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Interact."],"published-print":{"date-parts":[[2017,12,6]]},"abstract":"<jats:p>Expressive writing has been shown to improve physical, mental, and social health outcomes for patients struggling with difficult diagnoses. In many online health communities, writing comprises a substantial portion of the user experience, yet little work has explored how writing itself affects user engagement. This paper explores user engagement on CaringBridge, a prominent online community for writing about personal health journeys. We build a survival analysis model, defining a new set of variables that operationalize expressive writing, and comparing these effects to those of social support, which are well-known to benefit user engagement. Furthermore, we use machine learning methods to estimate that approximately one third of community members who self-identify with a cancer condition cease engagement due to literal death. 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