How do rewards shape physicians’ knowledge contribution in online health communities? An SOR–SDT perspective

Online health communities (OHCs) have become important platforms for delivering medical consultation and health information. The sustainability of OHCs depends on physicians’ knowledge contribution behavior (KCB). Drawing on the stimulus–organism–response (SOR) framework and self-determination theory (SDT), this study develops an integrated model to examine the effects of different rewards on physicians’ KCB through autonomous motivation. Data from 282 physicians in Chinese OHCs were analyzed using the partial least squares technique. The results show that autonomous motivation significantly enhances physicians’ KCB (β = 0.214, p < 0.001). Extrinsic rewards (β = 0.283, p < 0.001) and intrinsic rewards (β = 0.228, p < 0.001) are positively related to KCB, while showing opposite relationships with physicians’ autonomous motivation. Patients’ online gifts do not significantly moderate the relationship between autonomous motivation and KCB (β = 0.068, p > 0.05). This study extends the applicability of the SOR framework and SDT to OHCs by revealing the distinct relationships between rewards and autonomous motivation. It also highlights the limited role of online gifts in strengthening the motivation–behavior relationship.