Univ Access Inf Soc DOI 10.

1007/s10209-009-0154-3

LONG PAPER

Applying qualitative content analysis to study online support communities

Ulrike Pfeil Panayiotis Zaphiris

Springer-Verlag 2009

Abstract With the increasing popularity of online support communities for people with disabilities and older people, the research domain of online communities is gaining more and more research potential in the area of inclusive design. There are many studies that investigate social interactions within online communities. However, researchers seem to apply a variety of different methods in very different ways. This makes it often difcult to decide on the appropriate method. In order to provide guidance to researchers in the area of inclusive design, this paper reviews past research in this area and presents a self-contained methodology that is based on qualitative content analysis for studying social interactions in online support communities for people with special needs. A case study from an online community for older people is presented in order to set the theory into context. Keywords Online communication Qualitative content analysis Methodology Support communities

1 Introduction The term online community is commonly used to refer to people who meet and communicate in an online
U. Pfeil Centre for HCI Design, City University, London EC1V 0HB, UK e-mail: U.Pfeil-1@city.ac.uk P. Zaphiris (&) Department of Multimedia and Graphic Arts, Cyprus University of Technology, Limassol 3603, Cyprus e-mail: panayiotis.zaphiris@cut.ac.cy

environment [49]. However, no general agreement has been found so far with respect to a common denition of the term online community. Different researchers from different disciplines have different understandings and opinions about what the word community means. Some researchers consider online communities as an environment where support, empathy, and friendships develop [51]; others focus on the analysis, design and evaluation of different technologies that support online communication and group building [8, 33, 36, 45]. According to Preece and Maloney-Krichmar [48], an online community consists of people who come together for a particular purpose, and who are guided by policies [], and supported by software. Online communities offer the possibility for people to interact with others who have similar interests or who are facing a similar life situation. Meeting in an online environment can be especially valuable for people with disabilities and older people, as restricted physical mobility or other life circumstances might make it more difcult for them to meet others ofine. Online support communities often have the function of self support groups which are characterised by a high level of emotional support and understanding. In a recent study, the occurrence of empathy in online support communities for older people was investigated. The ndings, reported in details in [42], show some key differences between online and ofine support. The emphasis of this article is on the methodological issues of that study. The increasing popularity of online support communities for people with disabilities and older people makes this research area interesting for scholars and practitioners in the eld of inclusive design. In order to provide an online environment that nurtures the development of social

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support, it is necessary to understand how social support is conveyed in online communities. This article aims to provide valuable methodological guidance for inclusive design researchers to study social interactions within online support communities for people with disabilities and older people. In order to investigate social interaction in online communities, researchers often study the relationship between participants. In these cases, the focus is on investigating linguistic and communication patterns in online community messages [20] and/or on the actual content of messages in online communities [43, 44]. The number and variety of methods that are available to study social interaction and support within online communities is large. This variety often causes confusion about which method is the most appropriate to use in any given situation. Further work is therefore needed to evaluate the appropriateness of different methods and to rene and improve these methods for studying online social interactions of people with disabilities and older people. The aim of this article is to shed light on research methodologies that can be applied when studying online support communities for people with disabilities. In order to do that, issues that researchers come across when studying online support communities for people with disabilities and older people are highlighted, and possible solutions are discussed. For example, the paper elaborates on characteristics of Computer-mediated Communication (CMC) like anonymity, and the lack of visual cues impact on the research methods, and discusses ethical issues that need to be considered when investigating online support communities. Furthermore, a description is provided of virtual ethnography and content analysis, and the appropriation of these methods for studying online support communities is discussed. As the available space allows only for an overview of these issues, citations and literature suggestions are provided for readers who wish to get more detailed information and discussion about these issues. In order to set the current discussion into context, a small case study is described, in which the discussed issues are shown in practice. Based on the case study, a procedure is proposed for investigating online support communities for people with disabilities and older people, based on the method of qualitative content analysis. Although content analysis is commonly used to study online communities [6, 27, 28, 46, 70, 71], researchers seem to apply this method very differently and a single, comprehensive guide to the procedure is missing. In order to present a qualitative procedure to study online support communities, this article addresses relevant issues that have to be considered when applying content analysis. A common problem when doing content analysis is to ensure objective coding and to minimise researcher bias

[25, 29]. To address this issue, this article proposes new procedures that can support an unbiased and objective coding. Including these procedures into the process of qualitative content analysis also increases the transformability of the results to other contexts and offers a helpful guide for the documentation of the research ndings. The article starts with a literature review that addresses three different sub-topics: Characteristics of CMC and their inuence on research methods, ethical issues when doing internet research of online support communities, and an overview over ethnographic methods for Internet research. In the second part of the article, a procedure is proposed for performing qualitative content analysis. Special emphasis is laid on new parts of the procedure that improve objective coding and offer the possibility to reduce research bias. The proposed procedure is self-contained. It is presented in the context of a case study, which shows how this procedure can be applied to study social interactions within an online support community for older people. The paper concludes with a review of the proposed procedure and suggests issues for further research.

2 Literature review In the following section, issues that researchers come across when studying online support communities are discussed. The rst part is dedicated to characteristics of CMC and discusses how these characteristics impact the way online support communities can be studied. The second part discusses ethical issues that researchers come across when investigating online support communities. Thirdly, an overview of the methods of virtual ethnography and content analysis is presented in order to describe some of the possible methods and to introduce the reader to the methods that have been applied in the conducted case study. By addressing important issues that researchers come across when studying online support communities, a sound overview over opportunities and challenges that arise when studying online support communities is provided. 2.1 Characteristics of computer-mediated communication Patterns and means of communication have been changing with the invention of each new communication technology. Recently, the Internet has become a common means of exchanging experiences, information, and knowledge with others. New ways of using the Internet and its technologies for human-human communication evolve even though the medium itself has not changed fundamentally in the last 10 years [47]. Researchers have been adapting methods

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and theories from different research areas like sociology, social psychology, etc., when studying online communities [48]. The methods need to adapt to the specic characteristics of CMC in order to capture the essence and nature of the respective communication. Specic characteristics of CMC and their impact on methods to study them will be discussed in the next sections. 2.1.1 Lack of non-verbal cues One major issue that distinguishes CMC from face-to-face communication is the lack of non-verbal cues. Although some CMC technologies transmit video and voice of the communicators, most CMC technologies still use mainly text as a basis to convey messages. Non-verbal information like facial expressions, tone, gesture and eye-contact are not available in text-based CMC and have to be expressed in alternative ways. Some researchers claim that the absence of non-verbal cues is a disadvantage of CMC as compared to face-to-face conversation, because a lot of information can not be conveyed. Therefore, misunderstandings may arise and the accuracy of the receivers understanding of the message as intended by the sender is considerably lower than in face-to-face communication [9, 32, 52, 64]. Other researchers, however, state that communicators in CMC have found ways to make up for the non-existent cues and that people learn how to deal with text-only information quickly. According to them, CMC does not suffer from the exclusion of non-verbal cues [68, 72]. For example, Wolf [72] claims that emoticons are a common way to express emotions in CMC that would have been conveyed non-verbally in face-to-face conversation. The fact that CMC is mainly text-based means that text is often the only available data for the researcher in order to investigate communication patterns. It is therefore necessary for virtual ethnographers to pay special attention to the analysis of language and discourse [2]. In order to perform textual analysis, it is necessary to go over the text several times. On the positive side, in most cases, the whole textual conversation can be retrieved and saved easily. By downloading the whole conversation, the researcher can make sure that (s)he investigates all available data and does not miss anything (in contrary to taking notes in ofine communication, where it is more likely that the researcher misses some important information) [65]. On the other hand, this can also be seen as a restriction, as it is difcult for the researcher to actually observe the person that contributes to an online conversation and judge the written text according to the personal context of the contributors. The fact that text is the only data which is exchanged during communication also means that it is the only thing the researcher can investigate. This might lead to misinterpretations of the communication patterns.

2.1.2 Anonymity in CMC Another issue that is widely discussed by researchers regarding CMC is that of anonymity. This is especially interesting when investigating online communities. People log on with a freely chosen username and usually neither the other participants nor the moderators (if existent) know their ofine identity. Anonymity is believed to have a great inuence on the nature of CMC. Some researchers suggest that anonymity increases the possibility of aming (threatening or insulting other members of the online community) [7, 50]. The fact that nobody knows their ofine identity frees people from serious consequences of their actions. By simply pressing the logoff-button, people can escape an uncomfortable situation that might arise due to their misbehaviour. However, it was also found that anonymity leads to a higher degree of self-disclosure [34, 60]. This is especially the case for online communities with a high degree of emotional content, e.g., online support communities. The fact that the ofine identity of individuals is hidden reduces anxiety and allows participants to speak more freely about their feelings and problems [67]. Especially people who are more introverted in the ofine world use online communities to try out new parts of their identity and are more open towards others. Again, the reason for this is that there are no real consequences of their behaviour. People feel safer when they act anonymously and are therefore more open to reveal themselves to others [16, 35, 41]. When doing internet research, anonymity is believed to impact the investigation itself. The fact that people feel safer in online communication and reveal more information about themselves might be of advantage for the researcher, as (s)he might be able to gather more information from an online setting than in ofine investigations. People might be more likely to report on personal and controversial issues since they are less inhibited to talk about sensitive topics in an online environment. 2.1.3 Honesty in CMC Another widely discussed question is whether people actually tell the truth when communicating in online communities. Literature reports several stories that tell of people who harmed members of their online community by spreading lies. Online support communities are believed to be especially vulnerable with respect to this issue as the topics discussed there are often very personal and sensitive. There are stories reported where the dishonesty of a person within an online community caused harm to the trust and wellbeing of other online community members [13]. In contrast to that, Sussman and Sproull [62] found that people are more straight-forward and honest when

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delivering bad news via CMC compared to face-to-face delivery. Also, many researchers believe that such cases of dishonesty are rare exceptions and that people in online communities often build an environment of honesty and trust. They argue that the fact that the members experience a similar problem or situation and the high level of selfdisclosure can lead to close relationships. A strong feeling of belonging to a community encourages members of an online support community to take care of each other [51]. The fact that people might pose as somebody else in online communities or invent false stories and details about themselves should be kept in mind when doing Internet research. Getting familiar with the members and communication patterns of an online community can help the researcher to get to know the members of the online community better and build a trustworthy relationship with them. The closer the researcher is to the members of the online community, the more (s)he might be able to judge whether a member actually tells the truth. However, it is impossible to completely resolve the uncertainty about whether the participants actually tell the truth. 2.2 Ethical issues in Internet research Ethics in Internet research is a further highly debated topic among researchers and no consensus on this issue could be reached so far. However, it is important to be aware of existing guidelines and to think about ethics when choosing a community to be studied and the methodology to use. Ess and the AoIR ethics working committee [11] wrote a report of the current state of the art in ethics for Internet research. This report embraces ethical considerations for both observations of social interactions via the internet (e.g., observations of activities within online communities) and data gathering with the help of Internet technology (e.g., online surveys). The authors refer to ethical guidelines from social sciences that are used when researching human subjects as a basis for their framework. Ofine, human subject research either obtains data from the individual through intervention or interaction or obtains identiable private information. This is often also applicable when investigating online communities. Three major topics are important in human subject research: informed consent, the distinction between private and public, and anonymity of the participant [11]. In the following sections, each of these three principles will be discussed. Additionally, the last section will present other approaches that address ethical issues in Internet research. 2.2.1 Informed consent Informed consent requires the researcher to inform the participant prior to a study about the nature of the study and

to make sure that the participant understands this information. The participants must volunteer to take part in the study and must be aware that they can leave the study at any time without consequences. Concerning informed consent, Frankel and Siang [15] identied three major issues in Internet research: When is informed consent required; how can it be obtained; and how can it be validated? (p. 7). While there is no doubt that informed consent should be obtained when survey and interview data is gathered online, the issue gets difcult when it comes to observational data. In an online setting, it is easy to observe participants unobtrusively, e.g., by reading messages within a discussion board, or by participating in an online community without disclosing being a researcher. Sharf [58] writes about her experiences with gaining informed consent from individuals of an online community about breast cancer after the collection and analysis of the messages. She reported success with her approach, despite the fact that it is quite time-consuming. However, it is difcult to inform the participants after the observation, because they might have left the online community [15]. Similarly, to obtain informed consent from a whole online community is difcult, as questions arise whether every single community member has to give his/her consent or whether it is enough to just obtain consent from the community moderator. Waskul and Douglass [69] state that researchers should at minimum contact the key members of the community before they retrieve data from the online community. 2.2.2 The distinction between private and public Researchers agree that consent is not required for every research project, as the distinction whether the data collected is private or public has a great inuence on determining whether consent is required or not [15]. When doing research that involves human subjects, consent should be obtained when private data is collected. If the data is public, informed consent does not have to be obtained. However, the understanding of a public space as it is considered in ofine research is difcult to translate into the online world. The distinction between private and public in online communication is difcult to judge and the boundaries are not clear [26]. Some researchers believe that there are online communities which should be treated as private spaces, as members of online communities can form a great degree of belonging and trust within a community which separates them from other people. This is especially the case for online support communities where the communication is often characterised by a high level of emotional content. The fact that people reveal a lot of private information and disclose themselves often to a higher degree than ofine

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leads to the question whether or not the members treat online communities more like a form of private conversation [] embedded in the public space [4]. Thomsen et al. [65] state that many participants expect communication on the Internet to be private and that it should therefore be treated as such. Contrary to that point of view, many other researchers claim that the Internet is a public domain and messages posted on the internet are intended for the public [15]. They see the internet as a public space, because the access to online communities is often open and people should know and expect that their messages will be read by a wide audience. The ProjectH Research Group who worked on ethical issues for internet research in 19931994 voted in favour of an ethical policy that does not require researchers to get permissions for collecting and analysing messages posted in publicly accessible online communities [40]. Herring [19] investigates two approaches to ethical consideration in CMC research, one treating CMC material as public, the other one treating it as private. She concludes that the decision whether the material is public or private depends on the kind of CMC material that is investigated, as well as on the method that is used for the investigation. Thus, she states that no single set of disciplinary [ethical] guidelines is appropriate for all research paradigms, [and] it is difcult to imagine any single set of guidelines that could appropriately reect the nature of the interaction in all of these different genres (p. 165). In her view, both the researchers and the participants of an online community are responsible for the protection of the participants privacy. Participants of online communities have the responsibility to declare their online community clearly as public or private; on the other hand, researchers should also be considerate towards the protection of participants privacy, even if the material is publicly accessible [19]. King [26] states that the distinction between private and public online conversations is blurred. To give guidance in determining whether a conversation should be seen as private or public, he suggests that the lower the level of Group accessibility and the higher the degree of Perceived Privacy, the more care must be taken to avoid harming group members (p.126). Hereby, group accessibility is determined by factors like restricted membership (e.g., one has to pay/apply for it) or registration (e.g., one has to register in order to read and/or write messages). Assessing the perceived privacy is connected to the topic of the community (e.g., an online community which discusses computer hardware might be perceived as less private as an online community for people with breast cancer). Furthermore, messages about the nature of the community on the main website can give hints concerning perceived privacy [26].

2.2.3 Anonymity To protect personal information about the participants and to ensure condentiality, researchers often hide the true identity of the participants. In online communities, members usually use usernames instead of their real ofine names. One could argue that the fact that people participate anonymously in online support communities would make it easier for researchers to maintain this anonymity. But Sharf [58] argues that anonymity based on an invented username and the fact that one is not visible in an online community often encourages users to disclose very private feelings and information about themselves, although the medium through which they are communicating is public. Therefore, researchers have to be even more careful when dealing with sensitive data. The question arises whether using usernames is enough to ensure anonymity, as cited messages can be traced down when the username is available. Furthermore, many members feel attached to their username and some researchers therefore claim that usernames should be treated like real names and should not be revealed to the public [59]. Jacobson [24] states that, by using the usernames, researchers often create a wrong sense of anonymity in electronic research, which does not protect the participants. Similar questions arise concerning the quotation of messages. When the full quotation is available, the message as well as the sender can easily be traced down using current internet search technology. Therefore, when quoting messages, researchers might destroy the anonymity of the participants. People who wrote the quoted messages can be easily found and might be harmed by this exposure. Therefore, some researchers slightly change the content of quoted messages. While this ensures a higher degree of anonymity, Sixsmiths and Murray [59] also note that this could lead to wrong or biased conclusions. 2.2.4 Other perspectives Other researchers (mainly from the eld of humanities) have a completely different point of view when it comes to analysing and working with texts and artefacts published on the Internet. Cavazos and Morin [3] argue that texts and artefacts on the internet should be seen as public and as an artwork belonging to the author. Therefore, it is necessary to cite the authors of messages in order to ensure the copyright. This clearly contradicts with the understanding of anonymity that is used in the human subject research. The contribution of Herring [18], who states that the ethical decision depends on the data being used for the investigation, is also interesting in this context. Whereas research on group or individual interactions includes a lot of personal information about the participants and therefore

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poses ethical problems, linguistic and textual analysis of data is less critical. Herring [18] claims that when the focus of the research lies on the structure and textual composition of messages, ethical issues are less critical than when the research deals with the personal details of the participants. Depending on the nature of the research and the data that needs to be collected, the researcher should at the beginning of the project determine which approach to ethical consideration (s)he wants to follow. Depending on the research questions, appropriate actions should then be taken in order to protect the participants. 2.3 Methods of Internet research This section presents two (related) methods that can be used to study social interaction in online communities. Firstly, an overview of ethnographic research in online environments will be presented. Background information about common practices, as well as advantages and disadvantages of this approach are discussed. The second part of this section focuses on content analysis, which is the basis of the proposed self-contained methodology adopted in this papers case study. 2.3.1 Virtual ethnography According to Apgar [1], the basic activity when doing ethnographic research is to decode the world as the researcher observes it. By doing this, the researcher comes up with a rich description of the setting to be studied. In order to understand the shared knowledge of the community, the researcher needs to understand the language and be familiar with the groups communication and behaviour patterns. This requires the immersion of the researcher into the setting up to becoming part of the community and being able to view the community from an insiders point of view [10]. Maloney-Krichmar and Preece [36] state that the emphasis of ethnographic research lies on telling the story of a community through the words of its members (p. 220). But how can ethnography, as it is applied in ofine reality, be translated into the online environment? Rutter and Smith [55] state that the greatest dilemma of virtual ethnography is that there is no obvious place to go to carry out eldwork (p. 3). Fernback [14] discusses where people go when they participate in an online community and concludes that there is a there there (p. 218), describing online communities as settings where people come together. Ofine ethnography consists largely of doing eldwork and actually being part of the community. In contrast, online ethnography can be done from the work desk. Not having to physically go into the eld leads to fewer problems with accessing the community.

Furthermore, data from an online community can often be retrieved in an easy, cheap, and quick way by downloading the messages [55]. But it has to be mentioned that this also poses limitations. Thomsen et al. [65] state that in order to conduct virtual ethnography properly, the researcher should spend as much time on it as he would on the ofine counterpart. In their view, downloading all the material is not enough and it is not possible to obtain the necessary insight into the experience of the online community from only reading the archive. Virtual ethnography requires the researcher to become part of the community himself/herself and is therefore very time-consuming. Similarly, Rutter and Smith [55] state that it is necessary for the researchers to become visible for the members of the online community and actually take part in the communication as participants. In contrast, Maloney-Krichmar and Preece [36] state that the immersion of the researcher into the online community can also take place when the researcher observes what is going on without actively participating in the communication. In online communities, all the information about the community and the activities of the members is displayed in textual form. It is therefore necessary for a virtual ethnographer to pay special attention to the analysis of language and discourse [2]. A good example for the analysis of discourse in an online community is a study by Fayard and DeSanctis [12] investigating the discourse of an online community for information systems professionals. Conducting a language-focused discourse analysis of the messages that were exchanged over a period of 15 month, they specically focused on the evolution of contributor behaviour over time. The content of the text as well as the use of language (e.g., shared jargon, emoticons and common abbreviations) shape the community [30]. Given the great prominence of text, Thomsen et al. [65] state that a thorough analysis of the textual communication can lead to valuable ndings within the online community. Similarly, Mitra and Cohen [39] argue that it is possible to draw conclusions about the content and writers of online text by analysing text that they have created in a systematic way. They propose to not only look at the content of the text, but also consider its presentation and signicance. They also argue that the text under investigation has to be studied in the context of the surrounding text and linking to the original text, as the true meaning of a text can only be understood in relation to its context [39]. The advantage of the fact that all interaction takes place in a textual form of is that every activity within the online community is readily available for the researcher. Next to the current discourse itself, this is also true for the history and former activities of the online community, as well as for any rules about the appropriate behaviour (netiquette) that are explicitly stated. This

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reduces the probability that the researcher accidentally misses data. Thomsen et al. [65] recommend mixing textual analysis of the postings with long-term observation of the activities within the online community and with conducting interviews with members of the online community to further clarify the ndings of the previous methods. They name this approach a multi-source, multi-method triangulation. This approach was applied by Maloney-Krichmar and Preece [36], who conducted a multi-method analysis in order to investigate an online support community for people with a specic knee injury. The combination of the methods allowed the authors to provide a rich and descriptive explanation of the nature and patterns of this online community [36]. Also, a combination of quantitative and qualitative research methods is encouraged, as it allows for an in-depth investigation from different angles. For example, Rodgers and Chen [53] investigated an online support community for women with breast cancer in order to study the psychological benets of the community participation on the well-being of the women over time. They applied both quantitative content analysis and qualitative thematic analysis in order to investigate a typical prole of women participating in the discussion board, and identify whether and how women beneted from that participation. They concluded that indeed, the amount of participation in the online support community did correlate positively with the perceived well-being of these women over time. There are many different methods that can be applied in ethnographic studies of online communities (e.g., discourse analysis, narrative analysis, content analysis). Each method can be used in order to investigate communication activities in online community, but focussing on slightly different aspects of the communication (e.g., discourse analysis focuses mainly on dialogic and interactive patterns of the communication). This article focuses on one specic method that can be applied when doing ethnographic Internet research, namely content analysis. Content analysis can be applied as a self-contained method in order to investigate social interactions in online communities, but can also be combined with other methods, like for example interviews. The next section investigates issues that are specically related to content analysis. Different approaches to content analysis are presented and discussed. 2.3.2 Content analysis Despite the fact that content analysis is often criticised for its subjectivity and the fact that the way in which content analysis is employed could be inuenced by the questions one wants to answer, content analysis is one of the most commonly applied methods when investigating messages within online communities. Literature frequently refers to

two main approaches towards content analysis: quantitative and qualitative [31, 37]. Sorting the data into codes (specically dened categories) is part of both approaches to content analysis. The difference is that quantitative content analysis emphasises the statistical analysis of the data (e.g., test hypothesis with quantied measurements), whereas qualitative content analysis focuses on the themes and topics of the categories and the distribution, meaning and relations of them within the data under investigation. Frequency calculations can be part of the qualitative content analysis as well, but are used in a less rigorous way than in quantitative content analysis [56]. Quantitative content analysis allows a great amount of textual data to be reduced into numbers and frequencies that are suitable for statistical analysis [31]. However, Thomsen et al. [65] state that reducing the text to countable categories is prone to miss the ne nuances and patterns of the discourse. They state that the rigorous nature of quantitative content analysis does not account for meanings of the text that can be extracted by looking at the conversation at a whole. According to them, qualitative textual analysis is necessary to complement and support the quantitative methods, especially for the purpose of virtual ethnography. This article focuses on qualitative content analysis, as postings within an online community are often seen as a construct of social action, which is found to be best investigated with qualitative research methods [38]. Although originally rooted in the social sciences, qualitative research methods have recently become more popular also in other academic elds. The generic and interdisciplinary nature of qualitative research makes it possible for researchers from various academic backgrounds to apply the method. Qualitative methods often allow the researcher to freely adapt the steps to the peculiar characters of the research project [38]. Qualitative research is usually characterised as a continuous and iterative process. Analysis begins when the data is reduced to concepts, patterns and themes (e.g., extract codes out of a raw full data set). Further renement of the found patterns, displaying concepts that have been found and relating the patterns to existing frameworks is part of the analysis as well [38]. Mayring [37] proposes two approaches to qualitative content analysis: inductive category development (p. 3) and deductive category application (p. 4). Depending on the research question of the project, either the deductive or the inductive approach is more appropriate. This article focuses on the inductive approach to qualitative content analysis, as it offers a way to capture the essence of the communication within an online community. Unlike the deductive approach, which imposes a framework on the communication, inductive category development constructs a framework that describes the occurring

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communication patterns. In this way, the categories are data-driven and the overall code scheme describes the patterns and content of the online communication under investigation. Mayring [37] describes the procedure of inductive category development as part of qualitative content analysis as shown in Fig. 1 and [37]. After discussing issues that researchers face when studying online support communities, a self-contained methodology will be proposed for this purpose in the following section, based on Mayrings [37] model of qualitative content analysis (see Fig. 1).

particular case by addressing each of the steps separately. This should provide researchers with guidance on how to apply the procedure as well as how to address specic issues that arise (e.g., inter-coder reliability). 3.1 Ethics and choice of community In the case study, it was decided to investigate a discussion board of SeniorNet [57] (www.seniornet.org), a non-prot organisation that was founded in 1986 by Dr. Mary Furlong in the context of a research project. Social interaction is an important characteristic of SeniorNet and former studies about its online community described it as a supporting and caring environment [23]. SeniorNet includes many discussion boards about various topics. Each discussion board has a moderator, who watches over the discussion and encourages people to take part [23]. SeniorNet was found to be a suitable online community to study, for several reasons. First of all, the discussion boards are publicly available for all Internet users and there is no need to register in order to read them. Furthermore, SeniorNet is a well-known organisation. The fact that many users know and access it denes it as a public portal. SeniorNet is an organisation that educates older people about computers and the Internet. Therefore, it is assumed that the members are knowledgeable about the Internet and know that their contribution is public. Furthermore, members of discussion boards on SeniorNet have been participating in research before, which is underlined by links to the articles of the conducted research. Also, ethnographic research within the discussion boards of SeniorNet (also by investigating the messages) has been done before [23, 66, 73]. Taking all these into account, it was concluded that the members of SeniorNet are aware of the public nature of the discussion boards and therefore this online community can be treated as a public space where research data can be collected without having to achieve informed consent before data collection. However, to ensure condentiality and anonymity, the usernames of the members were not revealed in the study and the full quotation of messages was avoided. 3.2 The determination of the unit of analysis In order to code messages that exist in an online community, it is important to dene the scope of the segments that the raw data will be divided into for the coding. Among the most commonly applied units of analysis are the units of a message, a meaning, or a sentence [54]. The sentence unit is one of the more detailed units of analysis. As it is syntactically dened, it is often claimed that the procedure of segmenting the content into units of a sentence is xed and leads to a high inter-coder reliability concerning the segmentation [21]. In CMC, however, the

3 Case study In order to offer guidance to researchers in the area of inclusive design, a detailed procedure of qualitative content analysis for online support communities is presented in the following section. Issues that have to be considered during the application of the method are discussed, and suggestions about how to address them are provided. Within the process, new strategies, especially concerning the development of rules for objective segmentation and coding, are introduced. The proposed procedure for an inductive approach for qualitative content analysis is discussed in the context of a case study that aimed to investigate social interactions of members of an online community for older people. In particular, an investigation was conducted of a discussion board about depression within SeniorNet [57], an online community specically targeted at older people. The following section describes how the procedure was applied in this

Fig. 1 Procedure of inductive category development [33]

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Fig. 2 Example of a segmentation

judgment about what constitutes a sentence is not always that obvious. Take for example the following extract from a message, out of Rourke et al. [54]: Certain subjects could be called training subjects,i.e., How to apply articial respirationas in rst aidand though you may want to be a guide on the side []. (p. 12). In cases like this, it would be very difcult to judge where a sentence ends and a new one starts. Investigating content at the sentence level as the unit of analysis leads also to a high number of units that need to be coded. This can be very time-consuming. Furthermore, contextual information that is included in the construction of several sentences might be lost, when analysing the content on such a detailed level. Another possibility to separate the content into xed units is to use the unit of a message. This is particularly often applied when studying online discussion boards, as it consists of clearly distinct messages. This unit has the advantage that it is easy to dene. Unlike sentences and paragraphs, which might still cause some problems, messages are clearly distinct from each other. Furthermore, a message is a quite big unit and it is therefore less timeconsuming to analyse a large amount of content. However, some messages might contain different topics or aspects of the communication. By coding the whole message into one code, important information about the different themes within that message might be lost. Another commonly used unit of analysis is the unit of a meaning, which was introduced by Henri [17]. This approach provides the opportunity to code the content at an adjustable level of detail. Henri [17] justies the use of the unit of meaning by stating that it is absolutely useless to wonder if it is the word, the proposition, the sentence or the paragraph which is the proper unit of meaning, for the unit of meaning is lodged in meaning (p. 134). However, the judgement about what constitutes a meaning is very subjective and may lead to low inter-coder reliability results concerning the segmentation. However, as the procedure discussed later on will show, when using a meaning as the unit of analysis, there are opportunities and strategies that help to improve the objectivity of the segmentation, e.g., by constructing detailed rules that are to be followed during the segmentation. For the current data set, it was decided that the meaning should be the unit of analysis. The reasons for this decision

were that coding with the sentence as the unit of analysis would mean to overlook the overall meaning of a message. For example, one sentence viewed and coded separately would ignore the context within the message, in which the sentence was written. Coding the data set with a sentence as the unit of analysis was therefore seen as too restrictive and unmindful of the context. In contrast, using the whole message as the unit of analysis was seen as too shallow. Sometimes, people would include several topics within one long message and putting the whole message into one code would mean that important distinctions and details of the message get lost. By deciding that the unit of analysis should be the meaning, it was made sure that the content was coded in a way that all necessary detail prevails and, at the same time, the data could be seen in its context. As an example, Fig. 2 shows an excerpt of a message (we have deleted the name). This message is divided into two paragraphs which address different topics and have different meanings. Thus, they are separated into two separate text chunks. 3.3 Development of a rst set of codes A precondition of qualitative content analysis is that the researcher is well familiar with the raw data that (s)he analyses. In terms of discussion board postings, this means that the researcher should read through the posts several times, in order to capture the overall context and to get an overview over the dataset [22]. The sample size can differ, depending on the kind of data and the research question. It is necessary that the familiarisation with the data is done before the coding starts [63]. It also helps the researcher to view the later analysis of the data from an insiders point of view and take into account not only the messages, but also the context [38]. To get an impression of the context of the discussion board about depression within SeniorNet, the researchers rst read through all available posts within this discussion board in order to familiarise themselves with the members and get to know the communication patterns of the whole community, as well as of particular individual members. Once the researcher has immersed him/herself into the data, the coding can begin. A recommended way to acquire rst impressions is to highlight important key words that

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seem to describe the underlying idea [38]. The key words as well as accompanying notes provide the basis for the rst draft of codes. With the help of notes, it might even be possible at this stage to extract rst impressions about possible links between the codes. The process of extracting the codes out of the data set is iterative. Notes are a constant companion of the researcher during this process and they help him/her to rene and further characterise the codes and the relations between them. Although the researcher goes through these messages in chronological order, the process is iterative, and it is often necessary to go back several times to read a message again, make additional notes or rene the notes, because following the conversation and reading related messages adds to the understanding of the original message. At the end of this process, the researcher usually has a collection of notes that describe the data set. These notes are then grouped and used to determine the rst set of codes. This way, the researcher not only has a rst set of codes but also descriptions for each code and references to particular examples that describe this code in the data set. The detailed description of the codes can also help to sort them into higher-level categories. This process is repeated until so called saturation is reached. This is the case when no further codes can be extracted and the data set can be sorted into the existing codes without any discrepancies. In the conducted case study, four hundred (400) messages from the discussion board about depression within SeniorNet were investigated in more detail. It was found best to start with the earliest possible messages, as it would give the best insight in the context of the discussion. Starting from the last messages or messages from the middle of the discussion would have been likely to lead to missing some important information due to lack of knowledge from former messages. In case of the depression discussion board, this included messages between the 06/08/2000 and 14/02/2002. Through the iterative process, key terms and themes were then extracted out of the messages. This was done until saturation was reached and a rst set of codes was developed. The process was conducted inductively, which means that it was data-driven and not theory-driven. 3.4 Renement of the codes and unit of analysis After the rst set of codes (with the respective descriptions) have been determined, it is recommended to perform a rst informal check of the reliability concerning both the unit of analysis (segmentation) and the codes [37]. This can be done by an informal meeting with peer researchers in order to discuss the codes and rules for segmentation and investigate whether independent researchers would segment and code the messages in the same way.

After a rst set of codes had been established in the case study, the material so far was discussed with another researcher. By trying to segment and code text units together, discrepancies were found that still needed to be solved. For example, two codes that emerged from the data set were named Deep emotional support and Give help. One coder found it difcult to distinguish between these two codes as he argued that Deep emotional support is one way of providing help to another person (Give help). This rst informal reliability check showed that the researchers experience difculties in segmenting and coding the messages reliably. In order to improve the inter-coder reliability of the segmentation, it was discussed how to address discrepancies and a guide for the segmentation procedure and a rule-sheet for the coding were developed in order to ensure that the segmentation and the coding are as objective as possible. In the following, these two procedures are discussed in more detail. Concerning the segmentation, it is recommended to develop a guide for establishing the unit of analysis, especially when the researcher decided to choose a unit of analysis that is not explicit, but rather implicit (like meaning). In the reported case study, it was found helpful to think about three different aspects of the segmentation: the aim, the rules, and the procedure. This aim of the segmentation is a statement that makes it clear what the segmentation should full. In the specic case, the aim was to divide the text into as many pieces as needed without loosing coherence. Rules, on the other hand are statements that formulate specic characteristics of the segmentation. A set of several rules was established. An example of such rules is: A segment shall not be shorter than a sentence. Furthermore, the procedure describes the activities that have to be undertaken in order to segment a message. In the case study, the procedure started as follows: Firstly, read the whole message, and then divide the message into chunks that share the same meaning, then. This rule of segmentation can be developed out of a discussion with peer researchers. The aim is to come up with a narrow explanation of the procedure of the segmentation which is formulated in such a way that it gives clear instructions for the process of determining the segments. The guide gives a prescription of the process to be followed on such a level of detail, the division of the messages into segments will be as objective as possible. The guide for segmentation as it was developed for the case study is shown in Fig. 3. Concerning the coding, it was found useful to develop a detailed rule-sheet that aids the researcher in coding the text units. The idea behind the rule-sheet is that it provides questions which the researcher can answer in order to help nding the proper code for a segment. Questions that indicate certain characteristics can be drawn out of the descriptions of the codes and further rened and claried in

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Univ Access Inf Soc Fig. 3 Guide for segmentation procedure

a discussion with peer researchers. It is recommended to formulate the questions in a yesno format (e.g., is the segment about the situation of the poster?). Depending on how the researcher answers the question, (s)he might be led to other questions until nally (s)he would end up with the correct code for the respective text unit. The procedure of the development of the code scheme encourages the researchers to identify characteristics that distinguish the codes from each other. In the case of the distinction between the codes Deep emotional support and Give help, one important distinction that was identied was that text chunks coded into Give help should include specic advice about an issue. In contrast, the code Deep emotional support describes text chunks that express feelings of sympathy and understanding for the other person, without giving specic advice. This clarication also helps in further understanding the characteristics of the codes. Important aspects that emerge during the development of the rulesheet can thus be included in the description of the codes to clarify them further. Figure 4 shows the rule-sheet for the coding. It was used to ensure that the text units were coded objectively and in the same way during the nal coding. In order to sort the text chunks of the messages

into the correct code, the researchers went through the rule-sheet and answered the questions. The process started at the left top corner of the rule-sheet, asking whether the topic of the text chunk is mainly medical; if the answer to this question was no, one would go on asking whether the topic of the text chunk is technical, and so on. By going through the questions and answering them one by one, the rule-sheet would lead to the code that the text chunk should be sorted into. The outcome of the renements was a set of clearly dened codes and a detailed prescription about the process of the segmentation of the messages into text units with the same meaning. These assistive materials helped the researcher to ensure a coding that was as objective as possible. 3.5 Inter-coder reliability check It is often requiredeven for the qualitative approach of content analysisto perform a formal inter-coder reliability check [37]. The fact that the segmentation and the coding are reliable among different coders (at least two) backs up the consistency and validity of the code scheme and is essential as a basis for further interpretations and

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Is the topic mainly medical? Is it personalised?

yes

yes

Medical situation

no no

- Ask medical question - Give medical information

Is the topic technical?

yes

- Technical problems - Technical suggestion

no yes Ist it about activity within the depression discussion board? Does the content thank specific others or the whole community for something? Thanks Is it about encouragement of discussion and appreciation of the value of the discussion board? no Is the content about a problem of a third person? yes Third person story Is the content meta-information about the community activity? yes - Own activity - Activity of others

Does the content mainly refer to general activities within the community? (not specific support)

yes

no no Different channel

yes

Togetherness

no

no

Is the content for other members in the community (includes us)?

yes

What is the tone of the message ?

customized

Deep support

no generic Is the content about the poster ?

Does the message confim that the feelings / actions of another one are normal / right/ok ?

yes

Reassurance no

yes

What is the tone of the message ?

emotional

Does the content imply that the poster has made the same / similar experience, referring to a previous message ?

yes

Light support

Does the message give specific advice ?

yes

no non-emotional no Similar situation Does the message exdpress understanging / sympathy / feelings for another ?

Give help

Is it narrative ?

Does the content explicitly ask for help / support / prayers ? no no Off topic chitchat

yes

Does the content express wishes / blessings for specific others or the whole community ?

yes

yes

Best wishes Ask for support no

Deep emotional support

yes

Does the content refer to general personal problems / feelings / story ?

Is the content a joke or does it express humour / encouragement to play a game ?

yes

Humour

yes Is it on topic ? no

no

General feeling yes

Does the content ask about a wellbeing/situation of a specific other or whole community ?

yes

Interest

no Narration

Does the content express general encouragement, support and hope ?

yes

Light encouragement

Fig. 4 Rule-sheet for the coding procedure

conclusions. According to Mayring [37], it is recommended in qualitative research to train the coder before performing the reliability check.

The inter-coder reliability has to be checked for the segmentation as well as for the coding. As it is very complicated to measure the inter-coder reliability of these

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two criteria at once, it is recommended separating them and doing the checks independently. This ensures that each aspect is investigated thoroughly and that occurring unreliability can be traced back to the appropriate cause. 3.5.1 Inter-coder reliability of segmentation For the calculation of the reliability of the segmentation, it is important to investigate the segment boundaries that distinguish one segment from another. By comparing the segment boundaries of the different coders, it is investigated whether they put their boundaries at the same or at different positions. Furthermore, the number of agreements and disagreements are calculated. Every time the segment boundaries are determined at the same location within the text, this is counted as correct. On the contrary, every time a segment boundary occurs at a location where there was no segment boundary in the other coders data set, this is counted as wrong. Figure 5 presents two examples. With this method, there are only two possibilities, correct or wrong. Therefore, it is valid to measure the reliability in %. In both examples shown in Fig. 5, the inter-coder reliability would be 50%, as four of the segment boundaries have been identied identically, whereas four segment boundaries have been identied differently. In the case study, two independent researchers were asked to segment the rst ten messages of the data set into text chunks that shared the same meaning. Both researchers were familiar with the guide of segmentation and with the data set. They were given ten messages of the data set, and were asked to segment the messages into codes that shared the same meaning (following the guide of segmentation). After both of them completed the task, the segmentations of the two coders were compared and the reliability was calculated following the procedure shown in Fig. 5. The result for the reliability-test of the rst ten messages of the depression discussion board revealed an inter-coder reliability of 83%, which was considered to be satisfactory.

3.5.2 Inter-coder reliability of coding It is recommended to test the inter-coder reliability of the coding after testing the inter-coder reliability of the segmentation. To avoid confusion, the inter-coder reliability check of the coding should be done on a sample of presegmented messages. This ensures that discrepancies that may be found are due to the coding and not due to the segmentation. When it comes to the recommended way of calculating inter-coder reliability, there is a debate in literature about the best method. Whereas some think that calculating the percentage of agreed codes is sufcient [25], others claim that this method is not appropriate as it does not take into account the number of codes. They propose other methods of assessing inter-coder reliability, such as Cohens Kappa [5] and Krippendorffs Alpha [31]. As with qualitative content analysis, the threshold of intercoder reliability checks is not as rigid as in quantitative content analysis. The method of calculation should be chosen with respect to the research project and the analysis that will be done with the ndings. For example, when interpretations of the frequencies of the codes are a major part of the analysis, one of the more rigid methods of assessing the inter-coder reliability is appropriate. When using the percentage-calculation in order to asses the inter-coder reliability concerning the coding, it is recommended to aim for a result that is above 85% [25]. Respective thresholds for tentative agreement are 0.6 for Cohens Kappa [61] and 0.67 for Krippendorffs alpha [31]. A value of [0.8 is seen as sufcient for strong agreement. Once satisfactory inter-coder reliability is reached, all of the content can be coded and analysed. To measure the inter-coder reliability concerning the coding, a set of 10 pre-segmented messages were coded by two independent researchers. Both researchers were asked to assign codes to the text units, following the rule-sheet that was developed for coding (see Fig. 4). Each of the researchers did the coding individually and their coded

Fig. 5 Calculation of inter-coder reliability for the segmentation

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messages were compared afterwards. Cohens Kappa [5] resulted in 0.64, which according to Stemler [61] can be seen as substantial. This was considered as satisfactory for the purpose of this study, as the emphasis lays on qualitative, not quantitative analysis. Once the inter-coder reliability concerning the segmentation and the coding was established, the full set of data was coded by one researcher. 3.6 Data analysis Different types of analysis were performed with the full set of coded data, e.g., counting the frequencies of the codes, analysing the content of the codes qualitatively, using of word counts in order to analyse the frequencies and the characteristics of the words within the categories and codes, and analysing the interaction patterns of the codes (which code is followed by which within a conversation). For example, the most frequent category in the data set was Self-disclosure, which describes text chunks in which the poster discloses personal information. Counting the frequencies of the sub-categories (Similar situation, Ask for support, General feeling, Medical situation, and Narration) shows that people are much more likely to disclose information about themselves in order to trigger support than asking for support directly. Furthermore, the frequencies also showed that people mostly talked about their situation in an emotional way (General feeling) rather than in a narrative or medical way. Qualitative analysis backed up with quotes from the raw data set gives further insight into the issue. The variety of techniques used for analysis provided a rich description of the characteristics of the discussion board. Although the nature of the analysis was qualitative, the ndings could be enriched by some quantitative measures (e.g., frequencies). As the emphasis of this article is on the methodological issues, details about the ndings and conclusions of the study are not discussed here. A full report of the results and discussion can be found in [42].

4 Conclusion The goal of this article was to shed light on research methodologies that can be applied when studying online support communities for people with special needs. Towards this objective, issues have been highlighted that researchers come across when studying online support communities for people with disabilities and older people, and possible solutions have been discussed. Although the domain of online support communities for people with disabilities and older people is gaining research potential, there is little research on the methodological aspect

of studying these online communities. As a stopgap measure this paper has reviewed past research in this area and has presented a self-contained methodology that is based on qualitative content analysis for studying social interactions in online support communities. The article has shown that content analysis not only consists of quantitative analysis, such as statistical calculations with the frequencies of the codes, but can also be approached from a qualitative viewpoint, where the focus lies on extracting and investigating themes and relationships of the codes [56]. Furthermore, content analysis does not restrict the researcher whether to use an inductive or deductive approach when studying CMC. In order to set discussion into context, this paper has presented a case study, in which the discussed issues were set into practical context. A procedure for investigating online support communities for people with disabilities and older people has been presented, which is based on the method of qualitative content analysis. In this study, the inductive approach was emphasised, where the codes are derived from the data set. A procedure was proposed for an inductive approach to qualitative content analysis that can be followed and applied as a self-contained method in order to study social interactions in online communities. Focussing on online support communities for people with disabilities and older people, issues and challenges were addressed that arise when investigating this kind of online communities (e.g., ethical issues). Therefore, the proposed procedure specically addresses the needs of researchers and practitioners in the area of inclusive design. As the case study showed, this procedure can be used on its own, but is not restricted to that. Researchers are encouraged to embed the presented procedure in an overall ethnographic study of social interactions in online support communities. In combinations with other methods, like interviews, questionnaires, data logs, social network analysis, among others, it can be a valuable part of a triangulation of methods. It is believed that a triangulation of methods can enrich the ndings. Future research should therefore enhance the ndings by applying a variety of methods to study online support communities. Furthermore, investigations are encouraged of how the outcome of the procedure can be visualised to clarify the social interactions and user behaviour of online support community members. The application of the proposed procedure to a greater variety of online support communities could give valuable insight about its suitability and potential parts that need to be adjusted to the online support community that is being investigated. This could lead to developing this procedure further and rening current methodologies in a way that they can be optimally adjusted to the online community that is studied, as well as to the research question that drives the investigation.

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As the presented review of the current state of ethics in Internet research shows, no common consensus could be reached so far. Further research and investigations are necessary in order to explore the ethical considerations that Internet researchers should adhere to. The application of the proposed procedure in the reported case study yielded very promising results. However, only further application of the procedure to other online support communities can spot existing problems and improve the proposed procedure. Therefore, further critical applications of the proposed procedure in different contexts are necessary. It would for example be interesting to apply this procedure to the investigation of online support communities that use different technologies, like chats or mailing lists. Additionally, the application of this procedure to a variety of online support communities for people with mental or physical disabilities would give further insight into its applicability.

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