The motivations and outcomes of consumer engagement with online sexual health communities

PhD ThesisThe continuous improvement in living standards has resulted in increasing attention being paid to personal health. The definition of health nowadays no longer refers only to physical or mental health, it also includes sexual health. Sexual health is not only understood in a narrow sense as Sexually Transmitted Diseases (hereafter STDs), but also the enjoyment and satisfaction of having sex with partners. Positive sexual experiences are beneficial to both physical and mental health (Hensel et al., 2016). Although, despite it being an important part of our lives, sometimes sexual health is difficult to discuss due to the stigmatization and discrimination associated with STDs, which can affect patients’ intention to seek a doctor’s advice, leading those patients in need to ignore their illness for fear of unfair treatment which in turn can lead to serious physical outcomes and psychological burdens. The National Health Services (NHS) is under enormous pressure from an increasing demand for consultation; in 2020 more than 60 million people were listed as registered with the NHS (NHS Digital, 2020). This sometimes results in patients not being able to seek medical attention promptly or having only a short consultation time, which is sometimes not sufficient to properly address an individual’s health concerns, and more specifically their concerns about STDs. By gathering users from multiple backgrounds and experiences to form a virtual online community, Online Sexual Health Communities (OSHCs) provide a platform for information sharing and the exchange of emotions (relating to sexual health). Combining the advantages of a virtual environment such as unrestricted time and space, OSHCs not only provide a convenient and effective consultation with users who may have similar health issues but also reduce the pressure on the NHS (Nagendra et al., 2020). Despite the relevance of health communities in today’s societies, the reasons why consumers engage with OSHCs has rarely been studied, nor has the consequences of such engagement on consumers’ psychological and physical wellbeing. This study believes that learning about the motivations and outcomes of OSHC engagement is conducive to enriching the existing engagement literature in the field. From a practical point of view, it provides a more comprehensive guide for those establishing, or seeking to establish, OSHCs. Accordingly, a clear understanding of a user’s motivation for engaging with an OSHC iii can better help the founders of sexual health forums in improving their online communities. Furthermore, understanding the outcome of their engagement can help public organizations understand their influence on individuals’ wellbeing. Scholars are calling for qualitative research on the impact of social media on consumer behaviour and societal wellbeing (Davis et al., 2016; Shensa et al., 2017). The present study lies within transformative consumer research, which focuses on significant social issues and challenges (Davis and Ozanne, 2019). Interviews were chosen for data collection due to their ability to uncover underlying motivations, beliefs, attitudes, and feelings (Rubin and Rubin, 2005), particularly in discussions involving sensitive or embarrassing topics (for example, body image concerns and self-esteem) (Malhotra et al., 2007). The author of this thesis conducted semi-structured interviews with 20 participants from one of the most popular OSHCs on Facebook namely PrEp Facts: Rethinking HIV Prevention and Sex. Data were analysed through both manual coding and NVivo. Ten themes emerged from the interviews including eight motivations and two consequences of engagement, which enabled the development of a conceptual framework of engagement with OSHCs The contributions of this study can be viewed from both a theoretical and practical perspective. Theoretically, this study provides a conceptual framework regarding the motivations and consequences of consumer engagement. This study sheds light on eight motivations: information quality, information quantality, social support, fear, source credibility, convenience, online community quality, and privacy concerns. There are two outcomes of consumer engagement with OSHCs (health empowerment and entertainment), which contribute to the existing literature. Specifically, this study offers a comprehensive understanding regarding consumer engagement towards OSHCs, which can help online community moderators develop a better virtual environment based on consumer demands. Future research around this subject should use quantitative research methods to further verify the model developed in this study