JMIR Publications

ABSTRACT

Background:

Tinnitus Talk (TT) is a non-profit online self-help forum. Asking inactive users about reasons for discontinued usage of health-related online platforms such as TT is important for quality assurance.

Objective:

To explore reasons for discontinued use of TT and relations to perception of TT as well as age in former TT users, who did not log into the TT platform anymore.

Methods:

Initially, 13,745 users that did not use TT within the previous two months were contacted and the response rate was 20.47% (N = 2,814). After dataset filtering, a total of 2,172 past members of TT were included in the analyses. Nine pre-defined reasons for discontinued usage of TT were included in the survey as well as one open question. Moreover, there were 14 pre-defined questions focusing on perception of TT (usefulness, content, community, quality of members’ posts). Mixed methods analyses were conducted. Frequencies and correlations were calculated for quantitative data and Grounded Theory Methodology was utilized for exploration of the qualitative data.

Results:

Analyses of quantitative data revealed reasons for discontinued use of TT as well as associations of reasons with perceptions of TT and age. From the list of eight pre-defined reasons for discontinued use of TT, the most frequent one was that users could not find the information they were looking for (f=451, 16.7%). Overall, the highest rated perception of TT was for content was the ease of understanding (M=3.9, SD=0.64). A high number (almost 40%) of participants provided an additional free text for other reasons. Qualitative analyses identified in total 1,654 particular reasons, out of which more than 93% (f=1,544) of reasons could be inductively coded. The coding system consisted of 33 thematically labeled codes, clustered into ten categories. The most frequent other reason was the thinking that there is no cure or help for tinnitus symptoms (24.3%). Significant correlations (P < .001) were observed between reasons for discontinued usage and perception of TT. Several reasons for discontinued usage were associated with the examined dimensions of perception of TT (usefulness, content, community, as well as quality of members’ posts). Moreover, significant correlations (P < .001) between age and reasons for discontinued use were found, for example, older age being negatively associated with not needing TT anymore because of improvement. In addition, older participants had in general less positive perception of TT than younger ones (P < .001).

Conclusions:

The present study contributes to the understanding of reasons for discontinued usage of online self-help platforms, which were reported in other studies usually just as drop-out rates. Furthermore, groups of users who did not benefit from the use of TT were identified, and several practical implications for improvement of TT´s structure, content, and goals were suggested.