The study explores patient-to-patient representation of customer-to-customer (C2C) value co-creation within social media health communities. It investigates the influence of online social capital factors on C2C value co-creation behaviours via the sense of belongingness (SOB). The mediating effect of SOB explains the underlying mechanism behind the social capital–C2C value co-creation relationship, which earlier studies ignored. The study also examines the influence of value co-creation on individuals’ well-being. A quantitative approach is adopted to examine the relationships, where the surveyed data are tested using structural equation modelling. The analysis shows that social capital dimensions positively influence the individuals’ SOB to the community, affecting the C2C co-creation behaviours. Furthermore, among C2C value co-creation behaviours, responsible and helping behaviours positively influence subjective well-being, whereas information sharing does not. Overall, the study contributes to the customer domain of value co-creation by highlighting the antecedents and consequences of C2C co-creation.
AndersonK. C., AlbinssonP. A., & DucarrozC. (2024). Peer-to-peer community on social media: An exploratory cross-cultural study. Journal of Consumer Behaviour, 23(3), 1285–1306.
2.
AntheunisM. L., TatesK., & NieboerT. E. (2013). Patients’ and health professionals’ use of social media in health care: Motives, barriers and expectations. Patient Education and Counseling, 92(3), 426–431.
3.
BarrS. M., BudgeS. L., & AdelsonJ. L. (2016). Transgender community belongingness as a mediator between strength of transgender identity and well-being. Journal of Counseling Psychology, 63(1), 87–97.
4.
BaumeisterR. F., & LearyM. R. (1995). The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117(3), 497–529.
5.
BenetoliA., ChenT. F., & AslaniP. (2017). Consumer health-related activities on social media: Exploratory study. Journal of Medical Internet Research, 19(10), e352.
6.
BhattiZ. A., ArainG. A., YasinH. M., KhanM. A., & AkramM. S. (2021). The role of integrated offline/online social activity and social identification in Facebook citizenship behaviour formation. Information Technology & People, 34(5), 1419–1438.
7.
BourdieuP. (1984). Distinction: A social critique of the judgement of taste. Routledge, Taylor & Francis Group.
8.
BowlbyJ. (1969). Attachment and loss (No. 79). Random House.
9.
BruhnM., SaleschusM., & HadwichK. (2024). Development trends of customer-dominant logic. In Customer-dominant logic: Customer-dominant management as a new target in relationship marketing (pp. 401–408). Springer Fachmedien Wiesbaden.
10.
BuiM. T., & JengD. J. F. (2022). Capture coproduction behavior in networking alumni communities: Progress from platform belongingness, knowledge sharing, and citizenship behavior. Journal of Enterprising Communities: People and Places in the Global Economy, 16(1), 46–73.
11.
CaoY., LinJ., & ZhouZ. (2022). Promoting customer value co-creation through social capital in online brand communities: The mediating role of member inspiration. Computers in Human Behavior, 137, 107440.
12.
ChenC.-J., & HungS.-W. (2010). To give or to receive? Factors influencing members’ knowledge sharing and community promotion in professional virtual communities. Information & Management, 47(4), 226–236.
13.
ChenH., LiX., LiB., & HuangA. (2017). Negative trust and depression among female sex workers in Western China: The mediating role of thwarted belongingness. Psychiatry Research, 256, 448–452.
14.
ChiuC.-M., HuangH.-Y., ChengH.-L., & SunP.-C. (2015). Understanding online community citizenship behaviors through social support and social identity. International Journal of Information Management, 35(4), 504–519.
15.
ColemanJ. S. (1988). Social capital in the creation of human capital. American Journal of Sociology, 94(94), 95–120.
16.
ConnollyR., SanchezO. P., CompeauD., & TaccoF. M. D. S. (2023). Understanding engagement in online health communities: A trust-based perspective. Journal of the Association for Information Systems, 24(2), 345–378.
17.
De CremerD., & LeonardelliG. J. (2003). Cooperation in social dilemmas and the need to belong: The moderating effect of group size. Group Dynamics: Theory, Research, and Practice, 7(2), 168–174.
18.
DienerE., EmmonsR. A., LarsenR. J., & GriffinS. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71–75.
19.
DiepD. M., & MaiL. T. T. (2025). How does sense of belonging bridge the linkage between customer engagement and word of mouth in online nonprofit communities?Journal of Nonprofit & Public Sector Marketing, 1–24.
20.
EllisonN. B., LampeC., & SteinfieldC. (2010). With a little help from my friends: How social network sites affect social capital processes. In A networked self: Identity, community and culture on social network sites (pp. 132–153). Routledge.
21.
EllisonN. B., SteinfieldC., & LampeC. (2007). The benefits of Facebook “friends:” Social capital and college students’ use of online social network sites. Journal of Computer-mediated Communication, 12(4), 1143–1168.
22.
FanD. X., BuhalisD., FragkakiE., & TsaiY. R. (2025). Achieving senior tourists’ active aging through value co-creation: A customer-dominant logic perspective. Journal of Travel Research, 64(2), 427–443.
23.
FangY.-H., LiC.-Y., ArainG. A., & BhattiZ. A. (2019). How does participation and browsing affect continuance intention in virtual communities? An integration of curiosity theory and subjective well-being. Behaviour & Information Technology, 40(3), 221–239.
24.
FrowP., McColl-KennedyJ. R., & PayneA. (2016). Co-creation practices: Their role in shaping a health care ecosystem. Industrial Marketing Management, 56, 24–39.
25.
FullerJ. (2006). Why consumers engage in virtual new product developments initiated by producers. Advances in Consumer Research, 33, 639.
26.
GaoW., LiuZ., & LiJ. (2017). How does social presence influence SNS addiction? A belongingness theory perspective. Computers in Human Behavior, 77, 347–355.
27.
GefenD. (2000). E-commerce: The role of familiarity and trust. Omega, 28(6), 725–737.
28.
GilmourJ., MachinT., BrownlowC., & JeffriesC. (2020). Facebook-based social support and health: A systematic review. Psychology of Popular Media, 9(3), 328.
29.
GuanZ. (2016). The effect of need to belong on online social behaviors and cognitive interactions[Doctoral dissertation].
30.
HairJ. F., BlackW. C., BabinB. J., & AndersonR. E. (2010). Multivariate data analysis. Pearson College Division.
31.
HardymanW., DauntK. L., & KitchenerM. (2015). Value co-creation through patient engagement in health care: A micro-level approach and research agenda. Public Management Review, 17(1), 90–107.
32.
HeM., WangT., XiaH., & DaiJ. (2021). Empirical research on how social capital influence inter-organizational information systems value co-creation in China. Asia Pacific Business Review, 28(4), 493–517.
33.
HeinonenK., & StrandvikT. (2015). Customer-dominant logic: Foundations and implications. Journal of Services Marketing, 29(6/7), 472–484.
34.
HeinonenK., StrandvikT., MickelssonK., EdvardssonB., SundströmE., & AnderssonP. (2010). A customer-dominant logic of service. Journal of Service Management, 21(4), 531–548.
35.
HenselerJ., HubonaG., & RayP. A. (2016). Using PLS path modeling in new technology research: Updated guidelines. Industrial Management & Data Systems, 116(1), 2–20.
36.
HINT Survey. (2019). Health information national trend survey on social media usage for health. https://hints.cancer.gov/data/survey-instruments.aspx
37.
JoinerK. A., & LuschR. F. (2016). Evolving to a new service-dominant logic for health care. Innovation and Entrepreneurship in Health, 2016(3), 25–33.
38.
KathuriaT., & PandyaA. K. (2020). Listen, I am too responsible! Effect of schooling on sense of trust, responsibility and belongingness to the community of children working on the street in Chandigarh City, India. Children and Youth Services Review, 119, 105527.
39.
KimJ. (2019). Customers’ value co-creation with healthcare service network partners: The moderating effect of consumer vulnerability. Journal of Service Theory and Practice, 29(3), 309–328.
40.
KimH. C., & ZhuZ. Y. (2023). A gender perspective on the use of mobile social network applications to enhance the social well-being of people with physical disabilities: The mediating role of sense of belonging. Behaviour & Information Technology, 42(4), 444–457.
41.
KiteJ., FoleyB. C., GrunseitA. C., & FreemanB. (2016). Please like me: Facebook and public health communication. PLoS One, 11(9), e0162765.
42.
KumarA., ShankarA., TiwariA. K., & HongH. J. (2023). Understanding dark side of online community engagement: An innovation resistance theory perspective. Information Systems and e-Business Management, 27, 13–39.
43.
LatifM. S., WangJ. J., & ShahzadM. (2024). Do ethics drive value co-creation behavior in online health communities?Information Technology & People, 37(1), 1–28.
44.
LaudG., KarpenI. O., MulyeR., & RahmanK. (2015). The role of embeddedness for resource integration: Complementing SD logic research through a social capital perspective. Marketing Theory, 15(4), 509–543.
45.
LazarusD., KrishnaA., & DhakaS. (2014). Co-creation willingness matrix and capability continuum for classification and scaling of services. Journal of Global Marketing, 27(4), 213–225.
46.
LemonB. W., BengtsonV. L., & PetersonJ. A. (1972). An exploration of the activity theory of aging: Activity types and life satisfaction among in-movers to a retirement community. Journal of Gerontology, 27(4), 511–523.
47.
LevinsonW., KaoA., KubyA., & ThistedR. A. (2005). Not all patients want to participate in decision making: A national study of public preferences. Journal of General Internal Medicine, 20(6), 531–535.
48.
LinH.-F. (2008). Determinants of successful virtual communities: Contributions from system characteristics and social factors. Information & Management, 45(8), 522–527.
49.
LinZ., ChenY., & FilieriR. (2017). Resident-tourist value co-creation: The role of residents’ perceived tourism impacts and life satisfaction. Tourism Management, 61, 436–442.
50.
Ling-Yee LiE., LiuB. S. C., & LukS. T. (2017). Customer participation behavior in high-versus low-contact services: The multiple roles of customer trust. Journal of Global Marketing, 30(5), 322–341.
51.
LiuS., XiaoW., FangC., ZhangX., & LinJ. (2020). Social support, belongingness, and value co-creation behaviors in online health communities. Telematics and Informatics, 50, 101398.
52.
MarintheG., BrownG., JaubertT., & ChekrounP. (2021). Do it for others! The role of family and national group social belongingness in engaging with COVID-19 preventive health behaviors. Journal of Experimental Social Psychology, 98, 104241.
53.
MathisE. F., KimH. Lina, UysalM., SirgyJ. M., & PrebensenN. K. (2016). The effect of co-creation experience on outcome variable. Annals of Tourism Research, 57, 62–75.
54.
MayerR. C., DavisJ. H., & SchoormanF. D. (1995). An integrative model of organizational trust. The Academy of Management Review, 20(3), 709–734.
55.
McColl-KennedyJ. R., VargoS. L., DaggerT. S., SweeneyJ. C., & van KasterenY. (2012). Health care customer value co-creation practice styles. Journal of Service Research, 15(4), 370–389.
56.
McLure WaskoM., & FarajS. (2000). ‘It is what one does’: Why people participate and help others in electronic communities of practice. The Journal of Strategic Information Systems, 9(2–3), 155–173.
57.
McPhersonM., Smith-LovinL., & CookJ. M. (2001). Birds of a feather: Homophily in social networks. Annual Review of Sociology, 27(1), 415–444.
58.
MeekS., OgilvieM., LambertC., & RyanM. M. (2019). Contextualising social capital in online brand communities. Journal of Brand Management, 26(4), 426–444.
59.
MehraA., PaulJ., & KauravR. P. S. (2021). Determinants of mobile apps adoption among young adults: Theoretical extension and analysis. Journal of Marketing Communications, 27(5), 481–509.
60.
NahapietJ., & GhoshalS. (1998). Social capital, intellectual capital, and the organizational advantage. Academy of Management Review, 23(2), 242–266.
61.
NambisanS., & NambisanP. (2008). How to profit from a better virtual customer environment. MIT Sloan Management Review, 49(3), 53–61.
62.
NambisanP., & WattJ. H. (2011). Managing customer experiences in online product communities. Journal of Business Research, 64(8), 889–895.
63.
Osei-FrimpongK., & Owusu-FrimpongN. (2017). Value co-creation in health care: A phenomenological examination of the doctor-patient encounter. Journal of Nonprofit & Public Sector Marketing, 29(4), 365–384.
64.
ParkJ. H., GuB., LeungA. C. M., & KonanaP. (2014). An investigation of information sharing and seeking behaviors in online investment communities. Computers in Human Behavior, 31, 1–12.
65.
PierceJ. L., KostovaT., & DirksK. T. (2001). Toward a theory of psychological ownership in organizations. Academy of Management Review, 26(2), 298–310.
66.
Pitkin DeroseK., & VardaD. M. (2009). Social capital and health care access. Medical Care Research and Review, 66(3), 272–306.
67.
PreacherK. J., & HayesA. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.
68.
PutnamR. D. (1993). The prosperous community: Social capital and public life. The American Prospect, 13, 35–42.
69.
QinH., Patrick RauP.-L., & SalvendyG. (2009). Measuring player immersion in the computer game narrative. International Journal of Human-Computer Interaction, 25(2), 107–133.
70.
ReisH. T., ManiaciM. R., CaprarielloP. A., EastwickP. W., & FinkelE. J. (2011). Familiarity does indeed promote attraction in live interaction. Journal of Personality and Social Psychology, 101(3), 557.
71.
RihovaI., BuhalisD., GouthroM. B., & MoitalM. (2018). Customer-to-customer co-creation practices in tourism: Lessons from customer-dominant logic. Tourism Management, 67, 362–375.
72.
RihovaI., BuhalisD., MoitalM., & Beth GouthroM. (2013). Social layers of customer-to-customer value co-creation. Journal of Service Management, 24(5), 553–566.
73.
RiottaS., & BruccoleriM. (2021). Revisiting the patient-physician relationship through the lens of value co-creation and defensive medicine. Journal of Service Theory and Practice, 31(6), 868–892.
74.
SahaV., HollebeekL. D., VenkateshM., GoyalP., & ClarkM. (2025). Value co-creation: A metatheory unifying framework and fundamental propositions. Marketing Intelligence & Planning, 43(3), 574–603.
75.
SamsaÇ., & YüceA. (2022). Understanding customers hospital experience and value co-creation behavior. The TQM Journal, 34(6), 1860–1876.
76.
Sánchez-FrancoM. J., & RoldánJ. L. (2015). The influence of familiarity, trust and norms of reciprocity on an experienced sense of community: An empirical analysis based on social online services. Behaviour & Information Technology, 34(4), 392–412.
77.
SharmaS., ConduitJ., & Rao HillS. (2017). Hedonic and eudaimonic well-being outcomes from co-creation roles: A study of vulnerable customers. Journal of Services Marketing, 31(4/5), 397–411.
78.
ShenY.-C., HuangC.-Y., ChuC.-H., & LiaoH.-C. (2010). Virtual community loyalty: An interpersonal-interaction perspective. International Journal of Electronic Commerce, 15(1), 49–74.
79.
ShenC., WangM. P., ChuJ. T., WanA., ViswanathK., ChanS. S. C., & LamT. H. (2017). Sharing family life information through video calls and other information and communication technologies and the association with family well-being: Population-based survey. JMIR Mental Health, 4(4), e8139.
80.
ShiraziF., WuY., HajliA., ZadehA. H., HajliN., & LinX. (2021). Value co-creation in online healthcare communities. Technological Forecasting and Social Change, 167, 120665.
81.
SkandalisA. (2023). Transitional space and new forms of value co-creation in online brand communities. Journal of Business Research, 155, 113392.
82.
SmithJ. B. (1998). Buyer-seller relationships: Similarity, relationship management, and quality. Psychology and Marketing, 15(1), 3–21.
83.
SoperD. S. (2020). A priori sample size calculator for structural equation models[Software]. https://www.danielsoper.com/statcalc/calculator.aspx?id=89
84.
Statista. (2023). Global social networks ranked by number of users. Biggest social media platform[Report]. https://www.statista.com/statistics/272014/global-social-networks-ranked-by-number-of-users/
85.
SteinJ. P., Linda BrevesP., & AndersN. (2024). Parasocial interactions with real and virtual influencers: The role of perceived similarity and human-likeness. New Media & Society, 26(6), 3433–3453.
86.
StellefsonM., PaigeS., AppersonA., & SprattS. (2019). Social media content analysis of public diabetes Facebook groups. Journal of Diabetes Science and Technology, 13(3), 428–438.
87.
Stewart LoaneS., & WebsterC. M. (2017). Social capital and consumer value co-created within an online health community. Journal of Nonprofit & Public Sector Marketing, 29(3), 317–345.
88.
StrandvikT., HeinonenK., & VollmerS. (2018). Revealing business customers’ hidden value formation in service. Journal of Business & Industrial Marketing, 34(6), 1145–1159.
89.
SwarB., HameedT., & ReychavI. (2017). Information overload, psychological ill-being, and behavioral intention to continue online healthcare information search. Computers in Human Behavior, 70, 416–425.
90.
SweeneyJ. C., DanaherT. S., & McColl-KennedyJ. R. (2015). Customer effort in value cocreation activities: Improving quality of life and behavioral intentions of health care customers. Journal of Service Research, 18(3), 318–335.
TajfelH. (1978). Social categorization, social identity and social comparison. InTajfelH.(Ed.), Differentiation between social groups: Studies in the social psychology of intergroup relations (pp. 61–76). Academic Press.
93.
Tari KasnakogluB. (2016). Antecedents and consequences of co-creation in credence-based service contexts. The Service Industries Journal, 36(1–2), 1–20.
94.
TeoH.-H., ChanH.-C., WeiK.-K., & ZhangZ. (2003). Evaluating information accessibility and community adaptivity features for sustaining virtual learning communities. International Journal of Human-Computer Studies, 59(5), 671–697.
95.
TuY., NeuhoferB., & VigliaG. (2018). When co-creation pays: stimulating engagement to increase revenues. International Journal of Contemporary Hospitality Management, 30(4), 2093–2111.
96.
TuunanenT., LumivaloJ., VartiainenT., ZhangY., & MyersM. D. (2024). Micro-level mechanisms to support value co-creation for design of digital services. Journal of Service Research, 27(3), 381–396.
97.
UhrichS., GrohsR., & KoenigstorferJ. (2024). Customer-to-customer interactions in the sport fan context: typology, framework (C2CIF) and directions for future research. Journal of Service Management, 35(1), 53–70.
98.
VargoS. L., & LuschR. F. (2004). Evolving to a new dominant logic for marketing. Journal of Marketing, 68(1), 1–17.
99.
VargoS. L., & LuschR. F. (2008). Service-dominant logic: continuing the evolution. Journal of the Academy of Marketing Science, 36(1), 1–10.
100.
VargoS. L., & LuschR. F. (2014). Evolving to a new dominant logic for marketing. In The service-dominant logic of marketing (pp. 3–28). Routledge.
101.
VirléeJ. B., HammediW., & van RielA. C. R. (2020). Healthcare service users as resource integrators: Investigating factors influencing the co-creation of value at individual, dyadic and systemic levels. Journal of Service Theory and Practice, 30(3), 277–306.
102.
WangY., ZhangM., & MingY. (2022). What contributes to online communities’ prosperity? Understanding value co-creation in product-experience-shared communities (PESCs) from the view of resource integration. Information Technology & People, 35(7), 2241–2262.
103.
WeinsteinN., & RyanR. M. (2010). When helping helps: Autonomous motivation for prosocial behavior and its influence on well-being for the helper and recipient. Journal of Personality and Social Psychology, 98(2), 222–244.
104.
WHO. (2023). Top 10 causes of death. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
105.
YangX. (2025). Social capital and consumer co-creation behaviors on tourism social media: the mediating role of psychological ownership. Tourism Review, 80(5), 1141–1155.
106.
YiY., & GongT. (2013). Customer value co-creation behavior: Scale development and validation. Journal of Business Research, 66(9), 1279–1284.
107.
ZadehA. H., ZolfagharianM., & HofackerC. F. (2019). Customer–customer value co-creation in social media: Conceptualization and antecedents. Journal of Strategic Marketing, 27(4), 283–302.
108.
ZhaoL., LuY., WangB., ChauP. Y. K., & ZhangL. (2012). Cultivating the sense of belonging and motivating user participation in virtual communities: A social capital perspective. International Journal of Information Management, 32(6), 574–588.
109.
ZhaoJ., WangT., & FanX. (2015). Patient value co-creation in online health communities: Social identity effects on customer knowledge contributions and membership continuance intentions in online health communities. Journal of Service Management, 26(1), 72–96.
110.
ZieblandS. U. E., & WykeS. (2012). Health and illness in a connected world: How might sharing experiences on the internet affect people’s health?The Milbank Quarterly, 90(2), 219–249.
