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Join, Stay or Go?

Online health communities (OHCs) have become important resources from which members can obtain social support. Since most benefits of OHCs are provided by its members, it is crucial that OHCs maintain a critical mass of active members. This paper examines temporal changes in members' participation in a cancer-orientedOHC, focusing on the changes in members' motivations and behavior as they transition from newcomers to other roles or when they ultimately leave the community. Our work used mixed methods, combining behavioral log analysis, automated content analysis, surveys and interviews. We found that shifts in members' motivations seemed to be driven by two sources: the internal dynamics common to becoming a member of most online communities and the external needs associated with their cancer journey. When members' disease-driven needs for support decreased, most members quit the site. The motivations of those who stayed shifted from receiving support to providing it to others in the community. As in many online communities, old-timers contributed the vast majority of content. However, they encountered challenges that threatened their commitment, including negative emotions related to other members' deaths, which led them to take leaves of absence from the community or to drop out permanently. Implications for the motivation changes ofOHC members are discussed.