Why consumers voluntarily reward free health services in online health communities? An empirical investigation (Preprint)

BACKGROUND: Rewarding health knowledge and health service contributors with money is one possible approach for the sustainable provision of health knowledge and health services in online health communities (OHCs); however, the reasons why consumers voluntarily reward free health knowledge and health service contributors are still underinvestigated. OBJECTIVE: This study aimed to address the abovementioned gap by exploring the factors influencing consumers' voluntary rewarding behaviors (VRBs) toward contributors of free health services in OHCs. METHODS: On the basis of prior studies and the cognitive-experiential self-theory (CEST), we incorporated two health service content-related variables (ie, informational support and emotional support) and two interpersonal factors (ie, social norm compliance and social interaction) and built a proposed model. We crawled a dataset from a Chinese OHC for mental health, coded it, extracted nine variables, and tested the model with a negative binomial model. RESULTS: The data sample included 2148 health-related questions and 12,133 answers. The empirical results indicated that the effects of informational support (beta=.168; P<.001), emotional support (beta=.463; P<.001), social norm compliance (beta=.510; P<.001), and social interaction (beta=.281; P<.001) were significant. The moderating effects of social interaction on informational support (beta=.032; P=.02) and emotional support (beta=-.086; P<.001) were significant. The moderating effect of social interaction on social norm compliance (beta=.014; P=.38) was insignificant. CONCLUSIONS: Informational support, emotional support, social norm compliance, and social interaction positively influence consumers to voluntarily reward free online health service contributors. Social interaction enhances the effect of informational support but weakens the effect of emotional support. This study contributes to the literature on knowledge sharing in OHCs by exploring the factors influencing consumers' VRBs toward free online health service contributors and contributes to the CEST literature by verifying that the effects of experiential and rational systems on individual behaviors can vary while external factors change.