# How external stimuli drive physicians’ value co-creation behavior in online health communities: the mediating role of risk-benefit perceptions and moderating role of digital competency

## TL;DR

This study explores how external factors influence doctors' behavior in online health communities, showing that digital skills help them manage risks and benefits effectively.

## Contribution

The study introduces a model showing how risk-benefit perceptions mediate and digital competency moderates physicians' value co-creation behavior in OHCs.

## Key findings

- Perceived benefit positively influences physicians' value co-creation behavior, while perceived risk has a negative impact.
- Digital competency enhances the positive effect of perceived benefit and buffers the negative effect of perceived risk on physicians' behavior.
- External stimuli significantly influence physicians' risk-benefit perceptions, except for patient compliance's non-significant effect on perceived risk.

## Abstract

As Online Health Communities (OHCs) become increasingly integral to healthcare delivery, understanding how to actively engage physicians in value co-creation is a critical practical challenge. This study aims to investigate the mechanisms through which external stimuli influence physicians’ value co-creation behavior (VCB) in OHCs. Specifically, it examines the mediating role of risk–benefit perceptions and the moderating role of physicians’ digital competency in this relationship.

A cross-sectional survey was conducted among physicians in China with experience in OHCs. Based on the SOR framework and perceived value theory, a research model was developed encompassing environmental, technological, patient, and platform stimuli. Data from 547 valid questionnaires were analyzed using partial least squares structural equation modeling to test the hypotheses.

Perceived benefit exerted a positive effect on VCB, whereas perceived risk had a negative impact. With the exception of the non-significant negative effect of patient compliance on perceived risk, all external stimuli significantly influenced these perceptions. Digital competency significantly moderated these relationships, it enhanced the positive effect of perceived benefit on VCB, importantly, buffered the negative effect of perceived risk on VCB.

This study reveals that physicians’ VCB is driven by a nuanced risk–benefit calculus influenced by multilevel external stimuli. Digital competency plays a vital empowering role, helping physicians leverage benefits and mitigate risks. For OHCs operators and policymakers, our findings underscore the necessity of building a trustworthy environment through policy support and security features, while simultaneously implementing targeted training programs to enhance physicians’ digital competency, thereby fostering a vibrant and sustainable online health ecosystem.