title: Website Sharing in Online Health Communities: A Descriptive Analysis.
abstract: BACKGROUND
  An increasing number of people visit online health communities to seek health information. In these communities, people share experiences and information with others, often complemented with links to different websites. Understanding how people share websites can help us understand patients' needs in online health communities and improve how peer patients share health information online.
  
  
  OBJECTIVE
  Our goal was to understand (1) what kinds of websites are shared, (2) information quality of the shared websites, (3) who shares websites, (4) community differences in website-sharing behavior, and (5) the contexts in which patients share websites. We aimed to find practical applications and implications of website-sharing practices in online health communities.
  
  
  METHODS
  We used regular expressions to extract URLs from 10 WebMD online health communities. We then categorized the URLs based on their top-level domains. We counted the number of trust codes (eg, accredited agencies' formal evaluation and PubMed authors' institutions) for each website to assess information quality. We used descriptive statistics to determine website-sharing activities. To understand the context of the URL being discussed, we conducted a simple random selection of 5 threads that contained at least one post with URLs from each community. Gathering all other posts in these threads resulted in 387 posts for open coding analysis with the goal of understanding motivations and situations in which website sharing occurred.
  
  
  RESULTS
  We extracted a total of 25,448 websites. The majority of the shared websites were .com (59.16%, 15,056/25,448) and WebMD internal (23.2%, 5905/25,448) websites; the least shared websites were social media websites (0.15%, 39/25,448). High-posting community members and moderators posted more websites with trust codes than low-posting community members did. The heart disease community had the highest percentage of websites containing trust codes compared to other communities. Members used websites to disseminate information, supportive evidence, resources for social support, and other ways to communicate.
  
  
  CONCLUSIONS
  Online health communities can be used as important health care information resources for patients and caregivers. Our findings inform patients' health information-sharing activities. This information assists health care providers, informaticians, and online health information entrepreneurs and developers in helping patients and caregivers make informed choices.
authors.affiliation: Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
authors.forename: Chinmoy
authors.identifier: http://orcid.org/0000-0002-6322-4373
authors.initials: C
authors.lastname: Nath
authors.forename: Jina
authors.identifier: http://orcid.org/0000-0001-5811-9256
authors.initials: J
authors.lastname: Huh
authors.forename: Abhishek Kalyan
authors.identifier: http://orcid.org/0000-0002-7772-7916
authors.initials: AK
authors.lastname: Adupa
authors.forename: Siddhartha R
authors.identifier: http://orcid.org/0000-0003-3299-6052
authors.initials: SR
authors.lastname: Jonnalagadda
mesh_terms: D054626:Consumer Health Information; D006282:Health Personnel; D006801:Humans; D020407:Internet / Q000592:standards; D012944:Social Support
keywords: URLs; Web resources; consumer-health informatics; online health communities; online health community moderators; online systems; patient empowerment