{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:30:16Z","timestamp":1790073016509,"version":"4.0.1"},"reference-count":24,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Stigmatized women\u2019s health issues, such as polycystic ovary syndrome (PCOS) and endometriosis, are often marginalized or dismissed in traditional clinical settings. This drives individuals to seek peer support in anonymous online communities such as Reddit. While these digital platforms host critical discussions, they are often designed as static information repositories, failing to account for the complex emotional, temporal, and cultural dynamics that shape users\u2019 support needs. There is a disconnect between the lived experiences of users\u2014particularly feelings of clinical dismissal and the need for culturally specific advice\u2014and the design of the sociotechnical systems they rely on.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to deconstruct support practices in online women\u2019s health forums to provide a formative basis for designing more responsive digital health systems. We analyzed the intersections of discussion topics, emotional expression, temporal shifts (specifically the impact of the COVID-19 pandemic), and culturally situated discourse to identify unmet user needs and effective peer-support patterns.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a large-scale, mixed-methods analysis of 4995 posts and 460,317 comments from 5 major women\u2019s health subreddits (r\/WomensHealth, r\/TwoXChromosomes, r\/BirthControl, r\/Endometriosis, and r\/PCOS). Computational methods included Latent Dirichlet Allocation for topic modeling, Valence Aware Dictionary for Sentiment Reasoning for sentiment analysis, and the NRC Emotion Lexicon for granular emotion classification. We segmented the data into pre-, during-, and post\u2013COVID-19 periods to analyze temporal shifts. This quantitative analysis was complemented by a 2-phase qualitative thematic analysis to identify and characterize engagement patterns within 147 validated culturally situated threads.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Our analysis revealed that the most prevalent and emotionally negative topic was \u201cPain & Doctor Visits,\u201d which was uniquely characterized by high levels of fear and sadness linked to systemic clinical dismissal. The COVID-19 pandemic triggered a significant topical \u201cturn inward,\u201d with discussions shifting away from social or political issues and toward somatic concerns (eg, \u201cPCOS\u201d \u201cPain & Doctor Visits\u201d). Paradoxically, this period saw a simultaneous rise in both negative emotions (eg, fear and sadness) and expressions of community trust. Critically, our qualitative analysis of culturally situated discourse uncovered a consistent three-stage \u201cplaybook\u201d for effective support: (1)\n Affirmation<\/jats:italic>\n to establish psychological safety and validate cultural experiences; (2)\n Information Scaffolding<\/jats:italic>\n to provide actionable, culturally tailored advice; and (3)\n Intercultural Bridging<\/jats:italic>\n to facilitate community-wide learning and empathy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Online health forums operate as essential, resilient sociotechnical infrastructures that actively compensate for failures and gaps in formal health care. The \u201cAffirmation-Scaffolding-Bridging\u201d model identified in our research provides a clear, formative framework for designing future digital health interventions. These findings can guide the development of new platforms that are emotionally aware, culturally responsive, and adaptive to user needs and external crises.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/87782","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:25:06Z","timestamp":1773156306000},"page":"e87782-e87782","source":"Crossref","is-referenced-by-count":1,"title":["Peer Support in Online Women\u2019s Health Communities: Mixed Methods Formative Analysis of Reddit Discourse"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3812-7547","authenticated-orcid":false,"given":"Kimia Tuz","family":"Zaman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0542-699X","authenticated-orcid":false,"given":"Wordh Ul","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7715-1742","authenticated-orcid":false,"given":"Nova","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7668-5996","authenticated-orcid":false,"given":"Juan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Zad S Jimenez J Finlayson M . Hell hath no fury? Correcting bias in the NRC emotion lexicon. Presented at: Proceedings of the 5th Workshop on Online Abuse and Harms (WOAH 2021); Aug 6, 2021:102-113; Online. 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Sentiment analysis of the COVID-related r\/depression posts. arXiv. Preprint posted online on Jul 28, 2021. [doi: 10.48550\/ARXIV.2108.06215]"},{"key":"R10","unstructured":"Nwaoha F Gaffar Z Chun HJ Sokolova M . Longitudinal sentiment topic modelling of reddit posts. arXiv. Preprint posted online on Jan 24, 2024. URL: https:\/\/arxiv.org\/pdf\/2401.13805 [Accessed 31-08-2025]"},{"key":"R11","unstructured":"Murray C Mitchell L Tuke J Mackay M . Symptom extraction from the narratives of personal experiences with COVID-19 on reddit. arXiv. Preprint posted online on May 21, 2020. URL: https:\/\/arxiv.org\/pdf\/2005.10454 [Accessed 31-08-2025]"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Zaman KT Hasan WU Li J . Exploring the dynamics of online social support for ADRD caregivers: a study on online peer support groups. Presented at: 2023 IEEE International Conference on E-health Networking, Application & Services (Healthcom); Dec 15-17, 2023; Chongqing, China. Mar 25, 2024.[doi: 10.1109\/Healthcom56612.2023.10472395]","DOI":"10.1109\/Healthcom56612.2023.10472395"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1177\/009365092019001003","article-title":"Interpersonal Effects in Computer-Mediated Interaction","volume":"19","author":"Walther","journal-title":"Communic Res"},{"issue":"CSCW3","key":"R14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3434184","article-title":"Patterns of patient and caregiver mutual support connections in an online health community","volume":"4","author":"Levonian","journal-title":"Proc ACM Hum-Comput Interact"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1609\/icwsm.v8i1.14526","article-title":"Mental health discourse on Reddit: self-disclosure, social support, and anonymity","volume":"8","author":"De Choudhury","journal-title":"Proceedings of the International AAAI Conference on Web and Social Media"},{"issue":"3","key":"R16","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1089\/1094931041291295","article-title":"The online disinhibition effect","volume":"7","author":"Suler","journal-title":"Cyberpsychol Behav"},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Yu B . The emotional world of health online communities. In: iConference \u201911: Proceedings of the 2011 iConference. 2011:806-807. 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Cross-cultural differences in mental health expressions on social media. Presented at: Proceedings of the 3rd Workshop on Cross-Cultural Considerations in NLP (C3NLP 2025); Albuquerque, New Mexico. 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