve the efficiencies of hospitals and physicians' offices. It can also significantly improve the quality of healthcare. With the growing popularity of web 2.0 technologies such as blogs, podcasts, and wikis, many healthcare organizations and professionals are embracing social media. Social media refer to blogs, social networks, and other media for social interaction. The use of social network software and its ability to promote the connection between patients and the rest of the medical industry has been dubbed “Health 2.0,” and the number of organizations adopting Health 2.0 is growing. The Centers for Disease Control and CIGNA, for example, have active pilots in virtual worlds, such as Second Life, to test whether social media can help spread the word about issues like nutrition awareness, cancer screening, and infectious-disease prevention. American Red Cross uses Twitter to update information on natural disasters. Medscape, a social network for doctors, offers specialists, primary care physicians, and other health professionals integrated medical information and educational tools, and allows them to discuss, post, and answer questions about diseases and treatments. The social-networking revolution is also coming to healthcare on the consumer side. The Internet technology and social media are making it easier than ever for consumers to find timely, personalized healthcare information online. Previously connected mainly through email discussion groups and chat rooms, now patients are able to build more sophisticated virtual communities that enable them to share information about treatments and support, and build online personal networks of friends. Patientslikeme.com is a platform that enables people to share information that can improve the lives of patients diagnosed with life-changing diseases. Patients can chat on the website, blog about their illness, and support each other with recommendations. DailyBurn and myfitnesspal.com, on the other hand, focus on fitness and healthy lifestyles instead of diseases. Registered members can update their health information and the websites provide suggestions tailored to the user's particular health/fitness needs, such as daily calorie intake and customized exercise plans. People can exercise together with their friends and participate in various fitness challenges. Researchers have started to investigate the benefits of these health-related online social networks from different perspectives. Ni and Sun [30] study why doctors are willing to participate in online information platforms and how they benefit through participation. Kane and Ransbotham [22] analyze how people work together to create peer-produced medical information in social media platforms. Yan and Tan [51] propose an inhomogeneous Partially Observed Markov Decision Process model to study the helpfulness of an online healthcare community to patients' health condition dynamics. Xiao et al. [50] examine factors that influence patients' online health information search and find that perceived health status could affect patients' online health search frequency as well as diversity. The privacy concern, trust and information sensitivity are factors that have an impact on people's decision on providing their health information online [4]. Decades of research indicate that physical activity is an important behavior for health promotion and disease prevention [18] and [42]. Despite widespread dissemination of information supporting the health benefits of physical activities, the percentage of sedentary American adults reaches almost 35% [3], and over half do not exercise regularly [33]. Therefore, it is important to study what motivation mechanisms really work. According to the new physical activity guidelines announced by the U.S. Department of Health and Human services in 2008, two and a half hours a week of moderate aerobic physical activity can help adults gain substantial health benefits, and children can benefit from an hour or more of physical activity a day. The National Prevention and Health Promotion Strategy, developed by the Surgeon General's National Prevention and Health Promotion Council, is shifting the nation from a focus on sickness and disease to one based on prevention of disease and promotion of wellness, which will help lead to longer, healthier, and more productive lives for all Americans. Many digital health communities have emerged to do exactly that: promoting a healthy lifestyle and encouraging people to exercise more. They provide different motivation mechanisms to help achieve the goal. However, little research has been done on whether these motivation mechanisms are effective. The objective of this study is to analyze the effect of health-related social networks and their motivation mechanisms using data collected from a digital health community. Our two main research questions are: • Does active participation in health-related online social networking motivate people to exercise more? • What motivation mechanisms used in digital health websites motivate their users to exercise more? The rest of the paper is organized as follows. In Section 2, we review the literature on motivation theory in sports and the relationship between social networking and health. Data and regression results are provided in Section 3. Section 4 concludes the paper with future research directions.

In this paper, we investigate the effectiveness of the motivation mechanisms used in an online fitness community. We hypothesize that online social networking activities and one's support network motivate people to exercise more, and people who pay for services are more likely to exercise compared to the ones with only a free membership. We build our theory based on the sports motivation literature and the social network literature. Our empirical results support all of our hypotheses. There is a clear trend that young people's participation in physical activity declines as they get older. Previous studies also show the importance of early interventions in order to assist young adolescents and adults to keep physical activity at a healthful level. Our preliminary results are encouraging in the sense that digital health communities do seem to play a role in motivating people to exercise. More health and fitness oriented websites and mobile apps are emerging every day. They not only provide tools that enable people to track their own activity levels, but also connect users to a community of like-minded people. Our results show that the social networking functions provided by these websites are indeed linked to people's exercise level. This conclusion is consistent with the traditional sports motivation literature that social support is an important motivator of one's physical exercise activities, although the social networking function comes in the form of digital networking. These findings encourage the research community as well as the digital health community providers to further investigate the effectiveness of online social networking tools on their users' health and fitness. Our research also provides insights into the design of motivation mechanisms. The significant positive correlation between the number of motivators and the number of achieved goals indicates that motivators play an important role in encouraging people to exercise more. Therefore, when health providers decide to go digital and use some mechanisms to motivate people to exercise, setting up motivator groups is a good choice. Some other possible motivation mechanisms include giving points or badges once a user achieves his/her exercise goals, creating competition among motivation groups, etc. Different mechanisms vary in their effectiveness of motivating users to exercise. In order to keep their users exercising and maintain the growth of their websites, incorporating the most effective mechanisms into the service should be an important consideration in the design process. Our research is a first step that sheds light on this important process. This is preliminary work. We used data from one health-related social networking website only and tested three hypotheses. We have found that there is a relationship between a user's fitness achievements and his social activity online. However, we do not infer any causal relationship here. In the future, we will collect more data from other similar websites which might have different motivation mechanisms to validate our results. Some of the interesting questions we may consider in the future are: what other motivation mechanisms can be effective besides the online motivator group? How can people use these health websites to improve their health status? How shall we design the digital health communities to induce adherence to fitness activities? There have been much recent discussions about using information technology to improve the quality of healthcare in the U.S. Given the prevalence of social networking technologies such as Facebook and Twitter, understanding whether IT-enabled social networking activities would and how to motivate people to exercise and stay fit is extremely important. In today's environment where our national obesity rate is over 20%, and 9 out of every 10 U.S. Internet users now visit a social networking site in a month, this research activity could potentially discover an important tool that benefits the nation as a whole to stay healthy and fit.