Community as a Precommitment : Enhancing Self-Control in Online Healthcare Platform



The advent of IT in healthcare has precipitated an unprecedented digital revolution, evidenced by the growing prevalence of telemedicine platforms, mobile health applications, and an array of other digital health interventions. The impetus for this rapid acceleration can be largely attributed to the COVID-19 pandemic, which has necessitated the adoption of remote health interactions. In 2021 alone, health and fitness applications experienced a staggering 26% increase in global downloads, reaching a zenith of 2.48 billion. Despite this surge in usage, the true impact of these applications on health outcomes remains an open question, with research yielding a spectrum of results. These digital healthcare interventions, while revolutionary, do not mandate user engagement and consequently, they face similar challenges of self-control that are well-documented in the domain of traditional healthcare. Habits such as regular exercise, smoking cessation, and maintaining a healthy diet require significant self-regulation, a trait that is not automatically instilled by the mere use of digital tools. The vast majority of self-control literature has been confined to offline environments — gym attendance, strategies for quitting smoking, and healthy shopping choices — and does not fully translate to the new digital health landscape, which is characterized by its high accessibility and the ease of sharing information. Our study moves away from the traditional efficacy assessments of mobile health applications and toward understanding how online health communities (OHCs) enhance self-control among their users, particularly through emotional precommitment. These communities act as a digital agora where individuals openly share personal health records, in the unique ecosystem of OHCs, members willingly divulge their health records, using real-time information sharing as a strategic precommitment tool to reinforce self-discipline. Contrary to prior literature that often correlates self-control with offline precommitment mechanisms with financial disincentives, our research delves into the emotional dimension within OHCs. The intricate social dynamics within these communities elicit emotional responses crucial for reinforcing self-regulatory behaviors. An aspect of our research will also examine the potential modulation of the OHCs' impact on self-control by the strength of community member networks. We have collected extensive data from a widely-used health diary application, which features tens of thousands of users who provide a rich tapestry of behavioral patterns. This data forms the foundation for our hypothesis that engagement in OHCs correlates with more consistent and qualitative health record maintenance. Our findings indicate that individuals active in OHCs are more likely to consistently log their diet, enjoy improved nutritional intake, and engage in longer durations of physical activity when compared to their non-participating counterparts. Addressing potential endogeneity, we are incorporating propensity score matching (PSM) to robustly evaluate the self-control effects. A comprehensive difference-in-differences analysis is set to affirm that participation in an OHC is more than symbolic—it is a commitment mechanism fueled by emotional rather than financial incentives. Our study brings to light the underexplored domain of emotional precommitment within OHCs and highlights the platforms' potential in enhancing self-discipline. By weaving together the theory of self-control with the mechanics of online communities, we offer a new perspective that has profound implications for the design of mobile health interventions and for the academic dialogue on Information Systems. As we acknowledge the constraints of self-reported data and the call for longitudinal research to determine the enduring impact of OHCs on self-discipline, we recognize a fertile ground for future inquiry. To extend the frontiers of this research, further studies could investigate the differentiation in user engagement based on the typologies of communities and how engagement manifests distinct effects, even within the same community activities. A comprehensive understanding of the mechanisms that sustain user participation, stratified by user types, will offer critical insights into the design and facilitation of OHCs, fostering more targeted and effective digital health interventions.


  • Gayoon Kim School of Business and Technology Management, KAIST
  • Donggyu Min School of Business and Technology Management, KAIST
  • Chulho Lee School of Business and Technology Management, KAIST


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