Edited by: Jinhui Li, Jinan University, China
Reviewed by: Xiaoyan Chen, Xiamen University, ChinaLiang Chen, Tsinghua University, China
This article was submitted to Health Psychology, a section of the journal Frontiers in Psychology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Online health communities have become one of the most important means for people to seek social support during the coronavirus 2019 disease (COVID-19) pandemic. This study details content analysis of support-seeking strategies and social support offered on the online forum “Baidu COVID-19bar” across different stages of initial stage as well as during the entire initial stage of the COVID-19 pandemic. The results show that asking for support and disclosing directly were the main strategies used across the different stages and during the entire initial stage. Informational support and emotional support were the most common types sought in the first two stages and the entire initial stage, and informational support was the main type during the decline stage. Furthermore, asking for support was more likely to elicit informational support while disclosing directly was more likely to elicit emotional support. Theoretical and practical implications of the findings are discussed.
In January 2020, Coronavirus Disease 2019 (COVID-19) broke out. The COVID-19 pandemic is a major public health emergency, having demonstrated a rapid transmission speed, wider infection range, and is the hardest to control of any disease in recent years. It has been listed as a “Public Health Emergency of International Concern” by the World Health Organization (
With the popularization of mobile terminal equipment and the development of network communication technology, people can search for and discuss information about the COVID-19 in online communities. Online communities, through collaborative technologies and the characteristics of being quick to use, interactive, and low-cost, enable users to communicate, coordinate, and collaborate to promote group interaction, and in turn build and share information (
In addition, research by
In previous studies related to the COVID-19 epidemic, few studies have focused on the relationship between social support-seeking strategies and social support. When it comes to social support, previous studies pay more attention to analyse under the background of individualist culture. To fill the gap, this study is conducted against the background of collectivism in China, and analyzes the types and relevance of social support-seeking strategies and support provided in COVID-19. Also, few previous studies have explored the social support during different stages of COVID-19. Therefore, based on the life cycle of the crisis and the development trends of the epidemic, this study divides the initial period of the COVID-19 pandemic into three stages and analyses whether there are differences about support-seeking strategies and social support provided, as well as the relationship between the two.
Research on crisis and risk communication has posited that crisis events have the characteristics of importance, immediacy, and uncertainty (
As a global public health emergency, COVID-19 also followed a particular development order in China during the initial period. According to the daily confirmed cases and latest confirmed cases released by the National Health Commission of the People’s Republic of China, certain trajectories were followed. As shown in
Trajectory of confirmed cases of COVID-19 in China, 01.20.20–03.31.20.
Trajectory of daily confirmed cases of COVID-19 in China, 01.20.20–03.31.20.
Seeking support is defined as “intentional communicative activity with the aim of eliciting supportive actions from others” (
The raging COVID-19 pandemic has been a great source of anxiety, distress, and stress among the population (
In order to observe the individual support-seeking strategies in social media from a new and holistic perspective, the following research questions (RQs) are proposed:
RQ1a: What types of social support-seeking strategies were used in health communities across different stages of the initial development of COVID-19?
RQ1b: What types of social support-seeking strategies were used in health communities during the entire initial stage?
Providing social support refers to offering and expressing support to others. This behavior not only enables others to receive care and satisfaction but also has a positive psychological effect on the provider (
Providing social support information through the Internet has gradually become a common phenomenon. People can take more time and energy, compared to in face-to-face scenarios, to think about how to edit and organize complex social support-seeking information (
Thus, the following research questions are proposed:
RQ2a: What types of social supports were offered in health communities across different stages of the initial development of COVID-19?
RQ2b: What types of social supports were offered in health communities during the entire initial stage?
Whether and how social network members provide support is at least partially contingent on the strategies employed by individuals to ask for help (
The phenomenon of people asking for help, followed by other people observing these posts and trying to provide support, is common in online communities centered on COVID-19. Although previous studies have examined the relationship between direct/indirect strategies and social support, people spend significant time and energy applying a variety of strategies to satisfy the need for support in online communities; thus, in other words, the two dimensions (direct/indirect) cannot fully account for people’s use of strategies, nor for whether and how other strategies are used to elicit support. Therefore, in order to study the mechanisms underlying the seeking and giving of support during COVID-19, we introduce
Different characteristics that emerged across the different stages of the initial COVID-19 outbreak may have influenced the relationship between strategies and support. To assess the relationship, therefore, the following research questions are proposed:
RQ3a: What is the relationship between support-seeking strategies and social support offered in health communities across different stages of the initial development of COVID-19?
RQ3b: What is the relationship between support-seeking strategies and social support offered in health communities during the entire initial stage?
In order to generate a representative sample, this study collected data from Baidu Tieba, which is a widely used Chinese communication platform likened to the popular American classified ads website Craigslist (
Baidu Tieba provides a network platform for people to discuss on where data are freely accessible to everyone and convenient to collect. In order to avoid violating the privacy of users, we use numbers instead of usernames to refer to posters in order to maintain their anonymity. We used Python to crawl the contents of the “Baidu COVID-19bar,” including the content of each post and of replies thereto, from January 20, 2020 to the March 31, 2020. After screening out repetitive posts and posts that did not contain social support-seeking strategies, the number of posts for each stage was as follows: Stage 1: 199 original posts and 8,730 replies; Stage 2: 257 original posts and 7,492 replies; Stage 3: 355 original posts and 2,373 replies. The number of posts in the first stage was less than those in the second and third stages, but the number of replies during that stage was the highest. In the third stage, the number of posts was highest but the number of replies was much lower than in the other two stages. A total of 600 sample posts and corresponding replies were selected by random number generators from each stage and the overall three-stage sample to explore whether there were differences between each stage and how each stage compared with the overall situation.
We coded the original posts in the three stages based on the seven types of social support-seeking strategies proposed by
Asking for support refers to an individual’s need for information, advice, prayers, material help, ideas, and so on. Disclosing directly refers to the individual attracting the attention of others by expressing their feelings and experiences, which are related to their stressors, while not directly stating their need for support. Alluding to the stressor entails not directly pointing out the stressor; instead, individuals often imply the stressor through vague expressions, rhetoric, and citations. Using humor entails referring to something in a way that is intended to be funny. Celebrating achievements refers to an individual’s elaboration of an achievement, such as finding a job or recovering from an illness. Sharing stories and memories includes posting regrets about the loss of loved ones and detailing events that happened in the past. Shouting out refers to expressing appreciation for what a person or group is doing for an individual during a difficult period. Because the seven types of strategies differ in the degree of directness and indirectness, they cannot be simply classified as direct or indirect strategies. Thus, the above coding method entailed subdividing the complex support-seeking strategies in the context of social media into multi-dimensional and multi-level segments.
Based on the Social Support Behavior Code, we coded all replies except those from the original post publisher, including informational support, emotional support, esteem support, network support, and tangible support.
Informational support refers to providing advice or solutions to help the poster reanalyze and evaluate their problem from another perspective, as well as providing detailed facts and news. Emotional support refers to the expression of regret and sympathy for the problems or situations faced by the poster, and the detailing of similar experiences to convey understanding, as well as hope and encouragement, to the poster. Esteem support refers to expressing praise for the views or behaviors of the poster, affirming the views or behaviors of the poster, comforting the poster to assuage their feelings of guilt, and so on. Network support refers to providing a sense of belonging to others by expressing similar experiences. Tangible support refers to conveying a willingness to help the poster and providing substantial help to the poster.
Based on the above operational definitions of seeking strategy and social support, the identifications of variable types were constructed. The seven types of support-seeking strategies and five types of social support identified above were coded as “present” (1) or “not present” (0) on the posts considered.
All coding was carried out by two coders who completed in-depth training on the topic. The reliability test is completed by measuring inter-coder agreement and by calculating the reliability using the reliability test formula, which is as follows:
inter-coder agreement: k=2 * M/ (N1+N2)
reliability: r(reliability)=n * k/[1+(n − 1) * k]
M refers to the number of times coders had the same outcome; N1 refers to the number of times the first coder coded; N2 refers to the number of times the second coder coded; n refers to the number of coders; k refers to the inter-coder agreement.
As shown in
Inter-coder agreement and reliability of social support-seeking strategies and social support provided.
Variables | Inter-coder agreement | Reliability |
---|---|---|
Asking for support | 0.90 | 0.95 |
Disclosing directly | 0.87 | 0.92 |
Alluding to the stressor | 0.90 | 0.95 |
Using humor | 1.00 | 1.00 |
Celebrating achievements | 1.00 | 1.00 |
Sharing stories and memories | 1.00 | 1.00 |
Shouting out | 0.97 | 0.98 |
Informational support | 0.90 | 0.95 |
Emotional support | 0.93 | 0.97 |
Esteem support | 0.93 | 0.97 |
Network support | 0.97 | 0.98 |
Tangible support | 1.00 | 1.00 |
RQ1a and RQ1b asked what types of support-seeking strategies were used in the health community across different stages and during the initial period. To answer RQ1a and RQ1b, we conducted frequency analysis to examine the support-seeking strategies in the original posts. As shown in
Support-seeking strategies across the three stages.
Support-seeking strategies | Frequency |
---|---|
Asking for support | 390 (65.00%) |
Disclosing directly | 165 (27.50%) |
Alluding to the stressor | 21 (3.50%) |
Using humor | 0 (0.00%) |
Celebrating achievements | 0 (0.00%) |
Sharing stories and memories | 0 (0.00%) |
Shouting out | 21 (3.50%) |
Asking for support | 377 (62.80%) |
Disclosing directly | 220 (36.70%) |
Alluding to the stressor | 2 (0.30%) |
Using humor | 0 (0.00%) |
Celebrating achievements | 0 (0.00%) |
Sharing stories and memories | 0 (0.00%) |
Shouting out | 49 (8.20%) |
Asking for support | 517 (86.20%) |
Disclosing directly | 218 (36.30%) |
Alluding to the stressor | 0 (0.00%) |
Using humor | 0 (0.00%) |
Celebrating achievements | 0 (0.00%) |
Sharing stories and memories | 0 (0.00%) |
Shouting out | 0 (0.00%) |
Asking for support | 413 (68.80%) |
Disclosing directly | 301 (50.20%) |
Alluding to the stressor | 0 (0.00%) |
Using humor | 1 (0.20%) |
Celebrating achievements | 0 (0.00%) |
Sharing stories and memories | 0 (0.00%) |
Shouting out | 14 (2.30%) |
To sum up, the use of social support-seeking strategies across the three stages was consistent with the entire stage. Asking for support and disclosing directly were the main types, and asking for support was used more frequently compared to disclosing directly. Alluding to the stressor, shouting out, using humor, sharing stories and memories, and celebrating achievements were used least often.
RQ2a and RQ2b asked what types of social support were offered in the health community across different stages and during the entire stage. To answer RQ2a and RQ2b, we conducted frequency analysis to examine the social support offered in the reply posts. As shown in
Social support across the three stages.
Support type | Frequency |
---|---|
Informational support | 306 (51.00%) |
Emotional support | 141 (23.50%) |
Esteem support | 17 (2.80%) |
Network support | 1 (0.20%) |
Tangible support | 4 (0.70%) |
Informational support | 277 (46.20%) |
Emotional support | 153 (25.50%) |
Esteem support | 14 (2.30%) |
Network support | 5 (0.80%) |
Tangible support | 3 (0.50%) |
Informational support | 391 (65.20%) |
Emotional support | 7 (1.20%) |
Esteem support | 0 (0.00%) |
Network support | 1 (0.20%) |
Tangible support | 4 (0.70%) |
Informational support | 248 (41.30%) |
Emotional support | 72 (12.00%) |
Esteem support | 2 (0.30%) |
Network support | 3 (0.50%) |
Tangible support | 10 (1.70%) |
To sum up, the results shown with respect to the early stage and the peak stage are similar to those for the entire stage. That is, people primarily offered informational support and emotional support. In this process, informational support was used more than was emotional support, and esteem support, network support, and tangible support occurred much less often. However, in the decline stage, although informational support was still the most common type, emotional support clearly decreased.
RQ3a and RQ3b asked about the relationship between support-seeking strategies and social support offered in health communities across different stages and the entire stages. To answer these questions, chi-square tests were conducted.
As shown in
Results of chi-square test of asking for support, disclosing directly and social support in the early stage.
Informational support | Emotional support | |||
---|---|---|---|---|
Asking for support | YES | NO | YES | NO |
YES | 164 | 54 | 336 | |
NO | 80 | 130 | 123 | |
Disclosing directly | ||||
YES | 68 | 97 | 88 | |
NO | 197 | 64 | 371 |
As shown in
Results of chi-square test of asking for support, disclosing directly and social support in the peak stage.
Informational support | Emotional support | |||
---|---|---|---|---|
Asking for support | YES | NO | YES | NO |
YES | 178 | 66 | 311 | |
NO | 78 | 145 | 136 | |
Disclosing directly | ||||
YES | 78 | 142 | 135 | |
NO | 181 | 68 | 312 |
As shown in
Results of chi-square test of asking for support, disclosing directly and social support in the decline stage.
Informational support | ||
---|---|---|
Asking for support | YES | NO |
YES | 159 | |
NO | 33 | 50 |
Disclosing directly | ||
YES | 121 | 97 |
NO | 112 |
As shown in
Results of chi-square test of asking for support, disclosing directly, and social support during the three stages.
Informational support | Emotional support | |||
---|---|---|---|---|
Asking for support | YES | NO | YES | NO |
YES | 204 | 11 | 402 | |
NO | 39 | 148 | 126 | |
Disclosing directly | ||||
YES | 107 | 194 |
|
231 |
NO | 158 | 2 | 297 |
From the comparison of the three stages, it can be seen that the early stage is consistent with the peak stage—that is, asking for support was more likely to elicit informational support, while disclosing directly was more likely to elicit emotional support. In the decline stage, similarly, asking for support was more likely to elicit informational support. To sum up, the relationship between asking for support and informational support across the three stages was consistent with the entire stage.
From a general perspective, the “Baidu COVID-19bar” members mainly adopted strategies of asking for support and disclosing directly. Moreover, in the three stages, asking for support and disclosing directly were the main seeking strategies used.
There is a strong possibility that the individuals did not clearly understand information related to the pandemic and were worried about their situation, which may have resulted in anxiety, panic, and other emotions. In addition, support for information and advice, which can help people cope with uncertainty and reduce stress, can have a positive impact on individuals’ health outcomes (
In addition to seeking information and advice by asking questions on the “Baidu COVID-19bar,” users expressed their emotional needs by detailing their feelings and their experiences rather than directly explaining their information needs, so as to seek spiritual and emotional comfort; this is the strategy of disclosing directly. There is a strong possibility that the perceived social support during the pandemic provided users with a sense of companionship and belonging, as well as helping them reduce their long-term anxiety and enhancing their self-efficacy in coping with future uncertainty (
In the analysis of the three stages and the entire stage, respectively, asking for support and disclosing directly were found to be the main seeking strategies. This may be because people’s uncertainty and insecurity were persistent during the pandemic, wherein people were seeking information about outbreaks, medicines, and treatments. Thus, social support can adjust individual emotions and behaviors by managing uncertainty and alleviating anxiety. Fewer users applied the other five strategies to seek social support, perhaps because the contents of these strategies are usually accompanied by other topics, especially asking for support and disclosing directly. In addition, users primarily directly sought informational support or expressed emotional needs to others in the “Baidu COVID-19bar.”
This study found that, on the whole, users of the “Baidu COVID-19bar” mainly provided informational support and emotional support. In the three stages, informational and emotional support were the main support-seeking strategies used. This finding is in line with those of previous social support studies, possibly because, compared with the traditional social support environment, online health communities have the characteristics of interactivity, anonymity, and stronger interactivity, and the content published by individuals can be seen by more people. These factors may make people more willing to publish information and provide support to others in the community (
The results show that the social support the seekers obtained from the posts depended on the seeking strategy used. In general, the relationship between the two was not affected by the different stages of COVID-19—the conclusions are the same regardless of stage or in looking at the situation in its entirety. Asking for support was more likely to elicit informational support, and disclosing directly was more likely to elicit emotional support. Asking for support is a strategy for directly expressing individual needs, which is reflected in “Baidu COVID-19bar.” On the one hand, individuals did not seek help blindly or randomly, but rather sought reliable answers through “Baidu COVID-19bar” that gathers a large number of people who have encountered similar difficulties. On the other hand, asking for support strategy in the “Baidu COVID-19bar” usually takes the form of direct questions which represents clear requests. A two-way interaction process takes place between support seekers and potential support providers, that is, seekers formulate specific strategies, and providers evaluate the essence of the problem and their availability (
Individualistic freedom and a sense of control through individual behavior are more valued in Western individualist cultures, while social adaptation and tolerance of others are more emphasized in Eastern collectivist cultures (
The theoretical implication of this study is to analyse individual’s support-seeking strategies and the social support provided, as well as the relationship between the two across different stages and during the initial period of the COVID-19 pandemic. From the analysis, it was found that in all stages of the initial period of COVID-19 pandemic, informational support and emotional support were the primary social support forms offered by users in the online health community. This may have been driven by the characteristics of the online health community as well as people’s panic and uncertainty caused by the pandemic. What’s more, this study analyses support-seeking strategies and the social support provided from a micro perspective in COVID-19 pandemic, which can serve as a basis for similar studies and expand the field of research on social support. Unlike previous researches on social support under the individualist context in the West, this study enriches research findings on the characteristics of support-seeking strategies and social support, as well as the relationships between the two, provided under the collectivist context. As for the practical implications, the results of this study are of practical significance for public policy and intervention strategies. In public health emergencies, people experience anxiety, panic, and other psychological issues. Because they can strengthen their contact with others through the Internet, people can seek social support to reduce their anxiety during pandemics. Moreover, mental health organizations and all sectors of society should consider providing social support to people from online health communities, such as by developing online social support projects to meet the public’s need for social contact during public health emergencies.
Some limitations of this study are of concern, namely that posts deleted by posters or the administrators of the “Baidu COVID-19bar” will not be considered, which may undermine the integrity of the data. What’s more, this study only focuses on one online community. Thus, it provides a direction for future research, that is subsequent research could explore social support and social support seeking behaviors in a variety of online communities, as well as a comparative analysis of social support provision and seeking behaviors in online communities in different cultural contexts in the East and the West.
The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.
Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
YL designed the study and performed the data analysis and wrote the article. YZ and YX coded all the original post and reply post, performed the data analysis and wrote the article. All authors contributed to this study and approved the submitted version.
This study was supported by the Fundamental Research Funds for the Central Universities of China (Nos. 2020CDJSK07PT17, 2020CDSKXYXW008, and 2021CDSKXYXW008).
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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