A MUCHAS PREGUNTAS SOBRE OVN

The current findings, together with previous research, provide a basis on which to propose a new model of MHISG participation. This model, referred to here as The Tripartite Model of MHISG Participation, comprises four styles of participation (passive followers and help seekers,

mutual helpers, active help seekers, and active help providers) and is illustrated in figure 8.1. A

summary of the characteristics which define each participation style, arising from studies in this thesis, is provided in table 8.1.

The proposed model contains groupings of participation styles at three levels with transitions between the four styles of participation. It shares some attributes of the ‘membership life- cycle’ model [28] (see Chapter 1) in that both the latter and the Tripartite model include the ‘passive’ and ‘active help-seeker’ participation styles and transitions between roles. However, the Tripartite model also includes mutual helpers. The life-cycle aspect in this model is represented by the replications of the same structure which depict the generational cohorts observed in Chapter 5. This illustration has strong similarities with the graphical representation of the BlueBoard community structure in figure 2 of Chapter 5, which highlights the high- engaged users as central to the network surrounded by many low-engaged users in the periphery. This model also draws on suggestions that online communities are often characterised by a core-periphery structure [29, 30].

At the top layer of the Tripartite model are mutual helpers. High engagement (as measured by posting frequency), high awareness characteristics, network centrality, early registration relative to the peers with whom they communicate and a tendency to communicate about topics that resemble the consumer-defined notion of recovery are defining characteristics of this participation style.

The second layer of the Tripartite model comprises active help seekers and active help

providers. In contrast to the mutual helpers, these two participation styles are characterised by low engagement, low awareness characteristics, low network centrality and a tendency to communicate about topics that resemble the medical-defined notion of recovery. Active help seekers and active help providers are distinguished from each other based on the direction of help being provided, as indicated by the content of posts or activities such as starting a thread in order to seek help, or responding in a thread in order to provide help to another user.

At the base of the Tripartite model, there are passive followers and help seekers. Previous research has defined this group as those who read but do not actively participate; they are often referred to as ‘lurkers’ [31].

The arrows in the diagram represent transitions between participation styles. Hypothetically, any user may transition between any two participation styles and back again. The diagram only

includes arrows for which there is empirical evidence of the transition. Passive followers and help seekers are believed to benefit vicariously [32, 33]; however, they have also been observed to transition to the active participation styles: mutual helpers, active help seekers

and active help providers (Chapter 7 [3]). Mutual helpers benefit from each other, however, they often transition in their participation style temporarily to serve as active help providers

for the active help seekers (as indicated in the diagram by the two-way arrows).

The difference between active help providers and mutual helpers is defined by the extent to which the interactions between users are transient and asymmetrical. Active help providers are engaged in relatively transient interactions with other users, whereas mutual helpers are engaged in more sustained and symmetrical relationships with each other (resulting in higher posting frequency). The nature of these types of peer support, in terms of the types outlined in Chapter 1, is akin to mutual help between the mutual helpers and a consumer-run service between the active help providers and active help seekers. In the case of the latter, it involves users with low levels of awareness seeking help from consumers who are more advanced in their recovery and who have higher levels of awareness [34] and are providing their expertise in a voluntary rather than professional capacity. Hypothetically, the active help providers may also provide support to mutual helpers, although this was not directly investigated by a study in this thesis and requires investigation. In contrast to the conclusions from previous cross- sectional survey research (and the corresponding Membership Lifecycle model) which has suggested that there is a gradual progression from the role of low-engaged distressed newcomer to high-engaged help provider [28], the current research suggests that high-

engaged mutual helpers are also potentially differentiated from low-engaged active users from the outset of their participation by their awareness characteristics.

Figure 8.1. Tripartite Model of MHISG Participation. The arrows indicate transitions in participation style that have been evinced in the current thesis, although it is plausible that a user may transition between any two participation styles. Participation styles are outlined in table 8.1.

Table 8.1. Defining metrics of the participation styles in the Tripartite model

Participation

style Metrics

Mutual helpers Activity: High posting frequency

Characteristics: High interpersonal awareness, consumer, older, registration early relative to connected users

Connectivity: high network centrality

Content: typical of consumer model of recovery

Active help

providers ActivityCharacteristics: variable but often same as mutual helper, responding in a thread: variable but often same as mutual helper Connectivity: variable but often same as mutual helper

Content: typical of medical model of recovery

Active help seekers

Activity: low posting frequency, starting a thread Characteristics: low awareness

Connectivity: low centrality, peripheral in network Content: typical of medical model of recovery

Passive followers and help seekers

Activity: No posting frequency

Characteristics: No evidence from the current studies Connectivity: Not applicable

Content: Not applicable

Mutual helpers Active help providers Mutual helpers Active help seekers Active help

seekers Active help providers

Passive followers and help seekers

Mutual helpers Active help providers Active help seekers Generation 1 … Passive followers and help seekers Passive followers

and help seekers

Generation N

The most important contribution of the proposed Tripartite model is the shift from a dualistic model, in which participation is conceptualised only as active or passive, to a more refined model in which active participation is further differentiated by type of peer support. In the Tripartite model, the MHISG is sustained by a core group of users who are engaged in long- term symmetrical relationships with one another with the aim of achieving personal recovery. Peripheral to this are the majority of users who approach the group and engage in transient asymmetrical interactions with the core members and one another. The core members are engaged in mutual help and the peripheral members engage briefly with a consumer-run service. Although posting frequency alone does not discriminate between these different styles of participation, the studies in this thesis demonstrate that frequency is associated with these styles and may therefore serve as a legitimate proxy measure for them.