The Role of Online Discussion Forums During a Public Health Emergency

Research output: ThesisDoctoral Thesis

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During a public health emergency, access to professional healthcare may be constrained. Online discussion forums provide an alternative – access to a ‘Wise Crowd’ from which Collective Intelligence may emerge – but lie outside of traditional quality control structures.

This thesis examines whether certain characteristics of such platforms encourage and signpost higher quality information, and what utility this may offer during a Public Health Emergency of International Concern.

It synthesises results from three separate studies: interviews with Ebola witnesses during the 2014-16 West Africa outbreak; doctors’ assessments of the quality of information provided in response to questions asked on health discussion forums, including r/ebola on, dedicated to discussing Ebola; and an investigation of online health community moderators by non- participant observation, interviews, and access to private areas of discussion sites not accessible to general users.

The research goes beyond previous work in three major ways:

First, analysis of health-seeking behaviour presented in this thesis identifies three separate stages of risk perception and individual concern during an outbreak with different types of questions asked in each stage, each requiring different platform characteristics.

Second, assessment of the quality of the health advice in major online forums is determined in this study according to the judgements of doctors; this differs from previous research that used indirect assessment. Results suggests that such forums can provide signposts to good quality information.

Third, the investigation of the role of teams of volunteer moderators of reddit discussion forums identifies and analyses the task-components and skill-mix required to set up and manage a discussion forum during a serious disease outbreak. This points to a larger role for technical skills and forum experience than has previously been identified.

The conclusions of this thesis suggest ways in which online platforms may facilitate better health information exchange during future serious disease outbreaks.
Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
  • Watkins, Chris, Supervisor
  • Kleine, Dorothea, Supervisor
  • Pinkerton, Alasdair, Supervisor
Award date1 Oct 2017
Publication statusPublished - 2017


  • human-computer interaction
  • Collective Intelligence
  • Infectious Diseases
  • Ebola
  • Reddit

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