Online Psychosocial Support Among Women with Endometriosis in a Moroccan Facebook Support Group

Online Psychosocial Support Among Women with Endometriosis in a Moroccan Facebook Support Group | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Online Psychosocial Support Among Women with Endometriosis in a Moroccan Facebook Support Group Sarah Tabit, Elkhansa Layoussifi, Roukaya Benjelloun This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9586388/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Social networking platforms play an increasingly important role in supporting people living with chronic conditions. Facebook hosts numerous online support groups dedicated to health-related issues; however, the psychosocial role of these spaces remains underexplored in certain contexts. To date, no study has examined the dynamics of online social support for women living with endometriosis in Morocco. Methods This study aimed to examine the use of a Facebook-based online support group for women with endometriosis in Morocco, explore its network structure, identify key actors, and analyze communication patterns. A qualitative content analysis combined with social network analysis was conducted based on 1004 interactions extracted from a Facebook group comprising more than 1700 members. Results The findings indicate that informational support was the most frequently exchanged type of support, followed by emotional, esteem, and network support. Other communicative exchanges were largely characterized by non-verbal interactions. Network analysis revealed that group activity was primarily peer-driven, with member prominence depending not only on the level of engagement but also on the nature of participation. Distinct communication patterns highlighted a diversity of user profiles and e-behavioral tendencies within the group. Conclusion This study demonstrates that online social networks constitute a significant source of psychosocial support for women living with endometriosis in Morocco. By shedding light on patients’ expressed needs and peer-based dynamics, these findings underscore the importance of integrating online support spaces into more personalized and responsive health and social care approaches. Endometriosis Social media Facebook Social support Psychosocial support Online communities Social network analysis Morocco Figures Figure 1 Figure 2 Figure 3 Background Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity [ 1 ]. This ectopic tissue is hormonally responsive and exhibits functional characteristics similar to eutopic endometrium [ 1 ]. The etiopathogenesis of the disease remains incompletely understood, with its heterogeneous nature suggesting a multifactorial origin involving both innate factors, such as genetic and epigenetic predispositions, and acquired factors related to menstruation and environmental exposures [ 2 ]. Although these mechanisms may overlap, three main phenotypes of endometriosis are generally distinguished: superficial peritoneal lesions, ovarian endometriomas, and deep infiltrating endometriosis [ 3 ]. These lesions are believed to underlie the condition’s most prevalent clinical manifestations, notably chronic pain and infertility [ 4 ]. Endometriosis affects approximately 10–15% of women worldwide [ 5 ], yet it remains poorly known among the general population [ 6 ]. It is estimated that nearly two-thirds of women are unaware of the disease prior to diagnosis [ 6 ]. Beyond its physical manifestations, endometriosis has a substantial impact on patients’ mental health and overall well-being [ 4 ]. The disease has been shown to be significantly associated with psychological distress, including symptoms of anxiety and depression [ 7 ], and its chronic and often debilitating nature is linked to marked impairments in quality of life [ 7 ]. In response to the challenges associated with chronic conditions, patients increasingly seek psychosocial support through online platforms and social media [ 8 – 10 ]. These platforms host numerous support groups in which individuals affected by similar health issues can exchange information, share experiences, and provide emotional support [ 11 ]. The systematic analysis of interactions within such online communities offers considerable potential for advancing research in health and social care by providing access to patients’ lived experiences and expressed needs [ 12 ]. Previous studies have demonstrated that social networks can serve as effective tools for communication between patients, the general public, and healthcare professionals, contributing to improved health-related knowledge and outcomes [ 13 , 14 ]. Despite the growing international literature documenting the psychosocial burden of endometriosis, research addressing these dimensions within the Moroccan context remains extremely limited [ 15 , 16 ]. A review of national academic databases suggests that studies conducted in Morocco have primarily focused on clinical, diagnostic, or institutional aspects of the disease, with little attention paid to patients’ psychosocial experiences and support needs [ 15 , 16 ]. As a result, little is known about how women living with endometriosis in Morocco identify, express, and manage their psychosocial needs. In this context, examining patient-driven spaces of exchange, such as online support groups, represents a relevant and timely approach to documenting unmet needs and understanding how patients seek psychosocial support outside formal healthcare settings [ 17 , 18 ]. To date, no study has specifically investigated the role of social media in providing psychosocial support for women living with endometriosis in Morocco [ 15 , 16 ]. As patients’ practices progressively shift toward digital environments, there is a growing need for research to examine how these online spaces are used to express and manage psychosocial needs, especially in settings where empirical evidence remains scarce [ 19 ]. The present study therefore aims to examine a Facebook-based online support group characterized by open and authentic exchanges among its members. By exploring the structure of the network and the nature of interactions within this community, this work seeks to identify the specific needs of Moroccan women with endometriosis and to inform the development of more targeted and responsive care strategies in the future. Methods Study setting and online support group To the best of our knowledge, “Parlons Endométriose au Maroc” is the largest online support group specifically dedicated to Moroccan women affected by endometriosis and their support networks. This private Facebook group, created in July 2016, includes over 1700 members and is administered by the ENDOmind Association, a non-profit organization accredited by the French Ministry of Health. The association aims to raise awareness of endometriosis and promote its recognition as a public health issue [ 20 ]. Given its scope and level of activity, this group constituted the study setting, and the interactions exchanged within it formed the core data source for this research. Data collection The study sample consisted of interactions published on the group’s timeline between April 1 and September 30, 2021. An interaction was defined as a post, a comment on a post, a reply to a comment, or a reaction to a post or comment (Table 1 ) [ 21 , 22 ]. Table 1 Facebook interactions and definitions Interaction Definition Post Content shared by users; may include text, photos, videos, or articles. Comment Reply written in response to a post or another comment. Reaction Extension of the “Like” button allowing users to express emotions toward a post or comment (Like, Love, Care, Haha, Wow, Sad, Angry). Inclusion criteria (1) Posts, comments, or reactions published in the “Discussion” section of the group (2) Interactions occurring within the defined study period Exclusion criteria (1) Posts or comments lacking textual content, meaning, or context (2) Duplicate posts or comments (3) Reactions associated with excluded posts or comments A total of 1004 eligible interactions were manually extracted and recorded in a Microsoft Excel Professional Plus 2019 database. In addition, the list of group members was collected, and for each interaction the identities of the sender and recipient were documented to support subsequent network analysis. Data analysis Content analysis A qualitative content analysis was conducted by classifying interactions into social support categories based on Cutrona and Suhr’s Social Support Behavior Code (Table 2 ) [ 23 ]. Table 2 Social support categories according to Cutrona and Suhr Category Definition Informational Providing information about an issue or how to manage it. Emotional Communicating kindness or showing interest in emotional expressions. Esteem Conveying respect or expressing trust in one’s abilities. Network Expressing a sense of belonging to a group sharing common concerns. Tangible Providing or offering material goods or services. Interactions that did not fall within social support categories were classified using coding categories adapted from Gaysynsky et al.’s analysis of a Facebook group for young adults living with HIV (Table 3 ) [ 24 ]. Table 3 Non-social support categories (adapted from Gaysynsky et al.) Category Definition Expressions of gratitude Thanking another member or the group as a whole. Offering congratulations Expressing joy or acknowledging achievements. Administrative / engagement Highlighting ENDOmind Association projects or group activities. Banter Making jokes or humorous remarks. Socializing Greetings, celebrations, sharing life events or group-related activities. Group cohesion Expressing feelings about the group. Negative interaction Disrespectful, sarcastic, or hurtful remarks. Community protection Enforcing group norms or maintaining a supportive atmosphere. Nonverbal cues Use of emojis or reactions. Miscellaneous Content not fitting other predefined categories. During the coding process, additional categories emerged inductively in order to capture the full range of observed communication patterns (Table 4 ). Table 4 Additional categories identified in this study Category Definition Advertising Promoting services or products. Clarification Providing additional explanations or details. Initiative Introducing projects aimed at supporting group members. Each interaction was interpreted within its contextual thread to guide accurate categorization. An interaction could be assigned to more than one category when necessary to reflect its full communicative intent. Social network analysis Social network analysis was used to examine relationships and interaction patterns among group members [ 25 ]. In this framework, group members were considered network nodes, while posts, comments, and reactions constituted the links between them [ 25 ]. Degree centrality, defined as the number of links associated with a node, was calculated to identify highly connected and influential members within the network [ 26 ]. Network visualizations and centrality calculations were performed using Kumu , an online network mapping and analysis tool. This approach enabled the representation of the group’s overall structure, identification of key contributors, and exploration of communication patterns based on interaction frequency, type, and content. Ethical considerations The research protocol was approved by the Ethics Committee of Mohammed VI University of Health Sciences in Casablanca (approval date: September 24, 2021; file number: CERB/UM6SS/10/21). The study was conducted in accordance with the Declaration of Helsinki (2013). Although some Facebook data may be considered publicly accessible, ethical precautions remain essential in social media research [ 12 , 27 ]. As the study focused on a private group, authorization was obtained from the group administrator prior to data collection [ 28 ]. Informed consent was obtained electronically from participants upon joining the private Facebook support group. Data were collected without interacting with group members, ensuring that researcher presence did not influence the content analyzed. All data were anonymized prior to analysis. To protect participant privacy and anonymity, all group members were assigned arbitrary identifiers, and no personally identifiable information was collected. The multilingual nature of the data (French, Arabic, and phonetic Arabic) was taken into account during analysis, helping to reduce potential selection bias. Results Interaction Content Overview A total of 1004 interactions were analyzed and classified into three main categories: social support, non-social support, and additional categories (Table 5 ). Because an interaction could receive multiple codes, percentages do not sum to 100%. Overall, non-social support interactions were the most frequent (62.4%), followed by social support interactions (48%), and additional categories (7%). Table 5 Frequency of the main categories.a Category and subcategory N % Social support categories 482 48 Seeking social support 163 16.2 Offering social support 319 31.8 Non-social support categories 626 62.4 Expressions of gratitude 58 8.8 Offering congratulations 32 4.8 Administrative/engagement in group 1 0.2 Banter 8 1.2 Socializing 8 1.2 Group cohesion 8 1.2 Negative interaction 9 1.4 Community protection 0 0 Nonverbal cues 508 76.9 Miscellaneous 29 4.4 Additional categories 70 7 Advertising 3 4.3 Clarification 29 41.4 Initiative 38 54.3 a Percentages do not add up to 100% because multiple codes could be applied to each interaction. Seeking Social Support Social support–seeking interactions were classified into five categories: Informational Support, Emotional Support, Esteem Support, Network Support, and Tangible Support. Coding was conducted at the subcategory level. Because more than one type of social support could be sought within a single interaction, the total number of coded requests (N = 171) exceeded the number of interactions analyzed (n = 163). Frequencies and percentages for each subcategory (relative to N = 171) are presented in Table 6 . Table 6 Frequency of social support–seeking interactions Category and subcategory N % Informational support 141 82.5 Advice 11 6.4 Referral 21 12.3 Situation appraisal 0 0 Teaching 13 7.6 Other 96 56.1 Emotional support 22 12.8 Relationship 4 2.3 Physical affection 0 0 Confidentiality 0 0 Sympathy 2 1.2 Empathy 0 0 Encouragement 4 2.3 Prayer 4 2.3 Other 8 4.7 Esteem support 2 1.2 Compliment 0 0 Validation 0 0 Relief of blame 2 1.2 Other 0 0 Network support 6 3.5 Access 4 2.3 Presence 1 0.8 Companionship 1 0.8 Other 0 0 Tangible support 0 0 Loan 0 0 Perform direct task 0 0 Perform indirect task 0 0 Active participation 0 0 Express willingness 0 0 Other 0 0 Informational support (82.5%) was the most frequently requested form of social support. Within this category, the “Other” subcategory (56.1%) predominated, followed by “Referral” (12.3%), “Teaching” (7.6%), and “Advice” (6.4%). Emotional support (12.8%) ranked second. The “Other” subcategory (4.7%) was the most represented, followed by “Relationship” (2.3%), “Encouragement” (2.3%), “Prayer” (2.3%), and “Sympathy” (1.2%). Network support (3.5%) was the third most requested type of support, with “Access” (2.3%) as the predominant subcategory, followed by “Presence” (0.8%) and “Companionship” (0.8%). Esteem support (1.2%) was rarely requested, with “Relief of blame” (1.2%) as the only represented subcategory. No requests for tangible support were identified. Giving Social Support Social support–giving interactions were classified using the same five categories. Because multiple types of support could be provided within a single interaction, the total number of coded support-giving instances (N = 380) exceeded the number of interactions analyzed (n = 319). Frequencies and percentages for each subcategory (relative to N = 380) are presented in Table 7 . Table 7 Frequency of social support–giving interactions Category and subcategory N % Informational support 238 62.6 Advice 34 8.9 Referral 65 17.1 Situation appraisal 9 2.4 Teaching 34 8.9 Other 96 25.3 Emotional support 115 30.3 Relationship 8 2.1 Physical affection 0 0 Confidentiality 0 0 Sympathy 2 0.5 Empathy 17 4.5 Encouragement 18 4.7 Prayer 60 15.8 Other 10 2.6 Esteem support 20 5.8 Compliment 2 0.5 Validation 16 4.2 Relief of blame 2 0.5 Other 0 0 Network support 7 1.8 Access 3 0.8 Presence 0 0 Companionship 4 1.1 Other 0 0 Tangible support 0 0 Loan 0 0 Perform direct task 0 0 Perform indirect task 0 0 Active participation 0 0 Express willingness 0 0 Other 0 0 Informational support (62.6%) was the most frequently provided form of social support. The “Other” subcategory (25.3%) was dominant, followed by “Referral” (17.1%), “Advice” (8.9%), “Teaching” (8.9%), and “Situation appraisal” (2.4%). Emotional support (30.3%) ranked second. “Prayer” (15.8%) was the most prominent subcategory, followed by “Encouragement” (4.7%), “Empathy” (4.5%), “Other” (2.6%), “Relationship” (2.1%), and “Sympathy” (0.5%). Esteem support (5.8%) ranked third, with “Validation” (4.2%) as the most represented subcategory, followed by “Compliment” (0.5%) and “Relief of blame” (0.5%). Network support (1.8%) was the least frequently offered type of social support. “Companionship” (1.1%) was the predominant subcategory, followed by “Access” (0.8%). No instances of tangible support provision were identified. Non-social Support Categories The remaining interactions were classified into one or more of the following non-social support categories: Gratitude, Congratulations, Engagement, Banter, Socializing, Group cohesion, Negative interaction, Community protection, Nonverbal cues, and Miscellaneous. Coding was conducted at the subcategory level. Because multiple forms of non-social interaction could occur within a single exchange, the total number of coded instances (N = 661) exceeded the number of interactions analyzed (n = 626). Frequencies and percentages for each category (relative to N = 661) are presented in Table 8 . Table 8 Frequency of non-social support categories Category N % Gratitude 58 8.8 Congratulations 32 4.8 Engagement 1 0.2 Banter 8 1.2 Socializing 8 1.2 Group cohesion 8 1.2 Negative interaction 9 1.4 Community protection 0 0 Nonverbal cues 508 76.9 Miscellaneous 29 4.4 Nonverbal cues constituted by far the most frequently observed category (76.9%). Other non-social interactions were substantially less frequent, including gratitude (8.8%), congratulations (4.8%), and miscellaneous exchanges (4.4%). Categories such as banter, socializing, group cohesion, and negative interaction were only marginally represented, each accounting for approximately 1–1.4% of interactions. The community protection category was not represented in the dataset. Additional Categories Interactions that did not fall within social or non-social support categories were classified into three additional categories: Advertising, Clarification, and Initiative. This component of the analysis involved 70 interactions, corresponding to all interactions not fitting into previously established categories. Frequencies and percentages (relative to N = 70) are presented in Table 9 . Table 9 Frequency of additional categories Category N % Advertising 3 4.3 Clarification 29 41.4 Initiative 38 54.3 Initiative-related interactions were the most frequent (54.3%), followed by clarification (41.4%). Advertising interactions were rare (4.3%). Network Structure and Communication Patterns Overview Figure 1 provides an overview of the structure of the studied social network. The visualization illustrates how members are interconnected through the interactions exchanged within the group. Although all actors appear as nodes in the network, it is important to note that some members also hold specific administrative roles (administrators or moderators), which may influence their position or level of involvement. These roles were therefore considered in the subsequent structural analyses. Nodes depict members of the Facebook group and the links symbolize the interactions that occurred between them. Role of Administrators/Moderators Figure 2 illustrates the position and influence of administrators and moderators within the social network. The comparison of the network visualizations, with and without these actors, shows that their removal does not substantially alter the overall structure of the network. With the exception of a small number of nodes, the majority of members remain interconnected, suggesting that interactions within the group are largely maintained independently of administrators or moderators. The blue nodes depict the administrators/moderators. Degree Centrality In addition to differing in status, group members varied in their level of connectivity within the network. Degree centrality, defined as the number of links associated with a given node, was calculated to characterize members’ connectedness. Based on this measure, members were categorized into connectivity groups, as presented in Table 10 . Table 10 Members division based on connectivity Category Degree centrality N % Single-connected 1 48 26.4 Bi-connected 2 25 13.7 Sparsely-connected 3–9 68 37.4 Intermediate-connected 10–39 34 18.7 Well-connected 40–99 6 3.3 Very-well-connected ≥ 100 1 0.5 The sparsely connected category accounted for the largest proportion of members (37.4%), followed by single-connected (26.4%), intermediate-connected (18.7%), and bi-connected (13.7%) members. Only seven members belonged to the well-connected and very-well-connected categories, representing the most highly connected individuals within the network. Role of the Most Engaged Members Figure 3 illustrates the position and structural role of the most engaged members within the network, defined as those with a degree centrality ≥ 40. Compared with the removal of administrators or moderators, the exclusion of these highly connected members appears to have a more pronounced effect on the overall network structure. Although the central core of the network remains relatively dense, several peripheral nodes become detached, and only two of these nodes maintain bilateral connections with the core. Small nodes depict the less engaged members, while large nodes represent the most engaged members. The seven most engaged members are highlighted in blue. Contribution of the Most Engaged Members Table 11 presents the level and type of participation of the seven most engaged members, defined as those with a degree centrality ≥ 40. Their contributions are described in terms of posts, comments, reactions, and the number of connected nodes. Table 11 Number of posts, comments, reactions, and connected nodes of the most engaged members Member P C RC R RR CN A 5 45 58 2 58 106 B 1 1 26 27 17 72 C 1 15 20 22 13 50 D 4 17 36 10 5 46 E 1 16 18 26 8 45 F 1 19 25 21 11 43 G 0 16 9 14 7 40 P = Posts; C = Comments; RC = Received Comments; R = Reactions; RR = Received Reactions; CN = Connected Nodes (degree centrality). As shown in Table 11 , the contributions of the most engaged members varied in nature. Members A, D, and G primarily contributed through comments, whereas members B, C, E, and F were more active through reactions. Members A, B, and D received the highest numbers of comments and reactions, and members A and D also published the greatest number of posts. Table 12 further details the content of the interactions generated by the most engaged members, distinguishing between types of social support sought or offered and other categories of exchanges. Table 12 Analysis of the content shared by the most engaged members Members IS (S) IS (G) EmS (S) EmS (G) EsS (S) EsS (G) NS (S) NS (G) OC & AC A 11 19 1 12 0 1 0 0 28 B 0 0 0 0 0 0 0 0 6 C 2 3 2 2 0 0 1 0 19 D 3 14 1 2 0 0 0 1 8 E 6 4 1 6 0 1 0 0 10 F 7 5 0 6 0 0 0 0 13 G 6 5 0 9 0 3 0 1 6 Total 35 50 5 37 0 5 1 2 90 IS = Informational Support; EmS = Emotional Support; EsS = Esteem Support; NS = Network Support; OC = Other Categories; AC = Additional Categories; S = Seeking; G = Giving. Overall, the most engaged members were predominantly involved in providing social support rather than seeking it. Members A and D were particularly active in offering informational support, whereas Member B did not provide or seek any type of social support, contributing exclusively through interactions classified under other or additional categories. Discussion Choice of the Social Network Facebook is currently the most widely used social networking platform worldwide, ahead of Instagram, WhatsApp and YouTube [ 29 ]. Given its broad adoption across diverse age groups and socioeconomic backgrounds, Facebook appeared to be the most appropriate platform for this study. Its popularity and functionality favor the emergence of large online support groups, thereby offering access to rich, naturally occurring interactional data. This made it particularly suitable for exploring psychosocial support exchanges among women living with endometriosis in Morocco. Social Support Exchanges Overview The findings of this study indicate that informational and emotional support were the most frequently sought and provided forms of social support, whereas tangible support was both the least requested and the least offered. These patterns are consistent with those reported in online support groups addressing other health conditions, including comorbid cancer and dementia, lung cancer, hearing loss, and autism spectrum disorders [ 12 , 17 , 30 , 31 ]. Such convergence suggests that informational and emotional exchanges represent core functions of online health-related support communities, regardless of the specific condition involved [ 10 ]. Informational Support Informational support emerged as the dominant form of social support in our study, corroborating results from previous research conducted in online support groups for breastfeeding mothers and women experiencing postpartum depression [ 32 , 33 ]. These studies similarly highlighted the central role of information exchange in facilitating coping and self-management among individuals facing health-related challenges. In the present study, informational support was particularly prevalent among members affected by endometriosis. The “Other” subcategory, which primarily consisted of the sharing of personal experiences, was the most represented. This observation aligns with the findings of Price et al. and Evans et al., who reported that participants in online comorbid dementia and cancer as well as postpartum depression support groups were more likely to exchange experiential knowledge rather than refer to conventional informational sources such as brochures, books, or websites [ 17 , 34 ]. As suggested in their work, personal narratives function not only as vehicles for information transmission but also as mechanisms for social connection, normalization of experiences, and reduction of perceived isolation [ 17 , 34 ]. The “Referral” subcategory was the second most frequent type of informational support observed. This finding contrasts with results from studies such as that of Ellway et al., which examined online support groups for individuals affected by methamphetamine use and reported relatively few referral-type exchanges [ 9 , 35 ]. In the Moroccan context, the prominence of referrals may reflect systemic limitations in access to specialized endometriosis care, including the scarcity of dedicated treatment centers and insufficient expertise among healthcare providers, particularly in gynecology and obstetrics. Many group members explicitly expressed dissatisfaction and frustration regarding delayed diagnoses and inadequate medical guidance, which may have motivated peers to actively share recommendations for practitioners, investigations, or care pathways. Emotional Support Emotional support exchanges were also prominent in this study, a finding consistent with those reported by Wilson et al. in their analysis of an online support group for women with endometriosis in Malaysia [ 11 ]. This observation may be explained by the strong presence of self-disclosure in posts and comments, reflected in the dominance of requests classified under the “Other” subcategory. Wang et al. demonstrated that self-disclosure in online cancer support groups often serves to highlight emotional needs, which in turn elicits emotional support responses [ 35 ]. This mechanism has also been supported by subsequent reviews, which emphasize the central role of self-disclosure in eliciting emotional support within online health-related peer communities [ 36 ]. Conversely, more explicit question-based posts tend to signal informational needs and consequently generate informational support [ 35 ]. These mechanisms appear to operate similarly within the context of endometriosis. A particularly notable finding was the predominance of prayer as a form of emotional support offered by group members. This result may be understood in light of the central role of religious beliefs and socio-cultural traditions in Morocco [ 37 ]. Similar observations were reported by Bloom et al. in their study of online support exchanges among caregivers of cancer patients [ 38 ]. In both contexts, prayer may function as a form of symbolic support mobilized when biomedical solutions appear limited or insufficient. Thus, prayer emerges not merely as a spiritual practice, but as a culturally embedded coping mechanism and a form of collective emotional solidarity within online communities. Esteem Support Esteem support and network support were considerably less frequent than informational and emotional support, although esteem support was slightly more prevalent. This pattern aligns with findings reported by Yu et al. in their study of online health communities for individuals who are deaf or hard of hearing [ 30 ]. Within esteem support exchanges, validation was the most prominent subcategory. Many interactions involved affirming and legitimizing women’s concerns, particularly when criticizing perceived shortcomings of healthcare professionals. This theme did not emerge in the reviewed literature and appears to be specific to the context of our study. It may reflect broader systemic issues related to trust in healthcare provision and perceived gaps in communication, diagnosis, or management. Expressions of guilt were also frequently observed and often triggered strong supportive responses from other members, accounting for the relative prominence of the “Relief of blame” subcategory. This finding contrasts with those of Mohd Roffeei et al., who reported only limited mentions of guilt in an online support group for parents of children with autism spectrum disorders [ 31 ]. In the context of endometriosis, such guilt may stem from patients attributing disease progression or irreversible outcomes to personal failure, rather than to structural shortcomings within the healthcare system, including delays in diagnosis, insufficient information, or lack of standardized care pathways. Network Support Network support constituted a relatively small proportion of exchanges, a result that was anticipated and mirrors findings by Wright et al., who analyzed social support messages in blogs addressing environmental breast cancer risks [ 39 ]. The limited presence of explicit network support may be explained by the fact that network-related needs were largely fulfilled through group membership itself. Simply belonging to the online community may have provided members with a sense of inclusion and shared identity, reducing the need for overt expressions of network support. This interpretation is supported by Coulson et al.’s study of an online support group for individuals affected by Huntington’s disease, which showed that as group activity increased, explicit network support exchanges tended to decrease [ 40 ]. Tangible Support The near absence of tangible support observed in our study is consistent with findings reported by Taylor and Pagliari in their analysis of lung cancer discussions across social media platforms [ 12 ]. Although a small number of members expressed willingness to help and such offers were met with appreciation, no interactions involved concrete requests for or provision of material assistance. This likely reflects the inherent limitations of online environments in facilitating tangible support. As noted by Atwood et al. in their study of online forums related to bariatric surgery, tangible support—defined by Cutrona and Suhr—may be poorly suited to virtual settings, where logistical, geographical, and privacy barriers constrain direct assistance [ 41 ]. Other Communication Exchanges Gratitude Beyond functioning as a space for support exchange, the group also appeared to alleviate feelings of isolation and loneliness among its members. Numerous studies, including that of Finn, have shown that online interactions can enhance social participation and positively influence psychological well-being [ 42 ]. This dynamic was reflected in our findings, where expressions of gratitude were frequent. Many participants explicitly articulated relief, renewed hope, or appreciation for the understanding they encountered within the group. Such exchanges underscore the affective value of the community and reinforce the role of online support groups in promoting emotional resilience. Congratulations Messages of congratulations frequently followed the sharing of personal successes or positive developments. These interactions not only conveyed genuine joy but also illustrated the group’s empathetic and caring climate. Such affirming exchanges contribute to a supportive relational environment that encourages sustained engagement. This observation aligns with Coursaris and Liu’s assertion that congratulatory messages can facilitate and reinforce social support exchanges in online settings [ 43 ]. Banter, Socializing, and Group Cohesion Interactions involving banter, socializing, and expressions of group cohesion were markedly more common than negative interactions—by nearly a threefold margin. This pattern echoes the findings of Gaysynsky et al., who observed that light-hearted exchanges and informal social interactions can strengthen members’ sense of integration within online communities [ 24 ]. In our context, these forms of communication appeared to reinforce interpersonal connections and foster a sense of belonging. The emergence of a shared identity within the group further supports this interpretation. The use of the nickname “Endogirls” closely parallels the findings of Parsons, who documented the “Hystersisters” identity in an online support group for women who had undergone hysterectomy [ 44 ]. Such community-specific labels serve as symbolic markers of belonging and are instrumental in cultivating group cohesion. Nonverbal Cues One of the most striking findings of this study was the prominence of nonverbal cues, which accounted for more than three-quarters of all interactions. In our dataset, nonverbal cues—primarily in the form of reactions—were frequently used to convey emotions or clarify message tone, thereby enriching the communicative dynamics of the group. This level of use is not documented in earlier literature on online support groups [ 24 , 45 ]. However, more recent work has begun to draw attention to the role of nonverbal cues such as emojis in online support environments, highlighting their function in conveying empathy, emotional presence, and supportive intent within peer-based communities [ 46 ]. Divergence from prior research may be attributed to the evolution of Facebook’s interface. The introduction of “Reactions” in 2016 expanded the communicative possibilities of the platform by allowing users to express a wider range of affective states quickly and nonverbally [ 22 ]. To our knowledge, the present study is the first to explicitly incorporate Facebook Reactions into its analysis of support exchanges, which may explain the substantial representation of this interaction type. The increasing reliance on nonverbal cues within online health communities represents an important avenue for future research, particularly concerning their role in emotional expression, community building, and conversational regulation. Key Players and Network Hubs Role of Administrators/Moderators Network visualizations with and without administrators/moderators indicate that these actors were not central to the interactions (Fig. 2 ). This finding contrasts with the results of a previous study [ 47 ]. Cole-Lewis et al. , whose work analyzed member behavior and participation within a smoking cessation group, reported that moderators were the primary drivers of observed activity [ 47 ]. This does not appear to apply to our study, which motivated our decision to identify the actual cores of the network. Degree Centrality The analysis of degree centrality showed that the majority of group members communicated with fewer than ten other participants. This observation is consistent with the findings reported by Eghdam et al. , whose study focused on a Facebook group for individuals with mild cognitive impairment [ 45 ]. In their work, degree centrality followed a long-tail distribution, indicating that members were directly connected to only a small number of others [ 45 ]. Table 13 compares the distribution of degree centrality reported by Eghdam et al. [ 45 ] with that observed in the present study. Table 13 Distribution of degree centrality in the study by Eghdam et al. and in the present study Connectivity level % in Eghdam et al. study % in the present study Single connection 27.0 26.4 Bi-connected 14.0 13.7 Low connectivity 35.0 37.4 Moderately connected 22.0 18.7 Well connected 1.0 3.3 Highly connected ≈ 0 0.5 Role of the most active members The most active members were identified through the calculation of degree centrality. Nodes with high degree centrality generally correspond to “connectors” or “hubs” within a network [ 48 ]. Removing these nodes from the network visualization showed that they occupied a more prominent structural position than the administrators/moderators and that interactions predominantly occurred between members rather than being driven by moderation. In face-to-face support groups, there is often concern that highly active participants may dominate discussions, monopolize speaking time, or pursue primarily their own interests [ 49 ]. However, in the present study, removing the most active members had little effect on network density (Fig. 3 ). This suggests that if a member did not appreciate one or more highly active participants, they could easily ignore them and interact with others. A similar observation was reported by Eghdam et al. [ 45 ]. Communication patterns To further deepen our analysis, we examined the communication behaviors of the most active members. Our results revealed the existence of distinct communication patterns, both in terms of the types of interactions used and their frequency and content. Types of interactions Previous studies, notably that of Aldous et al. , have shown that participation on social media reflects a range of user profiles or interaction styles [ 50 ]. Our findings support this assumption, as the most active members displayed different tendencies when choosing to interact through posting, commenting, or reacting. Frequency of interactions Regardless of the nature of their participation, members with the highest number of interactions occupied a central position in group activity, as reflected by their degree centrality. This observation once again aligns with the study by Eghdam et al. , which demonstrated that centrality was significantly associated with interaction frequency [ 45 ]. Strengths and Limitations Study strengths There is a growing global trend toward personalized medicine [ 51 ]. This approach places the patient at the center of care and therefore requires a deeper understanding of individual needs [ 51 ]. Our study aligns with this perspective. By adopting a rigorous methodological approach to the analysis of online support groups, this work provides insights that are closely connected to patients’ lived experiences and expressed needs. Such an approach holds promise for healthcare professionals seeking to develop more targeted and appropriate models of care. Study Limitations The primary objective of this study was to document and describe the use of an online support group for women living with endometriosis in Morocco. However, this work did not assess the quality, reliability, or potential harmfulness of the information shared within this space. In addition, patients’ satisfaction with the support received was not examined. These aspects represent important limitations of the present study. Implications for Practice and Recommendations In light of our findings, it is clear that women living with endometriosis in Morocco have needs that are not adequately addressed by the current healthcare system. The most prominent unmet needs relate to informational and emotional support. To help address these gaps, we propose the following strategies: To develop a structured consultation pathway that, depending on patients’ requests and needs, allows for the provision of information, active listening, and supportive care for patients and their relatives; To design and make available scientifically validated content based on the most frequently sought information, with the aim of reducing the circulation of inaccurate or misleading messages; To organize therapeutic education sessions to support patients in managing their daily lives with endometriosis; To establish a psychological support and counseling unit to accompany patients throughout their care trajectory and to ensure systematic referral when appropriate. Future Research Directions Future research would benefit from evaluating both the positive and negative impacts of online peer-support environments. In particular, further studies should explore the quality and accuracy of the information exchanged, assess users’ satisfaction with the support provided, and examine the potential risks associated with participation in such platforms. In addition, future research should examine how emerging artificial intelligence–enabled tools may interact with peer-support dynamics in online communities, particularly with regard to information moderation, emotional support provision, and ethical governance. Conclusions This study is the first to examine the psychosocial dynamics shaping an online support group for women living with endometriosis in Morocco. By combining qualitative content analysis with social network analysis, it provides insight into how women use digital spaces to seek and provide informational, emotional, esteem, and network support. Beyond the expression of individual concerns, the platform also fosters a sense of belonging and shared understanding within a peer-driven environment. The findings further highlight the structural organization of the network, showing that group activity is primarily sustained by members rather than administrators or moderators. Members’ prominence within the network depends not only on their level of engagement but also on the nature of their participation, revealing distinct communication patterns and user profiles. These results underscore the importance of online support groups as complementary spaces for addressing unmet psychosocial needs and for informing more personalized and responsive approaches to care. Beyond the findings presented in this study, it is important to acknowledge the rapid evolution of digital health environments in recent years. Advances in artificial intelligence have profoundly transformed online platforms, including health-related social networks. AI-enabled tools are increasingly used to facilitate access to information, personalize content, support moderation processes, and, in some cases, provide automated psychosocial support through conversational agents. These developments open new perspectives for understanding how patients interact with digital support environments, while also raising important questions regarding information quality, ethical oversight, and the balance between automated and human-centered forms of support. Future research should therefore explore how artificial intelligence–enabled technologies interact with peer-based support dynamics in online communities and how they may complement, rather than replace, human forms of psychosocial care. In the context of endometriosis, such investigations are essential to better align digital health innovations with patients’ expressed needs and to support the development of more inclusive, patient-centered models of care. Declarations Ethics approval and consent to participate The study protocol was approved by the Ethics Committee of Mohammed VI University of Health Sciences, Casablanca, Morocco (approval date: September 24, 2021; reference number: CERB/UM6SS/10/21). The study was conducted in accordance with the Declaration of Helsinki (2013). Informed consent was obtained electronically from participants upon joining the private Facebook support group. Authorization to access and analyze anonymized interactions was obtained from the group administrator. Consent for publication Not applicable. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Author Contribution S.T. conceived the study, collected and analyzed the data, and drafted the manuscript. R.B. contributed to the study design and provided critical supervision. E.L. and R.B. critically revised the manuscript. All authors read and approved the final manuscript. Acknowledgement The authors would like to thank the ENDOmind Association and the administrator of the Facebook group for granting access to the data and supporting this research. Data Availability The datasets generated and/or analyzed during the current study are not publicly available due to privacy and ethical restrictions but are available from the corresponding author on reasonable request. References Inserm. Endometriosis [Internet]. Inserm. [cited 2021 Aug 4]. Available from: https://www.inserm.fr/dossier/endometriose/ Laganà AS, Garzon S, Götte M, Viganò P, Franchi M, Ghezzi F, Martin DC. The Pathogenesis of Endometriosis: Molecular and Cell Biology Insights. Int J Mol Sci. 2019;20(22):5615. Haute Autorité de Santé. Management of endometriosis: clinical practice guidelines [Internet]. France: Haute Autorité de Santé; 2017 [cited 2021 Nov 20]. 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Bloom RD, Reblin M, Chou WYS, Beck SL, Wilson A, Ellington L. Online social support for cancer caregivers: alignment between requests and offers on CaringBridge. J Psychosoc Oncol. 2021;39(1):118–34. Wright KB, Cai X, Fisher C, Rising CJ, Burke-Garcia A, Afanaseva D. A Content Analysis of Social Support Messages about Environmental Breast Cancer Risk within Blogs for Mothers. Health Commun. 2020;1–9. Coulson NS, Buchanan H, Aubeeluck A. Social support in cyberspace: A content analysis of communication within a Huntington’s disease online support group. Patient Educ Couns. 2007;68(2):173–8. Atwood ME, Friedman A, Meisner BA, Cassin SE. The Exchange of Social Support on Online Bariatric Surgery Discussion Forums: A Mixed-Methods Content Analysis. Health Commun. 2018;33(5):628–35. Finn J. An Exploration of Helping Processes in an Online Self-Help Group Focusing on Issues of Disability. Health Soc Work. 1999;24(3):220–31. Coursaris CK, Liu M. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9586388","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":651667193,"identity":"35d57cdd-a2c1-4c16-966f-713811bf0bcd","order_by":0,"name":"Sarah Tabit","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAv0lEQVRIiWNgGAWjYHACNoYEBhsGBvYG4jUAtSSkMTDwHCBFC0PCYQYGCQcidcjPb3724OGP84lrZ7A//sCYY0dYi8ExNnODhITbidtu95hJMG5LJkILG4OZBFjLnTNsDIzbmIlwWBv7N6CWc4nbbqQDHbatnrAWhmM8IFsOALUkGAAddpgIhx3LKTdISEs23nbmjJlE4rbjRDis+fi2hz9s7GS3HW9//OHjtmoiHIYCEkjVMApGwSgYBaMAOwAAn9o9KgMspEUAAAAASUVORK5CYII=","orcid":"","institution":"Faculty of Medicine, Mohammed VI University of Science and Health","correspondingAuthor":true,"prefix":"","firstName":"Sarah","middleName":"","lastName":"Tabit","suffix":""},{"id":651667194,"identity":"c0c648f1-73d9-45e9-a6eb-013a59c83ec0","order_by":1,"name":"Elkhansa Layoussifi","email":"","orcid":"","institution":"Faculty of Medicine, Mohammed VI University of Science and Health","correspondingAuthor":false,"prefix":"","firstName":"Elkhansa","middleName":"","lastName":"Layoussifi","suffix":""},{"id":651667195,"identity":"8bfa6d69-795e-4a98-99ed-25e9cae710c2","order_by":2,"name":"Roukaya Benjelloun","email":"","orcid":"","institution":"Faculty of Medicine, Mohammed VI University of Science and Health","correspondingAuthor":false,"prefix":"","firstName":"Roukaya","middleName":"","lastName":"Benjelloun","suffix":""}],"badges":[],"createdAt":"2026-05-01 13:23:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9586388/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9586388/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":111135825,"identity":"ea501826-19a2-434a-9f7a-c93eab20d5ea","added_by":"auto","created_at":"2026-06-05 11:12:37","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":409139,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eVisualization of the social network.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNodes depict members of the Facebook group and the links symbolize the interactions that occurred between them.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9586388/v1/68ad586a1270fc3abc713e17.png"},{"id":111135831,"identity":"de1c9a11-f7f0-44e5-934c-40db1d072b25","added_by":"auto","created_at":"2026-06-05 11:12:40","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":695587,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eVisualization of the social network with and without administrators/moderators.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe blue nodes depict the administrators/moderators.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-9586388/v1/b32056680498a18f1418a790.png"},{"id":111135834,"identity":"41e8cef8-7872-4463-8e7f-eb02a0847016","added_by":"auto","created_at":"2026-06-05 11:12:42","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":551086,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eVisualization of the social network with and without the most engaged members.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSmall nodes depict the less engaged members, while large nodes represent the most engaged members. The seven most engaged members are highlighted in blue.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-9586388/v1/85609f3f66891800f99a090e.png"},{"id":111136078,"identity":"a04b059f-2adc-4db4-b461-91e7b6bea370","added_by":"auto","created_at":"2026-06-05 11:14:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2169337,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9586388/v1/91e65242-f950-42a3-9be8-37ffb8c8f8b7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Online Psychosocial Support Among Women with Endometriosis in a Moroccan Facebook Support Group","fulltext":[{"header":"Background","content":"\u003cp\u003eEndometriosis is defined as the presence of endometrial tissue outside the uterine cavity [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This ectopic tissue is hormonally responsive and exhibits functional characteristics similar to eutopic endometrium [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The etiopathogenesis of the disease remains incompletely understood, with its heterogeneous nature suggesting a multifactorial origin involving both innate factors, such as genetic and epigenetic predispositions, and acquired factors related to menstruation and environmental exposures [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Although these mechanisms may overlap, three main phenotypes of endometriosis are generally distinguished: superficial peritoneal lesions, ovarian endometriomas, and deep infiltrating endometriosis [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These lesions are believed to underlie the condition\u0026rsquo;s most prevalent clinical manifestations, notably chronic pain and infertility [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEndometriosis affects approximately 10\u0026ndash;15% of women worldwide [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], yet it remains poorly known among the general population [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. It is estimated that nearly two-thirds of women are unaware of the disease prior to diagnosis [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Beyond its physical manifestations, endometriosis has a substantial impact on patients\u0026rsquo; mental health and overall well-being [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The disease has been shown to be significantly associated with psychological distress, including symptoms of anxiety and depression [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], and its chronic and often debilitating nature is linked to marked impairments in quality of life [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn response to the challenges associated with chronic conditions, patients increasingly seek psychosocial support through online platforms and social media [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. These platforms host numerous support groups in which individuals affected by similar health issues can exchange information, share experiences, and provide emotional support [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The systematic analysis of interactions within such online communities offers considerable potential for advancing research in health and social care by providing access to patients\u0026rsquo; lived experiences and expressed needs [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Previous studies have demonstrated that social networks can serve as effective tools for communication between patients, the general public, and healthcare professionals, contributing to improved health-related knowledge and outcomes [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the growing international literature documenting the psychosocial burden of endometriosis, research addressing these dimensions within the Moroccan context remains extremely limited [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A review of national academic databases suggests that studies conducted in Morocco have primarily focused on clinical, diagnostic, or institutional aspects of the disease, with little attention paid to patients\u0026rsquo; psychosocial experiences and support needs [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. As a result, little is known about how women living with endometriosis in Morocco identify, express, and manage their psychosocial needs. In this context, examining patient-driven spaces of exchange, such as online support groups, represents a relevant and timely approach to documenting unmet needs and understanding how patients seek psychosocial support outside formal healthcare settings [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo date, no study has specifically investigated the role of social media in providing psychosocial support for women living with endometriosis in Morocco [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. As patients\u0026rsquo; practices progressively shift toward digital environments, there is a growing need for research to examine how these online spaces are used to express and manage psychosocial needs, especially in settings where empirical evidence remains scarce [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The present study therefore aims to examine a Facebook-based online support group characterized by open and authentic exchanges among its members. By exploring the structure of the network and the nature of interactions within this community, this work seeks to identify the specific needs of Moroccan women with endometriosis and to inform the development of more targeted and responsive care strategies in the future.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy setting and online support group\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, \u003cem\u003e\u0026ldquo;Parlons Endom\u0026eacute;triose au Maroc\u0026rdquo;\u003c/em\u003e is the largest online support group specifically dedicated to Moroccan women affected by endometriosis and their support networks. This private Facebook group, created in July 2016, includes over 1700 members and is administered by the ENDOmind Association, a non-profit organization accredited by the French Ministry of Health. The association aims to raise awareness of endometriosis and promote its recognition as a public health issue [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Given its scope and level of activity, this group constituted the study setting, and the interactions exchanged within it formed the core data source for this research.\u003c/p\u003e \u003cp\u003eData collection\u003c/p\u003e \u003cp\u003eThe study sample consisted of interactions published on the group\u0026rsquo;s timeline between April 1 and September 30, 2021. An interaction was defined as a post, a comment on a post, a reply to a comment, or a reaction to a post or comment (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFacebook interactions and definitions\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInteraction\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinition\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePost\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContent shared by users; may include text, photos, videos, or articles.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReply written in response to a post or another comment.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExtension of the \u0026ldquo;Like\u0026rdquo; button allowing users to express emotions toward a post or comment (Like, Love, Care, Haha, Wow, Sad, Angry).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cp\u003eInclusion criteria\u003c/p\u003e \u003cp\u003e(1) Posts, comments, or reactions published in the \u0026ldquo;Discussion\u0026rdquo; section of the group\u003c/p\u003e \u003cp\u003e(2) Interactions occurring within the defined study period\u003c/p\u003e \u003cp\u003eExclusion criteria\u003c/p\u003e \u003cp\u003e(1) Posts or comments lacking textual content, meaning, or context\u003c/p\u003e \u003cp\u003e(2) Duplicate posts or comments\u003c/p\u003e \u003cp\u003e(3) Reactions associated with excluded posts or comments\u003c/p\u003e \u003cp\u003eA total of 1004 eligible interactions were manually extracted and recorded in a Microsoft Excel Professional Plus 2019 database. In addition, the list of group members was collected, and for each interaction the identities of the sender and recipient were documented to support subsequent network analysis.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eContent analysis\u003c/p\u003e \u003cp\u003eA qualitative content analysis was conducted by classifying interactions into social support categories based on Cutrona and Suhr\u0026rsquo;s Social Support Behavior Code (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocial support categories according to Cutrona and Suhr\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinition\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInformational\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProviding information about an issue or how to manage it.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCommunicating kindness or showing interest in emotional expressions.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEsteem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eConveying respect or expressing trust in one\u0026rsquo;s abilities.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNetwork\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpressing a sense of belonging to a group sharing common concerns.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTangible\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProviding or offering material goods or services.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eInteractions that did not fall within social support categories were classified using coding categories adapted from Gaysynsky et al.\u0026rsquo;s analysis of a Facebook group for young adults living with HIV (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNon-social support categories\u003c/p\u003e \u003cdiv class=\"Credit\"\u003e\u003cp\u003e(adapted from Gaysynsky et al.)\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinition\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExpressions of gratitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThanking another member or the group as a whole.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOffering congratulations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpressing joy or acknowledging achievements.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdministrative / engagement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHighlighting ENDOmind Association projects or group activities.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBanter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaking jokes or humorous remarks.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocializing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGreetings, celebrations, sharing life events or group-related activities.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup cohesion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpressing feelings about the group.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisrespectful, sarcastic, or hurtful remarks.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity protection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnforcing group norms or maintaining a supportive atmosphere.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNonverbal cues\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUse of emojis or reactions.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiscellaneous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContent not fitting other predefined categories.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eDuring the coding process, additional categories emerged inductively in order to capture the full range of observed communication patterns (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAdditional categories identified in this study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinition\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdvertising\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePromoting services or products.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClarification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProviding additional explanations or details.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInitiative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntroducing projects aimed at supporting group members.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e Each interaction was interpreted within its contextual thread to guide accurate categorization. An interaction could be assigned to more than one category when necessary to reflect its full communicative intent.\u003c/p\u003e \u003cp\u003eSocial network analysis\u003c/p\u003e \u003cp\u003eSocial network analysis was used to examine relationships and interaction patterns among group members [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In this framework, group members were considered network nodes, while posts, comments, and reactions constituted the links between them [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Degree centrality, defined as the number of links associated with a node, was calculated to identify highly connected and influential members within the network [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eNetwork visualizations and centrality calculations were performed using \u003cb\u003eKumu\u003c/b\u003e, an online network mapping and analysis tool. This approach enabled the representation of the group\u0026rsquo;s overall structure, identification of key contributors, and exploration of communication patterns based on interaction frequency, type, and content.\u003c/p\u003e \u003cp\u003eEthical considerations\u003c/p\u003e \u003cp\u003e The research protocol was approved by the Ethics Committee of Mohammed VI University of Health Sciences in Casablanca (approval date: September 24, 2021; file number: CERB/UM6SS/10/21). The study was conducted in accordance with the Declaration of Helsinki (2013).\u003c/p\u003e \u003cp\u003eAlthough some Facebook data may be considered publicly accessible, ethical precautions remain essential in social media research [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. As the study focused on a private group, authorization was obtained from the group administrator prior to data collection [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Informed consent was obtained electronically from participants upon joining the private Facebook support group. Data were collected without interacting with group members, ensuring that researcher presence did not influence the content analyzed. All data were anonymized prior to analysis.\u003c/p\u003e \u003cp\u003eTo protect participant privacy and anonymity, all group members were assigned arbitrary identifiers, and no personally identifiable information was collected. The multilingual nature of the data (French, Arabic, and phonetic Arabic) was taken into account during analysis, helping to reduce potential selection bias.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eInteraction Content\u003c/p\u003e \u003cp\u003eOverview\u003c/p\u003e \u003cp\u003eA total of 1004 interactions were analyzed and classified into three main categories: social support, non-social support, and additional categories (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBecause an interaction could receive multiple codes, percentages do not sum to 100%.\u003c/p\u003e \u003cp\u003eOverall, non-social support interactions were the most frequent (62.4%), followed by social support interactions (48%), and additional categories (7%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of the main categories.a\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory and subcategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial support categories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e482\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e48\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeeking social support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOffering social support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e319\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-social support categories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e626\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e62.4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExpressions of gratitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOffering congratulations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdministrative/engagement in group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBanter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocializing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup cohesion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity protection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNonverbal cues\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiscellaneous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdditional categories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e70\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdvertising\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClarification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInitiative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003ea Percentages do not add up to 100% because multiple codes could be applied to each interaction.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eSeeking Social Support\u003c/p\u003e \u003cp\u003eSocial support\u0026ndash;seeking interactions were classified into five categories: Informational Support, Emotional Support, Esteem Support, Network Support, and Tangible Support. Coding was conducted at the subcategory level. Because more than one type of social support could be sought within a single interaction, the total number of coded requests (N\u0026thinsp;=\u0026thinsp;171) exceeded the number of interactions analyzed (n\u0026thinsp;=\u0026thinsp;163). Frequencies and percentages for each subcategory (relative to N\u0026thinsp;=\u0026thinsp;171) are presented in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of social support\u0026ndash;seeking interactions\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory and subcategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInformational support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e141\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e82.5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdvice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReferral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSituation appraisal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e22\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e12.8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical affection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfidentiality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSympathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmpathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEncouragement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrayer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEsteem support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompliment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eValidation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelief of blame\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNetwork support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e6\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccess\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompanionship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTangible support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLoan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerform direct task\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerform indirect task\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActive participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExpress willingness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eInformational support (82.5%) was the most frequently requested form of social support. Within this category, the \u0026ldquo;Other\u0026rdquo; subcategory (56.1%) predominated, followed by \u0026ldquo;Referral\u0026rdquo; (12.3%), \u0026ldquo;Teaching\u0026rdquo; (7.6%), and \u0026ldquo;Advice\u0026rdquo; (6.4%).\u003c/p\u003e \u003cp\u003eEmotional support (12.8%) ranked second. The \u0026ldquo;Other\u0026rdquo; subcategory (4.7%) was the most represented, followed by \u0026ldquo;Relationship\u0026rdquo; (2.3%), \u0026ldquo;Encouragement\u0026rdquo; (2.3%), \u0026ldquo;Prayer\u0026rdquo; (2.3%), and \u0026ldquo;Sympathy\u0026rdquo; (1.2%).\u003c/p\u003e \u003cp\u003eNetwork support (3.5%) was the third most requested type of support, with \u0026ldquo;Access\u0026rdquo; (2.3%) as the predominant subcategory, followed by \u0026ldquo;Presence\u0026rdquo; (0.8%) and \u0026ldquo;Companionship\u0026rdquo; (0.8%).\u003c/p\u003e \u003cp\u003eEsteem support (1.2%) was rarely requested, with \u0026ldquo;Relief of blame\u0026rdquo; (1.2%) as the only represented subcategory.\u003c/p\u003e \u003cp\u003eNo requests for tangible support were identified.\u003c/p\u003e \u003cp\u003eGiving Social Support\u003c/p\u003e \u003cp\u003eSocial support\u0026ndash;giving interactions were classified using the same five categories. Because multiple types of support could be provided within a single interaction, the total number of coded support-giving instances (N\u0026thinsp;=\u0026thinsp;380) exceeded the number of interactions analyzed (n\u0026thinsp;=\u0026thinsp;319). Frequencies and percentages for each subcategory (relative to N\u0026thinsp;=\u0026thinsp;380) are presented in Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of social support\u0026ndash;giving interactions\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory and subcategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInformational support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e238\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e62.6\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdvice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReferral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSituation appraisal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e115\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e30.3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical affection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfidentiality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSympathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmpathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEncouragement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrayer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEsteem support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e20\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompliment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eValidation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelief of blame\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNetwork support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccess\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompanionship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTangible support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLoan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerform direct task\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerform indirect task\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActive participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExpress willingness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eInformational support (62.6%) was the most frequently provided form of social support. The \u0026ldquo;Other\u0026rdquo; subcategory (25.3%) was dominant, followed by \u0026ldquo;Referral\u0026rdquo; (17.1%), \u0026ldquo;Advice\u0026rdquo; (8.9%), \u0026ldquo;Teaching\u0026rdquo; (8.9%), and \u0026ldquo;Situation appraisal\u0026rdquo; (2.4%).\u003c/p\u003e \u003cp\u003eEmotional support (30.3%) ranked second. \u0026ldquo;Prayer\u0026rdquo; (15.8%) was the most prominent subcategory, followed by \u0026ldquo;Encouragement\u0026rdquo; (4.7%), \u0026ldquo;Empathy\u0026rdquo; (4.5%), \u0026ldquo;Other\u0026rdquo; (2.6%), \u0026ldquo;Relationship\u0026rdquo; (2.1%), and \u0026ldquo;Sympathy\u0026rdquo; (0.5%).\u003c/p\u003e \u003cp\u003e Esteem support (5.8%) ranked third, with \u0026ldquo;Validation\u0026rdquo; (4.2%) as the most represented subcategory, followed by \u0026ldquo;Compliment\u0026rdquo; (0.5%) and \u0026ldquo;Relief of blame\u0026rdquo; (0.5%).\u003c/p\u003e \u003cp\u003eNetwork support (1.8%) was the least frequently offered type of social support. \u0026ldquo;Companionship\u0026rdquo; (1.1%) was the predominant subcategory, followed by \u0026ldquo;Access\u0026rdquo; (0.8%).\u003c/p\u003e \u003cp\u003eNo instances of tangible support provision were identified.\u003c/p\u003e \u003cp\u003eNon-social Support Categories\u003c/p\u003e \u003cp\u003eThe remaining interactions were classified into one or more of the following non-social support categories: Gratitude, Congratulations, Engagement, Banter, Socializing, Group cohesion, Negative interaction, Community protection, Nonverbal cues, and Miscellaneous. Coding was conducted at the subcategory level. Because multiple forms of non-social interaction could occur within a single exchange, the total number of coded instances (N\u0026thinsp;=\u0026thinsp;661) exceeded the number of interactions analyzed (n\u0026thinsp;=\u0026thinsp;626). Frequencies and percentages for each category (relative to N\u0026thinsp;=\u0026thinsp;661) are presented in Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of non-social support categories\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGratitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCongratulations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEngagement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBanter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocializing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup cohesion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative interaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity protection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNonverbal cues\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiscellaneous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eNonverbal cues constituted by far the most frequently observed category (76.9%). Other non-social interactions were substantially less frequent, including gratitude (8.8%), congratulations (4.8%), and miscellaneous exchanges (4.4%). Categories such as banter, socializing, group cohesion, and negative interaction were only marginally represented, each accounting for approximately 1\u0026ndash;1.4% of interactions.\u003c/p\u003e \u003cp\u003eThe community protection category was not represented in the dataset.\u003c/p\u003e \u003cp\u003eAdditional Categories\u003c/p\u003e \u003cp\u003eInteractions that did not fall within social or non-social support categories were classified into three additional categories: Advertising, Clarification, and Initiative. This component of the analysis involved 70 interactions, corresponding to all interactions not fitting into previously established categories. Frequencies and percentages (relative to N\u0026thinsp;=\u0026thinsp;70) are presented in Table\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of additional categories\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdvertising\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClarification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInitiative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eInitiative-related interactions were the most frequent (54.3%), followed by clarification (41.4%). Advertising interactions were rare (4.3%).\u003c/p\u003e \u003cp\u003eNetwork Structure and Communication Patterns\u003c/p\u003e \u003cp\u003eOverview\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e provides an overview of the structure of the studied social network. The visualization illustrates how members are interconnected through the interactions exchanged within the group. Although all actors appear as nodes in the network, it is important to note that \u003cb\u003esome members also hold specific administrative roles\u003c/b\u003e (administrators or moderators), which may influence their position or level of involvement. These roles were therefore considered in the subsequent structural analyses.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eNodes depict members of the Facebook group and the links symbolize the interactions that occurred between them.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eRole of Administrators/Moderators\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e illustrates the position and influence of administrators and moderators within the social network. The comparison of the network visualizations, with and without these actors, shows that their removal does not substantially alter the overall structure of the network. With the exception of a small number of nodes, the majority of members remain interconnected, suggesting that interactions within the group are largely maintained independently of administrators or moderators.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eThe blue nodes depict the administrators/moderators.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eDegree Centrality\u003c/p\u003e \u003cp\u003eIn addition to differing in status, group members varied in their level of connectivity within the network. Degree centrality, defined as the number of links associated with a given node, was calculated to characterize members\u0026rsquo; connectedness. Based on this measure, members were categorized into connectivity groups, as presented in Table\u0026nbsp;\u003cspan refid=\"Tab10\" class=\"InternalRef\"\u003e10\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMembers division based on connectivity\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDegree centrality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle-connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBi-connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSparsely-connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermediate-connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWell-connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery-well-connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe sparsely connected category accounted for the largest proportion of members (37.4%), followed by single-connected (26.4%), intermediate-connected (18.7%), and bi-connected (13.7%) members. Only seven members belonged to the well-connected and very-well-connected categories, representing the most highly connected individuals within the network.\u003c/p\u003e \u003cp\u003eRole of the Most Engaged Members\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e illustrates the position and structural role of the most engaged members within the network, defined as those with a degree centrality\u0026thinsp;\u0026ge;\u0026thinsp;40. Compared with the removal of administrators or moderators, the exclusion of these highly connected members appears to have a more pronounced effect on the overall network structure. Although the central core of the network remains relatively dense, several peripheral nodes become detached, and only two of these nodes maintain bilateral connections with the core.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eSmall nodes depict the less engaged members, while large nodes represent the most engaged members. The seven most engaged members are highlighted in blue.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eContribution of the Most Engaged Members\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab11\" class=\"InternalRef\"\u003e11\u003c/span\u003e presents the level and type of participation of the seven most engaged members, defined as those with a degree centrality\u0026thinsp;\u0026ge;\u0026thinsp;40. Their contributions are described in terms of posts, comments, reactions, and the number of connected nodes.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab11\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 11\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNumber of posts, comments, reactions, and connected nodes of the most engaged members\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMember\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCN\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eP\u0026thinsp;=\u0026thinsp;Posts; C\u0026thinsp;=\u0026thinsp;Comments; RC\u0026thinsp;=\u0026thinsp;Received Comments; R\u0026thinsp;=\u0026thinsp;Reactions; RR\u0026thinsp;=\u0026thinsp;Received Reactions; CN\u0026thinsp;=\u0026thinsp;Connected Nodes (degree centrality).\u003c/em\u003e \u003c/p\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab11\" class=\"InternalRef\"\u003e11\u003c/span\u003e, the contributions of the most engaged members varied in nature. Members A, D, and G primarily contributed through comments, whereas members B, C, E, and F were more active through reactions. Members A, B, and D received the highest numbers of comments and reactions, and members A and D also published the greatest number of posts.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab12\" class=\"InternalRef\"\u003e12\u003c/span\u003e further details the content of the interactions generated by the most engaged members, distinguishing between types of social support sought or offered and other categories of exchanges.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab12\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 12\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnalysis of the content shared by the most engaged members\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMembers\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIS (S)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIS (G)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEmS (S)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEmS (G)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEsS (S)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eEsS (G)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNS (S)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNS (G)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eOC \u0026amp; AC\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e35\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e50\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e37\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e90\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eIS\u0026thinsp;=\u0026thinsp;Informational Support; EmS\u0026thinsp;=\u0026thinsp;Emotional Support; EsS\u0026thinsp;=\u0026thinsp;Esteem Support; NS\u0026thinsp;=\u0026thinsp;Network Support; OC\u0026thinsp;=\u0026thinsp;Other Categories; AC\u0026thinsp;=\u0026thinsp;Additional Categories; S\u0026thinsp;=\u0026thinsp;Seeking; G\u0026thinsp;=\u0026thinsp;Giving.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eOverall, the most engaged members were predominantly involved in providing social support rather than seeking it. Members A and D were particularly active in offering informational support, whereas Member B did not provide or seek any type of social support, contributing exclusively through interactions classified under other or additional categories.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eChoice of the Social Network\u003c/p\u003e \u003cp\u003eFacebook is currently the most widely used social networking platform worldwide, ahead of Instagram, WhatsApp and YouTube [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Given its broad adoption across diverse age groups and socioeconomic backgrounds, Facebook appeared to be the most appropriate platform for this study. Its popularity and functionality favor the emergence of large online support groups, thereby offering access to rich, naturally occurring interactional data. This made it particularly suitable for exploring psychosocial support exchanges among women living with endometriosis in Morocco.\u003c/p\u003e \u003cp\u003eSocial Support Exchanges\u003c/p\u003e \u003cp\u003eOverview\u003c/p\u003e \u003cp\u003eThe findings of this study indicate that informational and emotional support were the most frequently sought and provided forms of social support, whereas tangible support was both the least requested and the least offered. These patterns are consistent with those reported in online support groups addressing other health conditions, including comorbid cancer and dementia, lung cancer, hearing loss, and autism spectrum disorders [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Such convergence suggests that informational and emotional exchanges represent core functions of online health-related support communities, regardless of the specific condition involved [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInformational Support\u003c/p\u003e \u003cp\u003eInformational support emerged as the dominant form of social support in our study, corroborating results from previous research conducted in online support groups for breastfeeding mothers and women experiencing postpartum depression [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. These studies similarly highlighted the central role of information exchange in facilitating coping and self-management among individuals facing health-related challenges.\u003c/p\u003e \u003cp\u003eIn the present study, informational support was particularly prevalent among members affected by endometriosis. The \u0026ldquo;Other\u0026rdquo; subcategory, which primarily consisted of the sharing of personal experiences, was the most represented. This observation aligns with the findings of Price et al. and Evans et al., who reported that participants in online comorbid dementia and cancer as well as postpartum depression support groups were more likely to exchange experiential knowledge rather than refer to conventional informational sources such as brochures, books, or websites [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. As suggested in their work, personal narratives function not only as vehicles for information transmission but also as mechanisms for social connection, normalization of experiences, and reduction of perceived isolation [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe \u0026ldquo;Referral\u0026rdquo; subcategory was the second most frequent type of informational support observed. This finding contrasts with results from studies such as that of Ellway et al., which examined online support groups for individuals affected by methamphetamine use and reported relatively few referral-type exchanges [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. In the Moroccan context, the prominence of referrals may reflect systemic limitations in access to specialized endometriosis care, including the scarcity of dedicated treatment centers and insufficient expertise among healthcare providers, particularly in gynecology and obstetrics. Many group members explicitly expressed dissatisfaction and frustration regarding delayed diagnoses and inadequate medical guidance, which may have motivated peers to actively share recommendations for practitioners, investigations, or care pathways.\u003c/p\u003e \u003cp\u003eEmotional Support\u003c/p\u003e \u003cp\u003eEmotional support exchanges were also prominent in this study, a finding consistent with those reported by Wilson et al. in their analysis of an online support group for women with endometriosis in Malaysia [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. This observation may be explained by the strong presence of self-disclosure in posts and comments, reflected in the dominance of requests classified under the \u0026ldquo;Other\u0026rdquo; subcategory. Wang et al. demonstrated that self-disclosure in online cancer support groups often serves to highlight emotional needs, which in turn elicits emotional support responses [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. This mechanism has also been supported by subsequent reviews, which emphasize the central role of self-disclosure in eliciting emotional support within online health-related peer communities [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Conversely, more explicit question-based posts tend to signal informational needs and consequently generate informational support [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. These mechanisms appear to operate similarly within the context of endometriosis.\u003c/p\u003e \u003cp\u003eA particularly notable finding was the predominance of prayer as a form of emotional support offered by group members. This result may be understood in light of the central role of religious beliefs and socio-cultural traditions in Morocco [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Similar observations were reported by Bloom et al. in their study of online support exchanges among caregivers of cancer patients [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. In both contexts, prayer may function as a form of symbolic support mobilized when biomedical solutions appear limited or insufficient. Thus, prayer emerges not merely as a spiritual practice, but as a culturally embedded coping mechanism and a form of collective emotional solidarity within online communities.\u003c/p\u003e \u003cp\u003eEsteem Support\u003c/p\u003e \u003cp\u003eEsteem support and network support were considerably less frequent than informational and emotional support, although esteem support was slightly more prevalent. This pattern aligns with findings reported by Yu et al. in their study of online health communities for individuals who are deaf or hard of hearing [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWithin esteem support exchanges, validation was the most prominent subcategory. Many interactions involved affirming and legitimizing women\u0026rsquo;s concerns, particularly when criticizing perceived shortcomings of healthcare professionals. This theme did not emerge in the reviewed literature and appears to be specific to the context of our study. It may reflect broader systemic issues related to trust in healthcare provision and perceived gaps in communication, diagnosis, or management.\u003c/p\u003e \u003cp\u003eExpressions of guilt were also frequently observed and often triggered strong supportive responses from other members, accounting for the relative prominence of the \u0026ldquo;Relief of blame\u0026rdquo; subcategory. This finding contrasts with those of Mohd Roffeei et al., who reported only limited mentions of guilt in an online support group for parents of children with autism spectrum disorders [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In the context of endometriosis, such guilt may stem from patients attributing disease progression or irreversible outcomes to personal failure, rather than to structural shortcomings within the healthcare system, including delays in diagnosis, insufficient information, or lack of standardized care pathways.\u003c/p\u003e \u003cp\u003eNetwork Support\u003c/p\u003e \u003cp\u003eNetwork support constituted a relatively small proportion of exchanges, a result that was anticipated and mirrors findings by Wright et al., who analyzed social support messages in blogs addressing environmental breast cancer risks [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe limited presence of explicit network support may be explained by the fact that network-related needs were largely fulfilled through group membership itself. Simply belonging to the online community may have provided members with a sense of inclusion and shared identity, reducing the need for overt expressions of network support. This interpretation is supported by Coulson et al.\u0026rsquo;s study of an online support group for individuals affected by Huntington\u0026rsquo;s disease, which showed that as group activity increased, explicit network support exchanges tended to decrease [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTangible Support\u003c/p\u003e \u003cp\u003eThe near absence of tangible support observed in our study is consistent with findings reported by Taylor and Pagliari in their analysis of lung cancer discussions across social media platforms [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Although a small number of members expressed willingness to help and such offers were met with appreciation, no interactions involved concrete requests for or provision of material assistance.\u003c/p\u003e \u003cp\u003eThis likely reflects the inherent limitations of online environments in facilitating tangible support. As noted by Atwood et al. in their study of online forums related to bariatric surgery, tangible support\u0026mdash;defined by Cutrona and Suhr\u0026mdash;may be poorly suited to virtual settings, where logistical, geographical, and privacy barriers constrain direct assistance [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOther Communication Exchanges\u003c/p\u003e \u003cp\u003eGratitude\u003c/p\u003e \u003cp\u003eBeyond functioning as a space for support exchange, the group also appeared to alleviate feelings of isolation and loneliness among its members. Numerous studies, including that of Finn, have shown that online interactions can enhance social participation and positively influence psychological well-being [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This dynamic was reflected in our findings, where expressions of gratitude were frequent. Many participants explicitly articulated relief, renewed hope, or appreciation for the understanding they encountered within the group. Such exchanges underscore the affective value of the community and reinforce the role of online support groups in promoting emotional resilience.\u003c/p\u003e \u003cp\u003eCongratulations\u003c/p\u003e \u003cp\u003e Messages of congratulations frequently followed the sharing of personal successes or positive developments. These interactions not only conveyed genuine joy but also illustrated the group\u0026rsquo;s empathetic and caring climate. Such affirming exchanges contribute to a supportive relational environment that encourages sustained engagement. This observation aligns with Coursaris and Liu\u0026rsquo;s assertion that congratulatory messages can facilitate and reinforce social support exchanges in online settings [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBanter, Socializing, and Group Cohesion\u003c/p\u003e \u003cp\u003eInteractions involving banter, socializing, and expressions of group cohesion were markedly more common than negative interactions\u0026mdash;by nearly a threefold margin. This pattern echoes the findings of Gaysynsky et al., who observed that light-hearted exchanges and informal social interactions can strengthen members\u0026rsquo; sense of integration within online communities [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In our context, these forms of communication appeared to reinforce interpersonal connections and foster a sense of belonging.\u003c/p\u003e \u003cp\u003eThe emergence of a shared identity within the group further supports this interpretation. The use of the nickname \u0026ldquo;Endogirls\u0026rdquo; closely parallels the findings of Parsons, who documented the \u0026ldquo;Hystersisters\u0026rdquo; identity in an online support group for women who had undergone hysterectomy [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Such community-specific labels serve as symbolic markers of belonging and are instrumental in cultivating group cohesion.\u003c/p\u003e \u003cp\u003eNonverbal Cues\u003c/p\u003e \u003cp\u003eOne of the most striking findings of this study was the prominence of nonverbal cues, which accounted for more than three-quarters of all interactions. In our dataset, nonverbal cues\u0026mdash;primarily in the form of reactions\u0026mdash;were frequently used to convey emotions or clarify message tone, thereby enriching the communicative dynamics of the group. This level of use is not documented in earlier literature on online support groups [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. However, more recent work has begun to draw attention to the role of nonverbal cues such as emojis in online support environments, highlighting their function in conveying empathy, emotional presence, and supportive intent within peer-based communities [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDivergence from prior research may be attributed to the evolution of Facebook\u0026rsquo;s interface. The introduction of \u0026ldquo;Reactions\u0026rdquo; in 2016 expanded the communicative possibilities of the platform by allowing users to express a wider range of affective states quickly and nonverbally [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. To our knowledge, the present study is the first to explicitly incorporate Facebook Reactions into its analysis of support exchanges, which may explain the substantial representation of this interaction type. The increasing reliance on nonverbal cues within online health communities represents an important avenue for future research, particularly concerning their role in emotional expression, community building, and conversational regulation.\u003c/p\u003e \u003cp\u003eKey Players and Network Hubs\u003c/p\u003e \u003cp\u003eRole of Administrators/Moderators\u003c/p\u003e \u003cp\u003eNetwork visualizations with and without administrators/moderators indicate that these actors were not central to the interactions (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). This finding contrasts with the results of a previous study [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Cole-Lewis \u003cem\u003eet al.\u003c/em\u003e, whose work analyzed member behavior and participation within a smoking cessation group, reported that moderators were the primary drivers of observed activity [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. This does not appear to apply to our study, which motivated our decision to identify the actual cores of the network.\u003c/p\u003e \u003cp\u003eDegree Centrality\u003c/p\u003e \u003cp\u003e The analysis of degree centrality showed that the majority of group members communicated with fewer than ten other participants. This observation is consistent with the findings reported by Eghdam \u003cem\u003eet al.\u003c/em\u003e, whose study focused on a Facebook group for individuals with mild cognitive impairment [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. In their work, degree centrality followed a long-tail distribution, indicating that members were directly connected to only a small number of others [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab13\" class=\"InternalRef\"\u003e13\u003c/span\u003e compares the distribution of degree centrality reported by Eghdam \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e] with that observed in the present study.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab13\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 13\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of degree centrality in the study by Eghdam \u003cem\u003eet al.\u003c/em\u003e and in the present study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConnectivity level\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e% in Eghdam \u003cem\u003eet al.\u003c/em\u003e study\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% in the present study\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle connection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBi-connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow connectivity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerately connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWell connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighly connected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026asymp;\u0026thinsp;0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cp\u003eRole of the most active members\u003c/p\u003e \u003cp\u003eThe most active members were identified through the calculation of degree centrality. Nodes with high degree centrality generally correspond to \u0026ldquo;connectors\u0026rdquo; or \u0026ldquo;hubs\u0026rdquo; within a network [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. Removing these nodes from the network visualization showed that they occupied a more prominent structural position than the administrators/moderators and that interactions predominantly occurred between members rather than being driven by moderation.\u003c/p\u003e \u003cp\u003eIn face-to-face support groups, there is often concern that highly active participants may dominate discussions, monopolize speaking time, or pursue primarily their own interests [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. However, in the present study, removing the most active members had little effect on network density (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). This suggests that if a member did not appreciate one or more highly active participants, they could easily ignore them and interact with others. A similar observation was reported by Eghdam \u003cem\u003eet al.\u003c/em\u003e [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCommunication patterns\u003c/p\u003e \u003cp\u003eTo further deepen our analysis, we examined the communication behaviors of the most active members. Our results revealed the existence of distinct communication patterns, both in terms of the types of interactions used and their frequency and content.\u003c/p\u003e \u003cp\u003eTypes of interactions\u003c/p\u003e \u003cp\u003ePrevious studies, notably that of Aldous \u003cem\u003eet al.\u003c/em\u003e, have shown that participation on social media reflects a range of user profiles or interaction styles [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. Our findings support this assumption, as the most active members displayed different tendencies when choosing to interact through posting, commenting, or reacting.\u003c/p\u003e \u003cp\u003eFrequency of interactions\u003c/p\u003e \u003cp\u003e Regardless of the nature of their participation, members with the highest number of interactions occupied a central position in group activity, as reflected by their degree centrality. This observation once again aligns with the study by Eghdam \u003cem\u003eet al.\u003c/em\u003e, which demonstrated that centrality was significantly associated with interaction frequency [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStrengths and Limitations\u003c/p\u003e \u003cp\u003eStudy strengths\u003c/p\u003e \u003cp\u003eThere is a growing global trend toward personalized medicine [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. This approach places the patient at the center of care and therefore requires a deeper understanding of individual needs [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Our study aligns with this perspective. By adopting a rigorous methodological approach to the analysis of online support groups, this work provides insights that are closely connected to patients\u0026rsquo; lived experiences and expressed needs. Such an approach holds promise for healthcare professionals seeking to develop more targeted and appropriate models of care.\u003c/p\u003e \u003cp\u003eStudy Limitations\u003c/p\u003e \u003cp\u003eThe primary objective of this study was to document and describe the use of an online support group for women living with endometriosis in Morocco. However, this work did not assess the quality, reliability, or potential harmfulness of the information shared within this space. In addition, patients\u0026rsquo; satisfaction with the support received was not examined. These aspects represent important limitations of the present study.\u003c/p\u003e \u003cp\u003eImplications for Practice and Recommendations\u003c/p\u003e \u003cp\u003eIn light of our findings, it is clear that women living with endometriosis in Morocco have needs that are not adequately addressed by the current healthcare system. The most prominent unmet needs relate to informational and emotional support. To help address these gaps, we propose the following strategies:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eTo develop a structured consultation pathway that, depending on patients\u0026rsquo; requests and needs, allows for the provision of information, active listening, and supportive care for patients and their relatives;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eTo design and make available scientifically validated content based on the most frequently sought information, with the aim of reducing the circulation of inaccurate or misleading messages;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eTo organize therapeutic education sessions to support patients in managing their daily lives with endometriosis;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eTo establish a psychological support and counseling unit to accompany patients throughout their care trajectory and to ensure systematic referral when appropriate.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eFuture Research Directions\u003c/p\u003e \u003cp\u003eFuture research would benefit from evaluating both the positive and negative impacts of online peer-support environments. In particular, further studies should explore the quality and accuracy of the information exchanged, assess users\u0026rsquo; satisfaction with the support provided, and examine the potential risks associated with participation in such platforms.\u003c/p\u003e \u003cp\u003eIn addition, future research should examine how emerging artificial intelligence\u0026ndash;enabled tools may interact with peer-support dynamics in online communities, particularly with regard to information moderation, emotional support provision, and ethical governance.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study is the first to examine the psychosocial dynamics shaping an online support group for women living with endometriosis in Morocco. By combining qualitative content analysis with social network analysis, it provides insight into how women use digital spaces to seek and provide informational, emotional, esteem, and network support. Beyond the expression of individual concerns, the platform also fosters a sense of belonging and shared understanding within a peer-driven environment.\u003c/p\u003e \u003cp\u003eThe findings further highlight the structural organization of the network, showing that group activity is primarily sustained by members rather than administrators or moderators. Members\u0026rsquo; prominence within the network depends not only on their level of engagement but also on the nature of their participation, revealing distinct communication patterns and user profiles. These results underscore the importance of online support groups as complementary spaces for addressing unmet psychosocial needs and for informing more personalized and responsive approaches to care.\u003c/p\u003e \u003cp\u003eBeyond the findings presented in this study, it is important to acknowledge the rapid evolution of digital health environments in recent years. Advances in artificial intelligence have profoundly transformed online platforms, including health-related social networks. AI-enabled tools are increasingly used to facilitate access to information, personalize content, support moderation processes, and, in some cases, provide automated psychosocial support through conversational agents. These developments open new perspectives for understanding how patients interact with digital support environments, while also raising important questions regarding information quality, ethical oversight, and the balance between automated and human-centered forms of support.\u003c/p\u003e \u003cp\u003eFuture research should therefore explore how artificial intelligence\u0026ndash;enabled technologies interact with peer-based support dynamics in online communities and how they may complement, rather than replace, human forms of psychosocial care. In the context of endometriosis, such investigations are essential to better align digital health innovations with patients\u0026rsquo; expressed needs and to support the development of more inclusive, patient-centered models of care.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e The study protocol was approved by the Ethics Committee of Mohammed VI University of Health Sciences, Casablanca, Morocco (approval date: September 24, 2021; reference number: CERB/UM6SS/10/21). The study was conducted in accordance with the Declaration of Helsinki (2013). Informed consent was obtained electronically from participants upon joining the private Facebook support group. Authorization to access and analyze anonymized interactions was obtained from the group administrator.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eS.T. conceived the study, collected and analyzed the data, and drafted the manuscript. R.B. contributed to the study design and provided critical supervision. E.L. and R.B. critically revised the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to thank the ENDOmind Association and the administrator of the Facebook group for granting access to the data and supporting this research.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due to privacy and ethical restrictions but are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eInserm. Endometriosis [Internet]. Inserm. [cited 2021 Aug 4]. 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JAMA. 2015;314(10):999.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"discpsy","sideBox":"Learn more about [Discover Psychology](https://www.springer.com/44202)","snPcode":"","submissionUrl":"","title":"Discover Psychology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Endometriosis, Social media, Facebook, Social support, Psychosocial support, Online communities, Social network analysis, Morocco","lastPublishedDoi":"10.21203/rs.3.rs-9586388/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9586388/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSocial networking platforms play an increasingly important role in supporting people living with chronic conditions. Facebook hosts numerous online support groups dedicated to health-related issues; however, the psychosocial role of these spaces remains underexplored in certain contexts. To date, no study has examined the dynamics of online social support for women living with endometriosis in Morocco.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study aimed to examine the use of a Facebook-based online support group for women with endometriosis in Morocco, explore its network structure, identify key actors, and analyze communication patterns. A qualitative content analysis combined with social network analysis was conducted based on 1004 interactions extracted from a Facebook group comprising more than 1700 members.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe findings indicate that informational support was the most frequently exchanged type of support, followed by emotional, esteem, and network support. Other communicative exchanges were largely characterized by non-verbal interactions. Network analysis revealed that group activity was primarily peer-driven, with member prominence depending not only on the level of engagement but also on the nature of participation. Distinct communication patterns highlighted a diversity of user profiles and e-behavioral tendencies within the group.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThis study demonstrates that online social networks constitute a significant source of psychosocial support for women living with endometriosis in Morocco. By shedding light on patients\u0026rsquo; expressed needs and peer-based dynamics, these findings underscore the importance of integrating online support spaces into more personalized and responsive health and social care approaches.\u003c/p\u003e","manuscriptTitle":"Online Psychosocial Support Among Women with Endometriosis in a Moroccan Facebook Support Group","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-06-05 11:08:52","doi":"10.21203/rs.3.rs-9586388/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-06-03T20:34:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"60952787919109161714731694404435032140","date":"2026-06-03T19:54:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-06-01T09:31:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"275168845195463078792004789642233285084","date":"2026-05-28T19:20:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"130987575050673008872938638894419378484","date":"2026-05-28T16:01:09+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-28T15:54:49+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-28T15:52:04+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-05-11T15:12:57+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-05-09T00:13:13+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Psychology","date":"2026-05-08T22:05:46+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"discpsy","sideBox":"Learn more about [Discover Psychology](https://www.springer.com/44202)","snPcode":"","submissionUrl":"","title":"Discover Psychology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3c3123d7-b9bb-4d53-adf5-a11b559b2402","owner":[],"postedDate":"June 5th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-06-03T20:34:33+00:00","index":48,"fulltext":""},{"type":"reviewerAgreed","content":"60952787919109161714731694404435032140","date":"2026-06-03T19:54:03+00:00","index":47,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-06-01T09:31:18+00:00","index":43,"fulltext":""},{"type":"reviewerAgreed","content":"275168845195463078792004789642233285084","date":"2026-05-28T19:20:54+00:00","index":39,"fulltext":""},{"type":"reviewerAgreed","content":"130987575050673008872938638894419378484","date":"2026-05-28T16:01:09+00:00","index":34,"fulltext":""},{"type":"reviewersInvited","content":"15","date":"2026-05-28T15:54:49+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-28T15:52:04+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-06-05T11:08:58+00:00","versionOfRecord":[],"versionCreatedAt":"2026-06-05 11:08:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9586388","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9586388","identity":"rs-9586388","version":["v1"]},"buildId":"WvIrzKhiLBfengagbw6Ux","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}