The development of an online-based rural community of practice framework for addressing health issues among rural citizens: a grounded theory approach

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Abstract
Health literacy facilitates an individual’s ability to interpret and utilize medical information, thereby influencing their quality of life. Despite the benefits, the current oversaturation of information necessitates the support of healthcare professionals. Help-seeking behavior (HSB) is a term that describes the actions taken to assuage health concerns, and timely medical consultations are critical, especially for older individuals in rural areas who often face barriers to accessing care. These challenges are exacerbated by the perceived psychological distance from medical services in rural settings due to past negative experiences; however, the emergence of social media has helped form a bridge, allowing for direct communication with physicians. While consultations with artificial intelligence (AI) do occur, interaction with human physicians remains the gold standard. Thus, this study sought to understand social media’s role in facilitating health consultations in rural areas and the implications for primary care education among physicians. This qualitative study, conducted from September 2022 to June 2023, employed a grounded theory approach to analyze information about a social network-based consulting system that utilized the LINE application. Residents posted anonymous health-related concerns, and comments were extracted. Two researchers coded and assessed the data; another specialist reviewed the findings. A total of 621 citizens participated, generating 10,432 posts. The grounded theory approach identified five major themes regarding health-related social networking in rural settings: (1) mutual exploration for information sharing highlighted distrust toward primary care physicians; (2) temporary collaboration resulted in superficial health discussions and relationship-building through empathy; (3) conflicts arising from differing health perspectives and misinformation sharing led to intense debates; (4) anxiety was resolved through shared illness experiences and increased empathy, enhancing psychological safety; and (5) a mutual assistance community was created, characterized by improved health dialogues and HSB among participants. The high engagement with the social network-based consulting system in rural Unnan City highlights technology’s pivotal role in facilitating health dialogue and community engagement, despite challenges related to misinformation and health literacy complexities. As a reflection of the community’s health perceptions and dynamics, future adaptations should incorporate strategies to combat these challenges while preserving collaboration and support.

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