| The World Wide Web is widely used for medical communication, including online mutual-help communities of people focused on specific diseases. One successful example, sponsored by Breast Cancer Action Nova Scotia, provides high levels of support, information, and shared activities among many hundreds of people affected by breast cancer. Social capital theory suggests that a high level of trust helps to explain how groups such as this are able to thrive. According to this theory, trust is at the center of a virtuous circle of sharing, helping, and cooperation that provides a net benefit to all participants and even may benefit society in a broader way, for example by sharing a burden that is traditionally borne by family, friends, and healthcare providers.; Although online communication takes place under quite different conditions from the face-to-face interactions on which social capital research is predicated, this study shows that an online community, too, may be a site for social capital to accrue. This revelatory case study, based on the author's three-year participatory research with the <http://bca.ns.ca> community, explores how this website promotes transformations of trust.; The study finds a three-stage process in which (1) newcomers “lurk” in an environment that is rich with breast cancer symbolism and observe the community at their leisure; (2) participants are offered several ways to share personal disclosures, thus building mutual trust; and (3) a variety of shared activities, both virtual and face-to-face, help to build “thick trust.” This study shows that these three stages are sequential; are promoted by site design; and successfully move some participants to increased trust levels, thus explaining how a particular Web community can be beneficial to large numbers of users. The study suggests that an often overlooked, large group of beneficiaries may be lurkers. Use of medium theory provides a relevant new dimension by framing the transformation of social trust not just as a function of personal and group behavior but also as a function of the communication environment that is provided by computer-mediated communication and molded by both the site providers and the users themselves. |
