Table 2.

Themes.

Themes			Subthemes
Motivation
	Seeking information and support	Gaining knowledge about asthma illness and its treatment Validation of own experiences in the context of asthma Feeling less isolated Talking with fellow sufferers Enjoying reading conversations of users one got to know
	Helping others	Giving advice that could potentially save a life Supporting others with asthma and their carers Making people with asthma and their carers feeling less isolated Show others that living with chronic conditions is not always negative Making sure people with asthma take their disease seriously Disseminating of scientific information
	Feeling rewarded through helping	Positive feeling when helping others Replacement of role
	Financial or social recognition not important	Not important: reward is helping others, enjoying interactions Not important: all users shall be equal with equal voice importance Not important: voluntary nature—financial incentives potentially causing misuse Unsure/yes important: recognition of sensible/knowledgeable users
Awareness of the limits of peer self-management support
	Decisions on posts to reply to	Drawing from personal experience Providing a different point of view
	Types of support offered	Behavioral and emotional peer self-management support Empowering patients and carers through own experience Signposting to source information and support
	Medical self-management needs HCPs’a input	Showing appropriate insight of potentially serious medical issues Advising to seek medical help with appropriate urgency
Challenges
	Top 3 problems and difficulties encountered	Worrying about users struggling with asthma and not seeking medical help as appropriate Misunderstanding, spam, miracle cures, or dangerous ideas Negative tone of some conversations
	Posts causing superusers’ worries	Religion-based advocacies; derogatory, emotionally challenging posts Offering bad advice or indicating that users have little knowledge about asthma and its gravity
	Need of additional policies and guidance	Improve awareness of existing policies and guidance for safe engagement with asthma OHCsb Policies and guidance about buying asthma medications on the web Quicker removal of bad posts/advice
HCPs and asthma OHCs
	HCPs’ awareness of engagement with asthma OHCs	Engagement with asthma OHCs is not discussed during consultations with HCPs Engagement with asthma OHCs is not discouraged by HCPs HCPs’ belief that engagement with asthma OHCs focuses patients on illness and potentially increases their anxiety
	HCPs’ promotion of engagement with OHCs	HCPs should direct patients with LTCsc to moderated/trusted OHCs Advantage is obtaining behavioral and emotional self-management support that HCPs may not be able to offer Ways of promotion: posters up in the waiting rooms of relevant hospital departments and General Practice (GP) surgeries and face-to-face discussion of OHC information by nurses during asthma clinics
	Suggestions to reassure HCPs about OHC engagement	Clearer statements about contacting HCPs for medical self-management Improving HCPs’ awareness of benefits of online peer support; robust evaluation of the effects of OHC engagement Readily accessible guidance about keeping safe in social media Clear rules about posting activity; regular, nonintrusive participation of moderators
	HCPs’ participation in OHCs	Benefits: for the opportunity to get worries and questions addressed, as long as HCPs’ identity is stated Difficulties: potential scrutiny of all posts, limitation of expression of different points of view, lack of sufficient clinical details, and issues with code of conduct of HCP registering bodies

^aHCP: health care professional.

^bOHC: online health community.

^cLTC: long-term condition.