Exploring help-seeking behavior in online health communities among women with domestic violence experiences

Background: Domestic violence (DV) is one of the most pressing women’s health concerns globally. Previous literature shows that women tend to seek help from informal sources (i.e., close friends and family) rather than formal sources (i.e., legal and police). Owing to the increased time spent at home and worsened social isolation during the COVID-19 pandemic, more women experiencing DV visited online health communities (OHCs) to seek help due to their anonymity and timely responses. However, OHCs may circulate unverified risky, and unhealthy information to users. Despite the surge of literature examining information discussed in the DV population, it is still unclear what types of help women sought and received the most from OHCs. Without such knowledge, we cannot evaluate the usefulness of OHCs for women who would like to seek help in OHCs after a traumatic DV experience. Purpose: The aims of this study were to 1) describe the types of help sought by the women with DV experiences in OHCs, 2) describe the type and pattern (i.e., communication style) of the advice given in the OHC to women with DV experiences and 3) explore whether the needs of women with DV experiences were matched with the help they received in OHCs. Methods: This is an exploratory, descriptive study to explore help-seeking behaviors by women experiencing DV on the subreddit community r/domesticviolence from November 14, 2020, through November 14, 2021. For our analysis, we included posts by adult women (i.e., aged 18 or above) experiencing DV who seek advice on DV relationships or dealing with DV-related issues. We excluded posts from non-abused women, women victims under 18, non-English posts, good news announcements, gratitude posts without any advice-seeking, and posts related to advertisements. Two nursing students used the codebook developed and verified by a domain expert. Aims 1 & 2 used manual annotation and thematic analysis and Aim 3 used computation text mining tool (i.e., Linguistic Inquiry Word Count) and non-parametric statistical analysis (i.e., t-test or Mann-Whitney U). Results: Among 1,996 postings crawled, 250 postings were included after screening for women with DV experience. 68.8% sought information support, and 36% sought emotional support. DV (n = 43, 25%) and legal (n = 21, 12.2%) knowledge were the most frequent types of information help being sought. Based on initial postings, five themes emerged. 97.2% of the postings received information support, while 87.6% received emotional support. DV knowledge (n=414, 26.4%), DV shelter (n=242, 15.4%), and legal knowledge (n=190, 12.1%) were the most frequent types of information help received in OHC, while 68.6 % of postings received encouragement as emotional support. 29.6% offered networking help, and 78% offered experience sharing. Based on the comments, seven themes emerged. 80% of postings matched with the type of help requested, while 17 linguistic or postings features were found to be significantly different between the two groups (i.e., matched help and unmatched help). Conclusions: OHC is a resourceful platform for help-seeking among women with DV experience. This study can guide the development of future algorithms to detect help-seeking behavior within OHCs effectively