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- Social marketing in contexts of uncertainty: An analysis of social capital and health social support in online health communities facing treatment uncertaintyPublication . Baptista, Nuno Tiago Cláudio Leitão; Alves, Helena Maria Baptista; Pinho, José Carlos Martins Rodrigues deFor several medical treatments there is considerable scientific and medical uncertainty about the relative benefits and risks they imply. The literature indicates social support as an important factor in health uncertainty management. The concept of social support has gained considerable interest in the areas of behavioral medicine and health psychology research. Despite such interest, it is still not clear how it can be approached in social marketing interventions since there is a lack of conceptual and empirical literature discussing the concept from a social marketing perspective. The present thesis aims to explore how the social support concept can be better approached in social marketing interventions targeting contexts of treatment uncertainty. To attain this objective, first a scoping review of social marketing interventions in the health area operationalizing the concept of social support was undertaken. Results indicated that interventions have operationalized the concept in connection with all the key aspects of social marketing, including behavioral change, consumer research, segmentation and targeting, and exchange, as well as marketing mix and competition. However, the findings also indicated poor conceptualizations of social support and the underreporting of the theoretical rationale for the operationalization of the concept. Second, the study adopted a mixed-methods approach that involved netnography and social network analysis, to examine the nature of online social support, understood as a resource generated through social capital, using two distinct case studies: i) an online forum focused on health discussion about electronic cigarettes; ii) an online forum dedicated to menopausal hormone replacement therapy. Findings indicate that online health communities can be a place for extending the support networks of people facing treatment uncertainty as multiple typologies of peer-to-peer social support are remotely exchanged in the virtual communities. Both online health communities were found to have similar network structures characterized by small-world and scale free properties and reduced levels of reciprocity. Results also indicate that users mostly search for informational types of support in the online health communities and that they can be segmented based on the structural positions they occupy in the networks and patterns of support interaction. However, it was found that the information available in these forums can be subject to imprudent processes of selection by forum participants who try to conform online discussion to suit the forums’ shared and accepted narratives that highlight the benefits of these uncertain treatments, while minimizing the respective risks. From a theoretical perspective, this study has relevant implications for health uncertainty management literature by putting in evidence collective processes of information selection in the online health communities, that can hinder the main objective of these virtual spaces, that is to function as platforms for knowledge acquisition. Second it deepens understanding about the interconnected relations between the concepts of social capital and social support. The study also brings innovation in methods by combining social network analysis and netnography, two naturalistic and online-suited research methods to study online health communities. For practionaires, the results of the study provide significant insights that can be used to program social marketing interventions intended to increase and enhance the quality of social support available in these types of online health communities.