Table 3.

Participant rationales for health information communication approaches

Health information communication approach	Verbatim quotes from interview participants
Free health communicators (FCs)	Altruism: It’s because I believe that we should be – we live in a world where we need to be purposeful and helpful, that I’m able to communicate. Facebook provides such a vast area of people who can benefit from it that I think it’s the perfect tool to use.
	Instrumental support: Well, I want to keep everybody up-to-date on what’s going on with me, but then somebody else might have some idea or know another way to treat it, or know a good doctor. [I]t's good information for me. That way everybody's informed of it.
	Social support: Like with diabetes, it helps when you're trying to keep your blood sugar within check, it helps to have other people kind of rooting you on, giving you their experiences, telling you things that they've done to get their blood sugar down. Mainly, I guess, support.
	Privacy and stigma: Why I communicate health information? Believe it or not, I think it's easier sometimes to ask a whole group of people kind of anonymously on Facebook than it is to ask a doctor face-to-face.… I think, when you're on Facebook, you're kind of anonymous.
	Convenience: Well, the private messages just seem to be more convenient, and it’s – well, it’s not any more instant than e-mail, it just kind of happened that way. I just, I'm in Facebook, and I can private message somebody right there instead of going back into my e-mail.
Moderate health communicators (MCs)	Altruism: I would post, “Hey, I have some kind of issue with my kidneys.” All that’s gonna do is open up, “What kind of issue? Oh my gosh, are you okay? What are they gonna do?” I have no room to answer a million questions. If I were to post about it, which unless they tell me it was something relative to diabetes, and the information can help someone else, that’s the only way I would post it. If not, I mean it’s my personal information.
	Instrumental support: I belong to a diabetes care group that I get diabetes information on, although I don’t always find it to be real useful to me, I am controlling my diabetes with diet and exercise and it will only be one year since my diagnosis on September 25th. I'm fairly new to this, so I don’t find a lot of the information about meds and that kind of thing to be very helpful. I tend to look at more of their information on diet.
	Social support: I had a post this morning, I had a hypoglycemia issue about 4:30 this morning and I just, I was feeling poorly. I got something and I was kind of recovering, and I just posted an, “Argh, blood sugar dropping” on that, and that’s about it, really. I haven’t really posted anything related to health. The only thing I've done with the alternative diabetes is post my blood sugars in the morning, and I've just been on, associated with that group for just a few days, but I haven’t gotten very far with that. I may open up more, given that it’s a focus group on diabetes control.
	Privacy and stigma: In some ways, I’m embarrassed or ashamed to have it, but at the same time on the ADA board, or the forum, or even things from your site, like knowin’ your Facebook page.… As long as it’s just not—I guess my big thing is, is that as long as it’s not used against me in terms of employment, being rejected for something, that’s all.
	Convenience: I think [Facebook is] far more accessible, because I can go to it whenever I want to, rather than having to wait on somebody else’s schedule. To me, that is an important factor, and I have learned to appreciate it more as I've been involved with Facebook.
Off-Facebook-only health communicators (OCs)	Instrumental support: I belong to an online community where I share information about one of my conditions and also take surveys about conditions as well as occasionally participate in in-person focus groups regarding a medical condition so I don't feel a need to do this on [F]a[c]ebook.
	Social support: No. I mean the diabetes [group], but I don’t really post anything. I just see if anybody has any recommendations for anything or links to where, you know, make it, help with prescriptions and what not.
	Privacy and stigma: Well, because even though I have a lot of family and friends on [Facebook] – I mean I don’t really know how to describe this. It’s not really everybody’s business of what’s going on with my health. Just immediate family.
	Convenience: Just the typing. I type all day at work, so it’s a pain in the butt to have to do it when I’m not there. It’s much easier to pick up the phone and call.
	Facebook knowledge: I really don't know how exactly Facebook works other than reading comments from family members, friends etc who's comments I occasionally comment on.
Nondisclosing health communicators (NCs)	Instrumental support: Same as regarding Facebook: health information is for the use of healthcare professionals and myself. Communicating with others has shown to be of little value (to me) in handling my diabetes or other health issues.
	Social support: Who cares about me?
	Privacy and stigma: I refuse to be the typical senior who whines about health problems all the time. I manage my health problems and keep most of it to myself.
	Convenience: I don't have access to a computer 2 hrs. a day at the public library. Most of my time is taken up dealing with emails.