Objective:

To explore how anonymity affects user participation, specifically self-disclosure and social feedback, in online health communities (OHCs) and how this relationship is moderated by illness stage.

Key Findings:

• Anonymity influences both self-disclosure and social feedback behaviors in OHCs, impacting user engagement.
• Illness stage moderates the effects of anonymity on user interactions, suggesting tailored approaches may be necessary.
• Users may employ different identity strategies based on their needs at various stages of the cancer journey, indicating a dynamic approach to identity management.

Interpretation:

The findings suggest that identity management in OHCs is dynamic and context-dependent, influenced by the user's current illness stage, which can inform platform design to enhance user support.

Limitations:

• Existing research often treats identity choice as static, failing to account for within-person variations over time, which may limit understanding of user behavior.
• The study's focus is limited to a specific platform (Zhihu) and may not generalize to all OHCs, potentially affecting the applicability of findings.

Conclusion:

Understanding the dynamics of anonymity and identity management can inform the design of OHC platforms to better support users at different illness stages, paving the way for future research in this area.