Hierarchies of knowledge in responses to messages of newbies in online health support groups

Abstract

Objectives: To determine how hierarchies of knowledge are established in two online health forums: one for recovery from eating disorders and the other for diabetes. Methods: 28 threads, with a total of 55,462 words were collected from the eating disorders (ED) forum. From the diabetes (D) forum, 18 threads were extracted, with a total of 51,397 words. We performed a quantitative and a qualitative analysis of the structures and mechanisms to convey experiential knowledge and to deliver advice. Results: The frequency of strategies such as providing facts about the illness, sharing personal stories and using medical terminology was higher in the diabetes forum than in the eating disorder forum. In the category of providing advice, ED and D responders behaved as experts and formulated advice in an authoritative way by resorting to imperatives and deontics of obligation. Conclusion: In both fora, epistemic and emotional experiences are presented. The goal in each site is the creation of shared understanding among their members. Experiential knowledge is highly personal, and it is never depicted as antagonistic to medical expertise. Practice implications: Experiential knowledge is complex and rich and can complement medical expertise in the treatment of long-term and/or chronic health conditions.