Informational-to-relational pathway to value co-creation: role of patient influencers' E-WOM quality and parasocial relationships in OHCs

Purpose Drawing on service-dominant logic (SDL) and value co-creation literature, this study examines the association between patient influencers' E-WOM quality (E-WOMQ) and parasocial relationships (PSR) in online healthcare communities (OHCs). It examines whether PSR are associated with patients' participation in value co-creation (PVCC) across four dimensions during the healthcare journey, and whether PSR mediate the E-WOMQ–PVCC association. The study also examines online community experience (OCE) as a moderator of the E-WOMQ–PSR association. Design/methodology/approach A cross-sectional survey was conducted among members of OHCs in Bangladesh between July 2024 and September 2024, yielding 609 useable responses. This study employed PLS-SEM in SmartPLS 4.0 to test the proposed hypotheses. Findings E-WOMQ is positively associated with PSR. PSR is positively associated with information seeking, information sharing, personal interaction and responsible behaviour, and significantly mediates the associations between E-WOMQ and all four PVCC dimensions. OCE does not significantly moderate the E-WOMQ–PSR association. Originality/value This study extends SDL by specifying an informational-to-relational pathway in OHCs, linking the perceived quality of patient-influencer's healthcare information with relational evaluations and multidimensional patient value co-creation. The findings offer practical guidance for healthcare organizations, OHC managers and patient influencers on communicating relevant, helpful and transparent healthcare information while supporting constructive patient participation during the healthcare journey.