Design Guidelines for Online Health Forums: User-Centered Design Approach.

Abstract

Online health forums are used widely, yet evidence of their effectiveness is inconsistent. Evidence-based forum design guidance grounded in theory and lived experience could improve the efficacy and outcomes of these forums for the many people using them worldwide. This study aimed to draw on the experience of online forum users and staff, and insights from existing research on technology design and self-determination theory, to generate a set of theoretically grounded guidelines for safe and well-being-supportive online forums. We conducted 54 semistructured interviews (36 forum users and 18 forum staff) and 4 design workshops with forum staff, combined with input from a multidisciplinary research team. Principles of qualitative framework analysis were used to adapt a preexisting framework for well-being-supportive technology to the context of online health forums. The resulting design guidelines are framed around 4 overarching principles relating to the psychological needs for autonomy, competence, and relatedness as defined by self-determination theory, and the additional need for safety in online forums. Each principle is presented alongside pragmatic design heuristics and specific implementation strategies. User experiences of online health forums are mixed. We have drawn on self-determination theory to propose evidence-informed guidelines for service development and refinement, adaptable to specific user groups across diverse settings.