364:. Health professionals and patients can help explain the physical and emotional stages that individuals go through once they are diagnosed with a particular disease. Furthermore, health professionals understand the risks of misinformation and the role that health care providers need to play. Patients understand the practical information about coping with a disease and the importance of social support and empathy. Designers and developers are needed to understand and explain the technological options available to online health communities and the implications of specific design choices. Such collaborations are needed to explore topics on which there seems to be no prevailing wisdom, such as how the nature of the disease or illness impacts the online health community design; how to improve health literacy; and which of the many collaborative technologies that are available best support peer interaction. Finally, it is important to track and evaluate new technologies, such as
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behaviors. Whereas, other individuals choose to share more specific knowledge such as their private health information. Private information can be more valuable for other patients. However, it is also much more difficult to share than general knowledge. Regardless of the type of knowledge being shared, reputation, social support and sense of self-worth all were associated with more sharing. Furthermore, face concern, which is the extent to which a person values the protection and improvement his or her positive social image, promotes general knowledge sharing and inhibits private sharing. Emotions, time, and effort are some of the largest barriers to providing private knowledge. Beyond these factors, there are also various other structural factors that may impact community participation and engagement.
111:, allowing a more graphical representation of the topic to be discussed. This change lessened barriers to communication and enhanced community building. For example, the growth potential from linear to geometric was made possible through this change primarily because audiences could access static content more easily without the author's knowledge or synchronicity in time. Furthermore, the graphical nature of the World Wide Web made the exchange of medically relevant information more easily possible. Lastly, the widespread use of the World Wide Web in PC's made during the mid-1990s made the technology available to a much wider audience than previous technologies. By 1997, the World Wide Web was the predominant medium for
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unavailable. For example, while members of an online health community may know one another, a real strength and benefit of them is that they can connect people who would have otherwise been unable to do so. There are certain individuals who may have smaller in-person networks who can adequately address their medical needs. Therefore, for these individuals, online health networks may be particularly beneficial. Specifically, the availability of online health communities is especially appreciated by individuals with impaired mobility, potentially embarrassing medical conditions, or caretaker responsibilities that may prohibit them from receiving adequate face-to-face medical and emotional support.
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communities, trust is often predictably built over time, and can lead to the open exchange of valuable personal details that can facilitate the exchange of support and other resources. However, in online health communities, many individuals do not know each other personally, and also perceive their health information as a very personal and private subject. For people to receive the benefits discussed previously, they need to over come this barrier in online health networks and build a strong feeling of trust. Within these networks, potential factors that contribute to feelings of cognitive and affective trust include perspective taking, self-efficacy, and network density.
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communities can offer, removing yourself from them could stifle the beneficial effects. There are numerous reasons for why someone might stop participating in a community, such as a lack of need, a poor experience, or a failure of a sites design. However, some argue that oftentimes these situations are caused by a logical progression of life changes as a given person's experience with his or her condition evolves. Regardless of the reasons for leaving, both the participation and non-participation of a communities members is a very important factor to consider, as it has strong implications for the overall success of the community.
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sociability, and usability. The pragmatic dimension refers to the goals of a user, and if the use of the community aids achievement of those goals. The empathic dimension refers to the feelings and emotions of empathy that are felt when interacting with the community. The sociability dimension refers to the overall social experience that a patient feels when interacting with the community. Finally, the usability dimension refers to the experience a patient has when navigating the features of the community. Together these features can help identify for which patients and on what platforms the largest benefits will be seen.
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Patients interact with others in online health communities in a number of different ways. As a result, various types of social support occur in communities. When users are seeking advice, education, or referrals about a certain condition or experience, they receive informational support. Alternatively, when users are seeking things like encouragement, empathy, affirmation, or validation, they receive emotional support. Finally, when users are engaging in behaviors such as chatting or humor, they receive support in the form of companionship.
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individuals. Two major reasons for this behavior are (1) a lack of social responsibility to contribute, and (2) concern about how other may perceive them if they did decide to contribute. Several options for addressing this are shown to be effective. For example, if people are paired with an online "buddy" as part of the larger community, they are more likely to contribute as it can help give a larger sense of social responsibility. Nevertheless, driving adoption and engagement is a major hurtle for many online health communities.
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can be used to create an online health community. Beyond the platform used, communities can also vary in terms of how open and accessible they are. Some communities are open and public to anyone who is interested, while others are very private. Furthermore, some communities focus on multiple conditions, while other focus primarily on one. Finally, the target user population can also differ between networks. For example, some communities are targeted towards older adults, while others are exclusively for adolescents.
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is slightly limited. Despite that lack of extensive research on its benefits, there are still many situations where online health communities appear to aid patients and medical professionals. Additionally, many of these benefits are seen within specific illnesses, and are most beneficial for certain individuals, and would be otherwise unattainable outside of the context of online health communities.
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communities as part of their patient support services. Examples of these organizations include Kaiser
Permanente, Johns Hopkins, Cleveland Medical Center, and MD Anderson Cancer Center. Currently, online health networks run by both private companies, public hospitals, and even decentralized social groups are a regular part of the illness experience for many individuals.
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through these communities. However, there is less of an incentive for medical providers to participate. Doctors can be slow to adopt technologies that deviate or disrupt their regular patterns for providing care. The additional time and responsibility commitments and significant barriers to adoption of these communities for medical providers.
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feelings of inequality if posts do not receive equal responses. In addition, determining which post need clinical expertise, and which would suffice with community expertise is not an easy task, and can cause further issues. From this, when users do receive a response it can mislead them about what kind of consultation they are receiving.
53:. Eighty percent of American adult Internet users currently go online to find health care information for themselves and their loved ones, with health searches one of the most popular uses of the Internet. Furthermore, 1 in 4 of people with an illness have gone online to find other people who share similar experiences.
310:, as well as in their need for education and support about a disease or condition. To combat misinformation in these communities, some communities have incorporated health experts to moderate content for accuracy. While such steps may be beneficial, they also hold their own implications for community dynamics.
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or severe may garner stronger benefits given that the online health communities can provide resources they would likely not get elsewhere. More specifically, benefits of these communities have been seen in a variety of conditions such as cancer, HIV/Aids, infertility, diabetes, and other rare illnesses.
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There are a wide variety of online health communities. Some of these communities target vary specific conditions, while other are more open ended. That said, patients with certain conditions are shown to specifically benefit from these communities. Broadly, patients with conditions that are more rare
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Patient centered care is a health care strategy that is focused on engaging patients to become more active participants in their health care. The use of this strategy has shown to improve the efficiency of care, patient-doctor communication, treatment compliance, health outcomes, and decrease overall
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Patients show increased perceptions of empathy as a result of information seeking behavior on online health communities. In general, perceptions of empathy are shown to have potential benefits for impacting the success of health care treatment, as well as the healing process. Furthermore, traditional
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The importance of online health communities is evidenced by their popularity, as well as the significant impact they have on the lives of their members. That said, there is limited consensus on best practices in online health community design, and research on the benefits of online health communities
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Even more, these online communities provide users with a breadth of social resources that may be directly beneficial to their health. These communities have been particularly useful in providing emotional and informational support to those with various illnesses such as cancer, HIV/Aids, infertility,
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A third common feature type are those that allow for guidance. These guidance features often take advantage of the one-to-one and one-to-many communication features mentioned previously. Some communities have specific features that facilitate guidance from medical professionals, while others provide
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These online health communities can be formed across numerous different types of communication platforms such as blogs, chats, forums, wikis, and social media sites. As long as people are able to communicate with each other over the internet about medical conditions, any given communication platform
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At current rates, the number of patients who need specialized health care is growing more rapidly than the supply of well-trained professionals who can address these needs. As a result, current utilization rates of health care resources is much higher than is manageable. However, implementations of
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Another feature type that most online health committees have are those that allow for information distribution. These features often can take the form of a blog, news area, staff-written articles, or even a regularly scheduled email newsletter. These features can allow for the exchange of important
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An obvious factor for any online community is managing user participation, engagement, and behavior. Different people have different experiences with online health communities, which can lead to differing impacts and implications. Some individuals show high engagement, while others are more passive
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and acute illnesses, online health communities have shown a positive effect on social support. This support can be beneficial to patients in a number of ways, such as helping them adjust to the stress of a particular condition. Support is also a consistent indicator of survival for many conditions.
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Finally, another less common feature type are those that allow for the sharing of personal health information. Some community sites allow users to enter or upload specific health information, and share that with other users. This type of feature may raise some privacy and safety concerns for some,
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In terms of functionality, there are several primary features that most online health communities possess. The primary feature that most online health networks have are those that support social learning and networking. Communication is at the core of these communities. This communication can take
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As mentioned previously, these communities are distinct from general online communities in that they focus exclusively on health-related topics for those currently navigating the world of diseases, illness, and medicine. Furthermore, they also differ from other health-related sites that only allow
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There has been a wide and rapid adoption of online health communities from patient populations. However, some of the greatest benefits are realized when these communities also are utilized by medical professionals. For patients, there is a clear incentive to increase information, support, and care
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Given that one of the primary uses of online health communities is the exchange of health information between untrained individuals. In many cases, people do not use the best judgment when sharing and relying on information in online communities, but the consequences of poor information depends on
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While moderators are often put into place to help guide the conversation and flow of information in these communities, there are also users that occasionally adopt this role naturally. These influential users have accumulated the power to drastically influence other users and the community as a
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Beyond the extent to which people participate in these communities, there is also a distinction in the type of engagement that is seen by those who actively participate. Some individuals more frequently share general health information such as hospital information, drug side effects, and health
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In parallel with increased health care utilization, the cost of providing health care also continues to rise and may become unaffordable as a result of advancement cost and over treatment. Similarly, implementations of online health communities have resulted in both health care cost reductions.
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While these factors help explain the experience and participation of users during a very particular point in their lives, there are also several factors to consider about the experience of patients who stop using or participating in these communities over time. Based on the benefits that these
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In some online health communities, health experts are incorporated as moderators in order to provide people with accurate clinical knowledge. Inclusion and participation from moderators can help create a more empathic community culture. However, the inclusion of moderators can also give users
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what the information is and how it is used. Medical information can have grave consequences when poor advice is taken or is erroneously applied; or when professional treatment is not sought. The criticality of health-related information necessitates careful consideration of how to design for
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While online health communities can provide general benefits. There are also particular individuals who may benefit most from them. In particular, online health communities are especially beneficial when they are used in a way that allows for connections and resources that would otherwise be
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As these communities emerged, more and more research was conducted assessing their benefits, complications, and other features. Much of this research has supported their beneficial aspects. As a result of these benefits, medical health organizations increasingly began including online health
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Even more, with the evolution of Web 2.0 functionality and
Internet penetration during the 2000s, web-based programs became increasingly utilized as a mechanism by which to incorporate social, interactive, and guided behavior change processes. Many of these behaviors for patients and medical
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Furthermore, a common issue with online health communities is a lack of engagement from those with medical conditions, even after they have decided to adopt the technology. Users often don't feel they have an obligation to share or create new content, even if they consume content from other
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Beyond this, there are several factors that have been identified for evaluating patient experiences with online health communities and evaluating who they benefit. The four main dimensions that contribute to a patient's experience with online health communities include: pragmatic, empathic,
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These communities are distinct from general online communities in that they focus exclusively on health-related topics for those currently navigating the world of diseases, illness, and medicine. Furthermore, they also differ from other health-related sites that only allow users to retrieve
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within a community is often impacted by the level of trust those community members have for each other. Distributing personal information can have many consequences if it is not handled properly. Not only does it decrease ones security, but it can also threaten their safety. In in-person
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the form of both one-to-one communication and one-to-many communication. Oftentimes they feature discussions on practical problems faced by people during their condition such as depression, side-effects of medications, etc. and answers to those problems provided by other members.
381:). Understandably, individuals who showed much higher levels of engagement reap the highest benefits in outcomes such as emotional support, help giving, and emotional expression. That said, even lurkers can see some beneficial level of peer support from the online communities.
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Traditionally, patients are not well-equipped to manage their own illnesses. The resources that online health communities provide cut down on the need for in-person visits with medical professionals and allow patients to address many low level health issues on their own.
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Patients who use online health communities may also see increased adherence to health treatments. Given the resources such as social support that these communities provide, they are more able to manage the tasks and responsibilities that their treatment requires.
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For medical professionals, online health communities can be valuable tools to help foster interdisciplinary collaboration across various institutions. This collaboration can help medical professionals provide more diverse and beneficial care to patients.
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While less common, a fourth feature types that is sometime available in online health communities are those that are designed to drive more user engagement. Examples of these kinds of features include features such as gamification or social recognition.
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In online health communities composed of medical professionals, participation can lead to increased exchange of medical information, as well as the adoption of disease specific knowledge that can be used to inform treatment and other medical decisions.
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Patients who utilize online health networks often experience increases in knowledge specific to the disease or condition that they are dealing with. This increased disease knowledge can help patients make more informed decisions about their health.
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Beyond the effects that online health communities can have on specific psychological and behavioral outcomes in various illnesses, there are several other broad benefits that they can provide to the institution and structure of health care.
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users to retrieve information. The main hallmark of these communities is that they allow for communication between multiple people. That said, they can take a variety of forms, and vary drastically in their scope.
68:. Depending on the specific community, patients and medical professionals are able to engage in behaviors such as sharing their illness experiences, exchange knowledge, and increase disease-specific expertise.
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information. The main hallmark of these communities is that they allow for communication between multiple people. That said, they can take a variety of forms, and vary drastically in their scope.
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health care utilization. Through improved access to personalized information, patient participation, and emotional support, online health communities promote patient centered care practices.
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medical provider empathy is costly and time-consuming. Perceptions of empathy from online health communities can act as a feasible replacement for provider empathy.
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1962:
1944:
1900:
1720:
1434:
1332:
1322:
1229:
1009:
991:
947:
929:
888:
870:
826:
672:
654:
572:
554:
427:specific tailored mentoring or coaching.
64:community features such as discussion or
1255:Evaluation & the Health Professions
514:
298:, necessitates more careful design and
1589:
1587:
2219:
2217:
2215:
2213:
2211:
1922:
1920:
1690:
1688:
1686:
1456:
1454:
1407:Medicine, Institute of (2008-08-27).
969:
967:
7:
1933:Journal of Medical Internet Research
1311:Journal of Medical Internet Research
918:Journal of Medical Internet Research
859:Journal of Medical Internet Research
794:
792:
740:
738:
694:
692:
643:Journal of Medical Internet Research
632:
630:
543:Journal of Medical Internet Research
532:
530:
528:
526:
524:
522:
520:
518:
72:diabetes, and other rare illnesses.
2230:Western Journal of Nursing Research
1113:American Journal of Kidney Diseases
115:online health communities to form.
1090:10.1111/j.1540-4560.1984.tb01108.x
14:
2294:. Montréal, Québec, Canada: ACM.
1701:AMIA Annual Symposium Proceedings
1202:Translational Behavioral Medicine
1789:Medical Care Research and Review
84:With the invention of email for
747:Computers, Informatics, Nursing
210:Interdisciplinary collaboration
1409:Retooling for an Aging America
974:Nambisan, Priya (2011-05-01).
701:CyberPsychology & Behavior
219:Medical professional knowledge
1:
2000:10.1016/j.jbusres.2011.08.009
1641:Health Care Management Review
1550:Journal of Surgical Education
1476:10.1016/s1474-4422(09)70327-8
1988:Journal of Business Research
1653:10.1097/hmr.0b013e3182099f82
1125:10.1016/0272-6386(93)70072-7
759:10.1097/ncn.0b013e318224b31d
2285:"Online Health Communities"
2134:10.1136/amiajnl-2013-002282
1881:Computers in Human Behavior
1596:"Online health communities"
1562:10.1016/j.jsurg.2010.12.011
1462:cluster-randomised trial".
993:10.1136/amiajnl-2010-000058
2376:
2021:Jinyang, Li (2015-03-18).
1848:10.1109/hicss.2004.1265462
1527:10.1001/jama.298.17.2071-a
1370:10.1177/193758670800100406
16:Type of Internet community
2319:Encyclopedia of Community
1893:10.1016/j.chb.2014.04.039
1214:10.1007/s13142-011-0016-4
1035:Journal of Macromarketing
596:Online Health Search 2006
497:Diabetes Hands Foundation
20:Online health communities
2242:10.1177/0193945913520414
1801:10.1177/1077558707305942
1267:10.1177/0163278704267037
1078:Journal of Social Issues
1047:10.1177/0276146714538055
2300:10.1145/1125451.1125549
2184:10.1145/2531602.2531622
1842:. IEEE. pp. 9 pp.
1758:10.1089/cyber.2012.0348
1608:10.1145/1125451.1125549
809:10.1145/2145204.2145331
624:Online Health Community
327:Adoption and engagement
237:Health care utilization
2310:; et al. (2018).
2283:; et al. (2015).
2086:10.1287/orsc.1050.0158
308:technological literacy
201:Institutional benefits
136:Psychological benefits
2360:Online support groups
1158:. IEEE. p. 483.
713:10.1089/cpb.2007.0118
228:Patient centered care
2074:Organization Science
1464:The Lancet Neurology
1164:10.1109/ichi.2015.82
872:10.2196/jmir.7.1.e10
656:10.2196/jmir.9.2.e12
320:personal information
148:Across a variety of
107:labs introduced the
598:Summary of Findings
499:(Social Networking)
439:Example communities
350:information quality
318:The sharing of any
183:Treatment adherence
175:Behavioral benefits
127:Beneficial Outcomes
264:Who benefits most?
2333:Patient Power LLC
2193:978-1-4503-2540-0
2127:(e2): e212–e218.
2040:10.3926/jiem.1389
1946:10.2196/jmir.1696
1617:978-1-59593-298-3
1426:978-0-309-11587-2
1324:10.2196/jmir.1338
1173:978-1-4673-9548-9
931:10.2196/jmir.2423
818:978-1-4503-1086-4
556:10.2196/jmir.2476
166:Perceived empathy
157:Disease knowledge
2367:
2355:Medical websites
2322:
2316:
2303:
2289:
2272:
2271:
2261:
2236:(9): 1183–1198.
2221:
2206:
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2154:
2136:
2112:
2106:
2105:
2069:
2063:
2062:
2052:
2042:
2018:
2012:
2011:
1983:
1977:
1976:
1966:
1948:
1924:
1915:
1914:
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622:The Health Cloud
619:
613:
612:
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599:
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587:
586:
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558:
534:
503:Community health
314:Trust and safety
255:Illness benefits
246:Health care cost
51:health education
2375:
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2364:
2345:
2344:
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2314:
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2222:
2209:
2194:
2173:
2172:
2168:
2114:
2113:
2109:
2071:
2070:
2066:
2020:
2019:
2015:
1985:
1984:
1980:
1926:
1925:
1918:
1878:
1877:
1873:
1858:
1837:
1836:
1832:
1786:
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973:
972:
965:
911:
910:
906:
852:
851:
844:
819:
798:
797:
790:
753:(10): 564–573.
744:
743:
736:
698:
697:
690:
636:
635:
628:
620:
616:
607:
606:
602:
594:
590:
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304:health literacy
296:health literacy
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194:
192:Self management
185:
177:
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94:Bulletin Boards
82:
66:Internet forums
41:Changes in the
24:social networks
17:
12:
11:
5:
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2327:External links
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2166:
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2064:
2013:
1994:(3): 298–305.
1978:
1916:
1871:
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1830:
1795:(6): 650–672.
1779:
1752:(9): 650–657.
1736:
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1647:(2): 124–133.
1631:
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1556:(3): 231–238.
1540:
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1417:10.17226/12089
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1261:(3): 237–251.
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1041:(3): 353–367.
1025:
986:(3): 298–304.
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480:HealthUnlocked
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450:PatientsLikeMe
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445:Smart Patients
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377:in their use (
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611:. 2006-09-01.
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465:DailyStrength
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340:Accessibility
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277:Complications
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29:
25:
21:
2318:
2291:
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2229:
2175:
2169:
2124:
2120:
2110:
2080:(1): 64–79.
2077:
2073:
2067:
2030:
2026:
2016:
1991:
1987:
1981:
1936:
1932:
1884:
1880:
1874:
1839:
1833:
1792:
1788:
1782:
1749:
1745:
1739:
1704:
1700:
1644:
1640:
1634:
1599:
1553:
1549:
1543:
1521:(17): 2070.
1518:
1514:
1508:
1470:(1): 46–54.
1467:
1463:
1408:
1402:
1364:(4): 55–69.
1361:
1357:
1351:
1314:
1310:
1299:
1258:
1254:
1248:
1208:(1): 72–82.
1205:
1201:
1190:
1155:
1149:
1119:(4): 25–30.
1116:
1112:
1106:
1084:(4): 77–98.
1081:
1077:
1071:
1038:
1034:
1028:
983:
979:
921:
917:
907:
862:
858:
800:
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455:HealthBoards
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40:
19:
18:
2336:healthcare.
1939:(4): e122.
1902:11603/24530
1887:: 319–333.
1707:: 627–636.
549:(6): e115.
475:GiveForward
356:, informed
62:interactive
43:health care
22:are online
2349:Categories
2281:Neal, Lisa
2050:2099/16495
1317:(4): e71.
924:(1): e16.
865:(1): e10.
649:(2): e12.
509:References
354:clinicians
346:accessible
300:evaluation
32:caregivers
2250:0193-9459
2143:1067-5027
2094:1047-7039
2059:2013-0953
2008:0148-2963
1955:1438-8871
1911:0747-5632
1809:1077-5587
1766:2152-2715
1713:1942-597X
1661:0361-6274
1570:1931-7204
1535:0098-7484
1484:1474-4422
1378:1937-5867
1275:0163-2787
1222:1869-6716
1133:0272-6386
1098:0022-4537
1055:0276-1467
1002:1527-974X
940:1438-8871
881:1438-8871
767:1538-2931
721:1094-9313
665:1438-8871
565:1438-8871
358:designers
292:usability
90:Listservs
2268:24473058
2202:12846999
2161:24449805
1973:22204869
1825:26278195
1817:17717378
1774:23786170
1731:24551364
1677:22777283
1669:21317657
1626:53244997
1578:21618817
1500:12208881
1492:19959398
1445:25009893
1386:21161915
1343:21169160
1291:38052061
1283:15312283
1240:24073033
1063:55588268
1020:21486888
958:23470259
899:15829472
837:25360442
783:21124184
775:21709546
729:18537512
683:17513283
583:23803284
491:See also
414:Features
362:patients
103:In 1991
47:Internet
2259:4112166
2152:4173171
1964:3278108
1866:7675570
1722:3900205
1436:2562151
1394:6518430
1334:3056526
1231:3717687
1182:6862908
1141:8465832
1011:3078657
949:3636206
890:1550634
828:4211623
674:1874721
574:3713879
485:Inspire
460:MedHelp
379:lurkers
366:Web 2.0
150:chronic
86:ARPANET
80:History
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