Posting About Cancer: Predicting Social Support in Imgur Comments

Abstract

People who are affected by cancer can benefit greatly from social support and digital social networks, though our understanding of online support is primarily founded in dominant platforms like Facebook. In addition, while previous scholarship indicates that social support is available online, little research has examined predictors of support provision. A content analysis was performed to examine the relationship between narrative features in Imgur posts and social support in comments. Imgur ( Imgur.com ) is a social media site and image-hosting platform, amassing over 250 million monthly visitors. Six post features were hypothesized to predict support, including explanations of the diagnosis experience, evidence of agentive problem solving, indications of positive reappraisal, pleads for the audience to get a checkup, references to mortality, and inclusion of humor. The results of this study indicate a relationship between narrative construction and social support, finding that the inclusion of narrative features in cancer-related posts influenced the provision of support in comments. Findings of this study could have implications for a multitude of stakeholders interested in social support provision, including healthcare professionals and researchers interested in the use of social media platforms for support, and organizations interested in designing supportive online platforms for individuals coping with cancer.

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Article
Online communities can be a source of support for individu-
als coping with stressful situations, including illnesses like
cancer (e.g., Rains & Young, 2009; Wright, 2002), heart dis-
ease (Lindsay et al., 2009; Tak & McCubbin, 2002), and
depression (Evans et al., 2012; Rains et al., 2016). Online
support networks are especially beneficial to individuals
with limited mobility, weak or unsupportive offline support
networks, and/or rare illnesses (Rains & Wright, 2016;
Sposito et al., 2015). The proliferation of digital technology
and connectivity has expanded the opportunities for online
support networks to develop, and research has shown these
can vary greatly (Hayes et al., 2016; Meng et al., 2017; Rains
et al., 2015). While early digital research explored more pro-
fessionally moderated support forums (e.g., White &
Dorman, 2001; Wright, 2002), research has since expanded
to include social networking sites—most prominently
Facebook (Buehler et al., 2019; Gage-Bouchard et al., 2017;
High et al., 2014; Vitak & Ellison, 2013). However, recent
reviews of the support literature have called for research on
additional digital platforms (Meng et al., 2017; Rains et al.,
2015), allowing for more comprehensive assessments of the
functions of support in social media and increased generaliz-
ability of research inquiries.
In addition, while previous scholarship has provided
descriptive analyses of online support availability and the
classification of support types, comparatively little research
has examined predictors of support in networked communi-
ties on social media (for exceptions see Davis et al., 2015;
Hale et al., 2018; McLaughlin et al., 2012). In their review of
support literature from 2004 to 2015, Meng et al. (2017)
found that only 6.8% of reviewed studies evaluated anteced-
ents to support provision, including characteristics of support
seekers (e.g., support availability, family interaction, and
narcissism) and message features that elicited support (e.g.,
self-disclosure and the inclusion of family and prayer in
posts). Therefore, while the availability of support through
digital platforms has been established in previous scholar-
ship, more work is needed to determine the factors that
engender online support.
965209SMSXXX10.1177/2056305120965209Social Media <span class="symbol" cstyle="Mathematical">+</span> SocietyHale et al.
research-article20202020
1Indiana University Bloomington, USA
2University of Minnesota, Twin Cities, USA
Corresponding Author:
Brent J. Hale, The Media School, Indiana University Bloomington, 940 E.
Seventh Street, Bloomington, IN 47405, USA.
Email: brjhale@iu.edu
Posting About Cancer: Predicting Social
Support in Imgur Comments
Brent J. Hale1, Ryan Collins1, and Danielle K. Kilgo2
Abstract
People who are affected by cancer can benefit greatly from social support and digital social networks, though our understanding
of online support is primarily founded in dominant platforms like Facebook. In addition, while previous scholarship indicates
that social support is available online, little research has examined predictors of support provision. A content analysis was
performed to examine the relationship between narrative features in Imgur posts and social support in comments. Imgur
(Imgur.com) is a social media site and image-hosting platform, amassing over 250 million monthly visitors. Six post features
were hypothesized to predict support, including explanations of the diagnosis experience, evidence of agentive problem
solving, indications of positive reappraisal, pleads for the audience to get a checkup, references to mortality, and inclusion
of humor. The results of this study indicate a relationship between narrative construction and social support, finding that
the inclusion of narrative features in cancer-related posts influenced the provision of support in comments. Findings of this
study could have implications for a multitude of stakeholders interested in social support provision, including healthcare
professionals and researchers interested in the use of social media platforms for support, and organizations interested in
designing supportive online platforms for individuals coping with cancer.
Keywords
cancer, social support, social media, comments, health communication

2 Social Media + Society
In response to calls for further research evaluating ante-
cedents to support provision and across social media plat-
forms, a content analysis was performed of 117 cancer-related
Imgur posts and 2511 corresponding comments, examining
the relationship between post features and social support in
comments. The Imgur platform falls in a genre of social net-
works defined by a culture of anonymity (which also includes
sites like Reddit and Tumblr), in which the expectation of
semi-anonymity influences engagement and discourse (e.g.,
Kilgo et al., 2018; Massanari, 2017). Moreover, the voting
system utilized by the platform (a bidirectional setup using
upvotes and downvotes) allows users to influence how con-
tent is displayed in the site (similar to Reddit). Accordingly,
the architectural and cultural dissimilarities between the
Imgur platform and Facebook, which has received the bulk
of previous scholarly attention, uniquely positions Imgur for
comparison with previous social support research. Therefore,
this work contributes to social support research by examin-
ing the relationships between post features and the provision
of support in comments, helping us better understand online
support exchange. Findings of this study have implications
for stakeholders interested in social support provision,
including researchers, healthcare professionals, and organi-
zations interested in designing supportive online platforms
for individuals coping with cancer.
Social Support and Social Media
According to Berkman (1984), social support is defined as
“the emotional, instrumental, and financial aid that is
obtained from one’s social network” (p. 415). For individu-
als dealing with health issues like cancer, the availability and
reception of social support can have important implications
for psychological and physical health outcomes (Berkman,
1984; House et al., 1988; Uchino et al., 1996). Prior research
suggests that support is a significant factor in facilitating suc-
cessful coping processes (DeLongis & Holtzman, 2005),
seems to mediate stress and well-being (Cohen & Wills,
1985; Dunkel-Schetter et al., 1987), and helps individuals
overcome challenges (Hale et al., 1997). In addition, online
social support networks attenuate spatial boundaries that
often accompany long-term illness (Sposito et al., 2015).
Compared to other health communities, the cancer commu-
nity is one of the most supported and supportive (Dakof &
Taylor, 1990; Davison et al., 2000; Walther & Boyd, 2002;
Wright & Bell, 2003), with established support resources for
cancer patients to connect with medical professionals and
survivors.
Despite a growing variety of social networks online, pre-
vious online social support research has predominantly
focused on Facebook (e.g., Buehler et al., 2019; Gage-
Bouchard et al., 2017; High et al., 2014; Vitak & Ellison,
2013), which makes sense considering the popularity of the
platform. However, Meng and colleagues (2017, p. 48) argue
that the preeminence of Facebook in support research may
“privilege a particular group of people and cultural prac-
tices” hindering our ability to infer generalizable practices of
digital support exchange. Other social media platforms have
distinct features that affect their site culture, such as the lev-
els of anonymity/pseudonymity they afford, character restric-
tions imposed upon comments, and the ranking of comments
according to user feedback (e.g., votes), potentially resulting
in a different sense of community and group identity (Barnes,
2018; Reagle, 2015). This study expands support research
through an examination of Imgur, which is characterized by
a culture of anonymity, humor, and image-based communi-
cation (Hale, 2017; Mikal et al., 2014). Considering the sen-
sitive nature of life-threatening illness, individuals could at
times prefer anonymous platforms like Imgur over identifi-
able sites like Facebook for disclosing fears and seeking sup-
port (Walther & Boyd, 2002).
Imgur (Imgur.com) is a social media site and image-host-
ing platform, amassing over 250 million monthly visitors
(Imgur, 2019b). Carr and Hayes (2015) define social media as
“Internet-based channels that allow users to opportunistically
interact and selectively self-present, either in real-time or
asynchronously, with both broad and narrow audiences who
derive value from user-generated content and the perception
of interaction with others” (p. 50). Conforming to this defini-
tion, Imgurians (Imgur users) interact by (1) sharing visual
and textual user-generated content through posts (at least one
image is required per post), (2) responding to posted content
using short (140 characters) comments, and (3) voting on
posts and comments using “upvotes” and “downvotes,”
which signify like and dislike, respectively. Although users
remain principally anonymous, the Imgur network predomi-
nantly consists of Millennial men (Imgur, 2019a), similar to
Reddit (Statista, 2019), which differs from networks like
Facebook where userbases are demographically heteroge-
neous across gender, age, and income (Weareflint, 2018).
The pseudonymity of Imgur could have implications for
social support provision. To create an Imgur account, users
disclose and verify limited personal information (e.g., their
phone number, email, and/or connection to another social
network), though this information is not accessible to other
users. Subsequent user interactions are pseudonymous (simi-
lar to Reddit), though posting and commenting history is pre-
served by the platform (unless deleted by the user).
Architecturally, Imgur centralizes interaction within a “front
page” in which Imgurians view the same content and interact
with one another through popular community-selected posts.
This differs from sites like Facebook which utilize a user-
centered design (i.e., the user is positioned as the central
node of their social space), YouTube, which uses a channel-
based framework (i.e., users “subscribe” to channels), or
Reddit, which employs a community-of-interest design (i.e.,
subreddits). With content as the central node rather than the
direct connection with others, an individual channel, or com-
munity-of-interest, support provision becomes contingent on
post details and cultural norms, as opposed to user identity

Hale et al. 3
and corresponding social norms. Because of these differ-
ences in network size, demographic homogeneity, site affor-
dances, and architecture, Imgur is well-positioned for
comparison with previous examinations of platforms like
Facebook, YouTube (e.g., Hale et al., 2018; Liu et al., 2013),
and Reddit (e.g., De Choudhury & De, 2014). In particular,
while previous work has suggested that social media plat-
forms are useful for eliciting social support, an analysis of
support provision by Imgur users should provide a unique
contextual comparison. Thus, the first research question is
proposed to assess the supportiveness of Imgur discourse
about cancer-related posts:
RQ1. How frequently will social support emerge in com-
ments submitted in response to cancer-related Imgur
posts?
Types of Social Support
In addition to addressing supportive communication gener-
ally, previous scholarship has identified a variety of support
types, and several typologies of social support have been
extended (Cutrona & Russell, 1990; Cutrona & Suhr, 1992;
Neuling & Winefield, 1988; Rains et al., 2015). This study
evaluates four support types outlined by the Multi-
Dimensional Support Scale (MDSS) (Neuling & Winefield,
1988)—reassuring, empathic, informational, and tangible
support. Reassuring support provides confidence through
words of affirmation or hope (e.g., “You can do this!”).
Empathic support is provided to others in environments of
acceptance or love to facilitate an understanding of the indi-
vidual’s issues (e.g., “I understand where you are coming
from” or “I see how you are feeling”). Informational support
is provided to organize thoughts and provide appraisal for
the individual, including advice (e.g., “Perhaps consider a
diet change”). Finally, tangible support involves direct aid
through financial or physical assistance (e.g., “Can help
cover your healthcare costs?”). The relative prominence of
these support types fluctuates in online communities, with
research finding various levels of empathic or informational
support (Blank et al., 2010; Buis & Whitten, 2011; Ginossar,
2008; Love et al., 2012), informational support (Ginossar,
2008), and reassuring support (Hale et al., 2018). Accordingly,
the following research question is extended:
RQ2. How frequently will reassuring, empathic, informa-
tional, and tangible support emerge in Imgur comments
submitted in response to cancer-related Imgur posts?
Narrative
Previous research suggests that narrative construction can be
a beneficial coping strategy for individuals dealing with
chronic illness (Kreuter et al., 2007), as the purposeful con-
struction of a narrative allows patients to assign causality for
their condition, determine linearity of the illness process, and
produce a framework through which their situation can be
understood (Kellas, 2016; Kellas & Manusov, 2003; Ziebland
& Wyke, 2012). For cancer patients in particular, creating a
narrative can help regain a sense of agency or control over
the situation (Bishop & Yardley, 2004; Chou et al., 2011;
Midtgaard et al., 2007) encourages a sense of self-reliance
(Midtgaard et al., 2007) and allows patients to “renegotiate
agency within the medical system that positions doctors as
experts and cancer patients as merely recipients of treatment
and information” (Hale et al., 2018, p. 576). Beyond con-
structing a cancer narrative, sharing with others may be espe-
cially beneficial, as audiences respond by providing
appropriate forms of support, facilitating psychological
adjustment and promoting recovery for the patient (Berkman,
1984; House et al., 1988; Neuling & Winefield, 1988; Uchino
et al., 1996). Moreover, the response received from readers
or listeners is partially determined by the narrative structure
employed by the patient, as this helps the audience “make
sense of [their] own situation by suggesting a practical and
emotional frame for [their] response” (Ziebland & Wyke,
2012, p. 236).
Previous scholars have identified four cancer narrative
features connected with support provision: explanations of
the diagnosis experience, agentive problem solving, positive
reappraisal, and pleads for audience checkup (e.g., Chou
et al., 2011; Dunkel-Schetter et al., 1987; Hale et al., 2018;
Liu et al., 2013). For example, B. J. Hale and colleagues
(2018) found that when YouTube cancer vloggers explained
their diagnosis experience, signaled that they planned to pro-
actively deal with cancer, or provided positive reappraisal of
their cancer situation, they were more likely to receive
empathic support in comments than vloggers who did not
include these narrative elements. In contrast, vlogs that
included calls to action—or calls for viewers who are con-
cerned about their health to seek professional attention and
care—yielded fewer empathic comments. However, Liu
et al. (2013) found that this narrative element promoted vlog-
ger relatability and audience intimacy, which could increase
emotional engagement and empathy (Chou et al., 2011). This
study provides an opportunity to examine the relationship
between these four narrative features and the provision of
empathic support within a different platform (i.e., Imgur),
and thus the following hypothesis and research question are
extended:
H1. The inclusion of (a) the diagnosis experience, (b)
problem solving, and (c) positive reappraisal in Imgur
posts will increase the likelihood of empathic support in
comments compared with posts without these narrative
components.
RQ3. Will the inclusion of pleads for audience checkup
promote empathic support in comments compared to
posts without this narrative component?

4 Social Media + Society
In addition, sharing negative experiences (or possible out-
comes) may prompt empathy from others. Bareket-Bojmel
and Shahar (2011) argue that “negative feelings are impor-
tant for the processing of the disclosed experience . . . [and]
perhaps contribute to the emergence of empathy or closeness
among the interacting partners” (p. 752). The salient threat of
mortality (to oneself or someone else) is likely to emerge in
discussions about cancer, and thus could prompt empathy
from other Imgurians. Therefore, it is hypothesized that
direct references to mortality (e.g., “the doctors gave me six
months to live”) by Imgur posters will elicit empathic reac-
tions from commenters.
H2. The inclusion of mortality in post narratives will
increase the likelihood of empathic support in comments
compared with posts without mortality disclosures.
Furthermore, previous scholarship has drawn connec-
tions between humor, social support, and positive health
outcomes (Martin & Lefcourt, 2004; Mora-Ripoll, 2010;
Roaldsen et al., 2015). Some scholars argue that humor
functions as a distinct coping strategy (e.g., Mora-Ripoll,
2010; Roaldsen et al., 2015), while others contend that
humor facilitates support provision (Kuiper & McHale,
2009; Martin & Lefcourt, 2004). Moreover, previous analy-
ses of Imgur content indicate that humor is commonly uti-
lized in this context (Hale, 2017, 2019; Mikal et al., 2014).
B. J. Hale (2019) found that non-bona fide linguistic fea-
tures (e.g., humor, irony, and sarcasm) frequently mani-
fested but rarely coincided with support in comments
responding to Imgur posts about depression. However, it is
yet unknown whether a relationship exists between posts
that utilize humor and the provision of support in comments.
Therefore, an additional research question is forwarded to
examine this relationship:
RQ4. Will the inclusion of humor in posts affect the likeli-
hood of empathic support provision in comments?
Finally, while previous analyses suggest a prevalence of
empathic support online (Blank et al., 2010; Buis & Whitten,
2011; Love et al., 2012), and narrative features seem to best
elicit this support type, other forms of support (e.g., reassur-
ing, informational, and tangible) could also relate to narrative
components. It may be noted that the previous analysis of
YouTube vlogs conducted by B. J. Hale et al. (2018) found
that reassuring support was largely unaffected by narrative
features, and informational and tangible support types infre-
quently manifested in YouTube comments, hindering their
ability to ascertain the relationship between narrative features
and these two support types. However, the nature of support-
ive communication within Imgur could differ from other plat-
forms (e.g., YouTube), and thus the aforementioned narrative
features (i.e., explanations of the diagnosis experience,
agentive problem solving, positive reappraisal, and pleads for
audience checkup) could predict other forms of support in
this context. Therefore, a research question is proposed to
examine these possible relationships:
RQ5. Will narrative elements (i.e., the diagnosis experi-
ence, pleads for audience checkup, problem solving, posi-
tive reappraisal, references to mortality, and humor)
predict other types of support (i.e., reassuring, informa-
tional, and tangible)?
Method
A content analysis was performed to identify the provision of
social support (including reassuring, empathic, informa-
tional, and tangible support types) in comments responding
to cancer-related Imgur posts. In total, 117 cancer-related
Imgur posts and 2511 corresponding comments were ana-
lyzed, examining the relationship between post features (i.e.,
the diagnosis experience, problem solving, positive reap-
praisal, pleads for audience checkup, and humor) and social
support, providing naturalistic insight into online support
exchange in Imgur.
Sample
A sampling frame was created by collecting Imgur posts
from 9 November 2018 to 12 January 2019. Posts that con-
tained the term “cancer” (i.e., in the title, text, or tags) were
identified using the Imgur application programming inter-
face (API) and collected daily following a staggered sam-
pling strategy (N = 241). All user comments submitted to
these posts were also collected (N = 8247). Data were col-
lected at 8 a.m. on the first collection day (9 November), and
collection was shifted an hour later each day until data were
sampled at 8 p.m. (21 November). On the following day (22
November), the schedule began again at 8 a.m., and this pro-
cess was repeated until 12 January. Screenshots of each
Imgur post were captured and stored for analysis. This sam-
pling strategy allowed us to capture content without intro-
ducing bias toward posts and comments submitted at a
certain time of day or day of the week. From the sampling
frame, posts were filtered according to their focus on cancer
and the cancer experience (e.g., posts using language like
“this movie is cancer” were removed), leaving 122 posts (see
Figure 1). Five additional posts that received no user com-
ments were removed, as ascertaining relationships between
post and comment categories would not be possible without
comments (this decision was made a priori). Thus, the final
sample included 117 Imgur posts that directly discussed can-
cer or the cancer experience and generated at least one user
comment. Comments were filtered to only include thread-
starting root comments (i.e., comments that directly respond
to the post), as focusing on root comments informs our

Hale et al. 5
research questions more closely than examinations of
response comments that respond to other commenters. A
content analysis was performed of the remaining 117 cancer-
related Imgur posts (113 unique posters) and 2511 corre-
sponding comments (2322 unique commenters).
Coding Procedure
A codebook was developed to capture narrative features and
control factors in Imgur posts and social support in com-
ments. Two coders familiar with Imgur, including typical
posting and commenting practices (especially the use of
Imgur-specific humor; see Mikal et al., 2014), were trained
using the codebook. Intercoder reliability was assessed using
Krippendorff’s alpha (range = .72–1.0). In total, 38 posts
(31.2% of the sample) and 480 comments (19%) were exam-
ined for coder training and 21 posts (17.2%) and 254 com-
ments (10.1%) were used for calculating Krippendorff’s
alpha (overall α = .87). Once reliability was established, the
sample was equally distributed between the two coders.
Coders accessed each Imgur post via a stored hyperlink or
the archived screenshot (if the hyperlink was no longer
active) and categorized narrative features (diagnosis, prob-
lem solving, positive reappraisal, pleads for audience
checkup, mortality, and humor) and control variables (identi-
fiability, cancer type, preexisting support, and cancer sub-
ject). Comments were accessed via a spreadsheet and
categorized for social support types (reassuring, empathic,
informational, and tangible). All content categories were
coded across text and visuals (e.g., images or gifs), as multi-
modal communication is common in Imgur. Problem cases
were flagged by coders and collectively discussed.
Measures
Control Categories. Controls, including identifiability, cancer
subject, cancer type, and preexisting support were catego-
rized for each Imgur post. Identifiability was constructed by
combining three categories related to poster characteristics,
including posters that included their image (α = .91), sex
(α = .84), and/or age (α = .78). Poster sex was coded as male,
female, or unidentifiable, while poster age was grouped into
six categories: 0–10 years, 10–20 years, 20–40 years, 40–
60 years, 60+ years, or unidentifiable. When the poster
remained unidentifiable across these categories, the post was
categorized as anonymous. If the poster disclosed their sex or
age (or both), this was categorized as minor identifiability.
The post was classified as major identifiability when the
poster included an image of their self (e.g., a “selfie”). Can-
cer subject (α = .93) was coded as either self, other person,
animal (e.g., pets), or topic (e.g., posts about cancer that did
not include a reference to a person or animal). Cancer type
(α = 1.0) was categorized according to post content. Finally,
preexisting support (α = .92) was categorized as negative
support (e.g., negatively affected by family or friends), no
support, positive support (e.g., positively affected by family
or friends), or very positive support (e.g., emphasizing a par-
ticular person’s contribution or a large amount of support),
according to information provided by the poster, following
the framework used by B. J. Hale et al. (2018).
Narrative Categories. In addition to controls, six narrative
categories were coded for each Imgur post, including diag-
nosis, problem solving, positive reappraisal, pleads for audi-
ence checkup, mortality, and humor. Diagnosis (α = .9) was
coded using a dichotomous yes/no response for any discus-
sion of cancer diagnosis (e.g., a previous or future diagnosis
procedure, diagnosis details, or symptoms that led to diagno-
sis). Problem solving (α = .79) was also coded using a dichot-
omous yes/no response and included plans to proactively
deal with cancer or concentrated efforts to make things work.
Also coded dichotomously, positive reappraisal (α = .77)
was categorized when the poster described personal growth
or some positive emotional or social change as a result of
dealing with cancer. Audience checkup (α = 1.0) was coded
when the poster advocated for readers to get a checkup or
cancer screening (e.g., a doctor visit for potentially cancer-
ous growths or regular breast examinations). Mortality
(α = 1.0) was coded when the poster disclosed a timeline for
their possible death, the death of someone else (e.g., family
member or friend), or general mortality related to cancer
(e.g., statistics about their cancer type). Finally, humor
(α = .89) was coded when the poster included jokes, formu-
laic humor (i.e., Imgur-specific humor), or other humorous
language.
Support Categories. Within comments, each support type out-
lined by Neuling and Winefield (1988) was coded using a
Sampling Frame (N = 241)
All Imgur posts using the term
“cancer” from Nov 9 – Jan 12
Posts Excluded (N = 124)
Not focused on cancer/cancer experience (N = 119)
No comments included (N = 5)
Post Sample (N = 117)
Comments Excluded (N = 5736)
Post excluded (N = 3518)
Response comment (N = 2208)
Comment deleted by user/moderator (N = 5)
Comment removed by user (N = 5)
Comment Sample
(N = 2511)
Figure 1. A visualization of the filtering process used for posts
and comments.

6 Social Media + Society
dichotomous response. Reassuring support (α = .77) included
statements of hope (e.g., “I believe you’ll get through this!”),
support (e.g., “you can do this!”), complement (e.g., “you’re
looking great!”), and other features designed to uplift the
poster. Empathic support (α = .72) was coded when com-
ments contained statements acknowledging the poster’s
emotions or feelings (e.g., “I understand where you’re com-
ing from” or “I’ve felt that way too”), or encouragement to
continue discussing their experience (e.g., “please keep us
updated”). Informational support (α = .83) included verifi-
able non-personal information, including corrections to mis-
information provided by another person. Finally, tangible
support (α = .8) was coded when commenters expressed an
interest in assisting the poster in a tangible way (e.g., finan-
cially). Support types were not mutually exclusive.
Results
Descriptives
Overall, 75.6% of comments contained at least one form of
support (N = 1898), suggesting that the typical response to an
Imgur post about cancer is supportive (RQ1). Examining spe-
cific support types, reassuring support occurred most fre-
quently, followed by empathic, informational, and tangible
support (RQ2) (see Table 1). Comments that included infor-
mational support received the highest average score of the four
support types, followed by empathic, reassuring, and tangible
support, and also the highest average number of replies, fol-
lowed by tangible, reassuring, and empathic support.
In addition, each of the narrative features and categories
proposed for this study appeared in this dataset (see Table 2).
Explanations of the diagnosis experience, agentive problem
solving, and mortality were present in approximately 40% of
posts, followed in frequency by humor, positive reappraisal,
and pleads for audience checkup. A majority of Imgur post-
ers were anonymous, which is unsurprising considering the
pseudonymity afforded by the platform (see Table 2).
However, posters were identifiable in approximately 44% of
cases (N = 52), with nearly 32% of posters (N = 37) providing
an image of themselves (i.e., major identifiable). In addition,
Imgur posters described the cancer experiences of someone
else slightly more frequently than their personal experience,
followed by those of an animal (e.g., a pet) or the cancer
topic more generally (e.g., cancer statistics, emerging treat-
ments). Approximately 59% of posters (N = 69) detailed their
positive support networks, with fewer posters claiming no
support network (or neglecting to mention an existing sup-
port network), or having experienced negative feedback
from their network. Finally, while over a dozen forms of can-
cer were explicitly described in this dataset, nearly 47% of
Imgur posters (N = 55) did not report a specific cancer type.
Predicting Social Support
To ascertain the relationship between narrative features and
support provision in comments, a series of multilevel binomial
Table 1. Distribution of Support Types in Comments
(N = 2511).
Category Number of
instances
Percentage Mean
score
Mean
replies
Reassuring 1342 53.2 13.84 0.59
Empathic 725 28.7 16.90 0.51
Informational 476 18.9 18.27 1.70
Tangible 40 1.6 10.95 1.05
Support types were not mutually exclusive. Mean score reports the
average score for comments that included the support type. Mean replies
indicates the average number of response comments generated by a
comment that included the support type.
Table 2. Distribution of Post Categories (N = 117).
Category Number of
instances
Percentage
Problem solving 48 41.0
Diagnosis 46 39.3
Mortality 46 39.3
Humor 24 20.5
Positive reappraisal 11 9.4
Audience checkup 7 6.0
Identifiability
Anonymous 65 55.6
Minor identifiable 15 12.8
Major identifiable 37 31.6
Post subject
Self 41 35.0
Other 47 40.2
Animal 20 17.1
Topic 9 7.7
Preexisting support
Negative support 5 4.3
No support 43 36.8
Positive support 52 44.4
Very positive support 17 14.5
Cancer type
Lymphoma 12 10.3
Colon 9 7.7
Blood/bone 7 6.0
Brain 6 5.1
Lung 4 3.4
Breast 3 2.6
Skin 3 2.6
Testicular/prostate 3 2.6
Pancreatic 3 2.6
Esophageal/larynx 2 1.7
Thyroid/neuroendocrine 2 1.7
Other 8 6.8
Indeterminable 55 47.0

Hale et al. 7
logistic regression models were constructed that regressed
each support type on narrative and control variables. Models
for empathic, reassuring, and informational support were suc-
cessfully constructed, while tangible support could not be
modeled due to scarcity (1.6%, N = 40). Baseline categories
were adjusted between support models to assist interpretabil-
ity, and thus each is reported separately (Tables 3 to 5).
Empathic Support . Beginning with the control model (Model
1 in Table 3), post subject emerged as a significant predictor
of empathic support (χ2 (df = 3) = 13.17; p < .01), with posters
who disclosed the experiences of an animal or another
person more likely to receive empathic support in a given
comment than those who addressed cancer topically (897%
and 540%, respectively). Further pairwise comparisons
revealed that posters disclosing their personal experience
were also significantly less likely to receive empathic sup-
port in a given comment than those addressing the experi-
ences of an animal (p < .02) or another person (p < .02). In
addition, cancer type significantly predicted the likelihood of
empathic support in comments (χ2(12) = 95.79; p < .001),
with cancers of the blood/bone, lung, and esophagus/larynx
reporting the highest likelihood of empathic support provi-
sion, and skin, pancreatic, and thyroid/endocrine cancers
receiving the lowest. Identifiability emerged as nearly sig-
nificant (χ2(2) = 5.63; p = .06), although pairwise compari-
sons revealed that minor identifiable posters were 147%
more likely to receive empathic support in a given comment
than anonymous posters (p < .05). No significant relationship
was found between empathic support and preexisting sup-
port, (χ2(3) = 2.84; p = ns).
Adding narrative factors to the model yielded a number of
additional findings (see Model 2). The first hypothesis pre-
dicted that the inclusion of (a) the diagnosis experience, (b)
problem solving, and (c) positive reappraisal in Imgur posts
would increase the likelihood of empathic support in com-
ments compared with posts without these narrative compo-
nents. This hypothesis was only partially supported, as
explanations of the diagnosis experience increased the likeli-
hood of empathic support in a given comment by 145%
(χ2(1) = 9.54; p < .01), while problem solving (χ2(1) = 2.71;
p = ns) and positive reappraisal (χ2(1) = 0.77; p = ns) did not
significantly predict empathic support. In answering RQ2,
pleads for audience checkup did not predict empathic sup-
port (χ2(1) = 0.10; p = ns). The second hypothesis predicted
that referencing mortality would increase the likelihood of
empathic support in comments, and this hypothesis was sup-
ported (χ2(1) = 18.08; p < .001). The inclusion of mortality in
Imgur posts increased the likelihood of empathic support in
a given comment by 250%. Finally, these results indicate a
significant negative relationship between humor and
empathic support (χ2(1) = 6.27; p < .02), as the inclusion of
humor in posts predicted a 56% decrease in the likelihood of
empathic support in a given comment (RQ4).
Reassuring Support. Two additional models were constructed
to identify the relationship between narrative elements and
reassuring support, which emerged more commonly than
empathic support in this dataset—in approximately 53% of
comments (see Table 1). The control model (Model 3 in Table
4) reported several significant findings, with identifiability
(χ2(2) = 9.68; p < .01), preexisting support (χ2(3) = 8.73;
p < .04), and post subject (χ2(3) = 8.29; p < .04) predicting
reassuring support. Posters categorized as anonymous or
minor identifiable were less likely to receive reassuring
support in a given comment than those classified as major
Table 3. Multi-Level Binomial Logistic Regression Models
Predicting Empathic Support.
Model 1 Model 2
B SE BSE
Diagnosis 0.90** 0.29
Problem solving −0.36 0.24
Positive reappraisal 0.24 0.27
Audience checkup 0.13 0.42
Mortality 1.25*** 0.29
Humor −0.82* 0.33
Identifiability
Minor identifiable 0.90* 0.38 0.37 0.28
Major identifiable 0.47 0.36 0.57†0.32
Post subject
Self 0.93 0.88 1.08 0.82
Other 1.86* 0.88 1.43 0.87
Animal 2.30* 0.95 2.25* 0.88
Preexisting support
Negative support 0.57 0.35 −0.06 0.39
No support 0.22 0.40 −0.28 0.36
Positive support 0.30 0.40 −0.11 0.33
Cancer type
Lymphoma 3.14*** 0.80 1.27†0.66
Blood/bone 4.23*** 0.87 2.61*** 0.79
Colon 3.74*** 0.77 2.69*** 0.57
Brain 4.02*** 0.76 2.15*** 0.60
Lung 4.11*** 1.09 2.29** 0.86
Breast 2.81*** 0.71 1.75*** 0.55
Testicular/prostate 3.62*** 0.75 3.07*** 0.71
Pancreatic 1.53 1.02 0.59 0.86
Esophagus/larynx 4.30*** 0.81 2.65*** 0.70
Thyroid/endocrine 2.26** 0.74 2.08** 0.69
Other 3.76*** 0.91 2.24** 0.75
Indeterminable 3.72*** 0.70 2.55*** 0.56
Baseline categories included anonymous for identifiability, topic for post
subject, very positive support for preexisting support, and skin for cancer
type. Coefficients for narrative components (diagnosis, problem solving,
positive reappraisal, audience checkup, mortality, and humor) represent
the change in log-odds when the component is included. Statistical
significance is reported according to Wald chi-square. SE = standard error.
†p < .1, *p < .05, **p < .01, ***p < .001.

8 Social Media + Society
identifiable (43% and 58%, respectively). Also, posters who
reported having no existing support network were 50% less
likely to receive reassuring support in comments than those
who claimed a positive support network. Posters who dis-
closed their personal experiences or those of someone else
were more likely to receive reassuring support than posters
who addressed cancer topically (137% and 153%, respec-
tively). Cancer type did not emerge as significant (χ2(12) =
17.96; p = ns), though pairwise comparisons revealed that
some types (i.e., testicular/prostate, esophagus/larynx, and
brain) were more likely to receive reassuring support than the
baseline category (other cancers).
Adding narrative categories to the model yielded one addi-
tional significant finding (see Model 4). Answering RQ5,
posters who suggested that the audience should receive a
checkup were 48% less likely to receive reassuring support in
a given comment than those who did not (χ2(1) = 4.16; p < .05).
Diagnosis (χ2(1) = 2.23; p = ns), problem solving (χ2(1) = 1.23;
p = ns), positive reappraisal (χ2(1) = 0.91; p = ns), mortality
(χ2(1) = 0.00; p = ns), and humor (χ2(1) = 1.26; p = ns) did not
significantly predict reassuring support in comments.
Informational Support. Two final models were constructed to
evaluate the relationship between narrative elements and
Table 5. Multi-Level Binomial Logistic Regression Models
Predicting Informational Support.
Model 5 Model 6
B SE BSE
Diagnosis −0.19 0.28
Problem solving 0.24 0.20
Positive reappraisal 0.99** 0.34
Audience checkup −0.14 0.44
Mortality 0.00 0.24
Humor 0.16 0.24
Identifiability
Anonymous 0.11 0.33 0.23 0.33
Minor identifiable 0.74†0.40 0.79* 0.34
Post subject
Self −1.19*** 0.33 −1.29*** 0.35
Other −0.97** 0.37 −0.90* 0.39
Animal −1.11* 0.45 −1.20** 0.44
Preexisting support
Negative support 0.92* 0.43 1.34** 0.50
No support 0.50†0.30 0.65* 0.27
Very positive support 0.16 0.35 0.36 0.36
Cancer type
Lymphoma 1.49 1.23 1.16 1.19
Blood/bone 1.16 1.20 1.04 1.22
Colon 2.09†1.17 1.78 1.19
Brain 2.10†1.18 2.26†1.24
Lung 1.99 1.27 1.96 1.29
Skin 1.99 1.21 1.62 1.30
Testicular/prostate 1.90 1.25 1.79 1.29
Pancreatic 1.94 1.20 1.80 1.20
Esophagus/larynx 3.19* 1.35 2.97* 1.39
Thyroid/endocrine 1.24 1.23 0.86 1.23
Other 1.88 1.15 1.93 1.19
Indeterminable 1.32 1.18 1.06 1.18
Baseline categories included major identifiable for identifiability, topic
for post subject, positive support for preexisting support, and breast
for cancer type. Coefficients for narrative components (diagnosis,
problem solving, positive reappraisal, audience checkup, mortality,
and humor) represent the change in log-odds when the component is
included. Statistical significance is reported according to Wald chi-square.
SE = standard error.
†p < .1, *p < .05, **p < .01, ***p < .001.
Table 4. Multi-Level Binomial Logistic Regression Models
Predicting Reassuring Support.
Model 3 Model 4
B SE BSE
Diagnosis −0.34 0.23
Problem solving −0.24 0.22
Positive reappraisal −0.25 0.26
Audience checkup −0.65* 0.32
Mortality 0.00 0.19
Humor 0.28 0.25
Identifiability
Anonymous −0.56* 0.26 −0.57* 0.25
Minor identifiable −0.86** 0.28 −0.85** 0.29
Post subject
Self 0.86* 0.36 0.97* 0.38
Other 0.93** 0.35 0.98* 0.41
Animal 0.61 0.48 0.36 0.55
Preexisting support
Negative support −0.46 0.34 −0.41 0.45
No support −0.70** 0.24 −0.64** 0.23
Very positive support −0.27 0.26 −0.15 0.28
Cancer type
Lymphoma −0.05 0.36 −0.61 0.49
Blood/bone −0.17 0.33 −0.80†0.46
Colon −0.90†0.49 −1.35** 0.46
Brain −0.73* 0.34 −1.28* 0.52
Lung −0.58†0.31 −1.24** 0.45
Breast −0.10 0.39 −0.94 0.61
Testicular/prostate −1.15* 0.49 −1.64*** 0.50
Pancreatic −0.82†0.49 −1.47* 0.70
Esophagus/larynx −1.07** 0.38 −1.66*** 0.48
Thyroid/endocrine −1.10 0.76 −1.96* 0.86
Skin −0.51 0.65 −0.76 0.72
Indeterminable −0.62†0.32 −1.34** 0.48
Baseline categories included major identifiable for identifiability, topic
for post subject, positive support for preexisting support, and other
for cancer type. Coefficients for narrative components (diagnosis,
problem solving, positive reappraisal, audience checkup, mortality,
and humor) represent the change in log-odds when the component is
included. Statistical significance is reported according to Wald chi-square.
SE = standard error.
†p < .1, *p < .05, **p < .01, ***p < .001.

Hale et al. 9
informational support. In the control model (Model 5 in
Table 5), post subject (χ2(3) = 13.76; p < .01) and cancer type
(χ2(12) = 21.5; p < .001) significantly predicted informa-
tional support. Compared with posters who discussed cancer
topically, those reporting information about themselves
were 70% less likely to receive informational support in a
given comment, while posters detailing the experiences of
another person were 62% less likely, and those describing
an animal’s experiences were 67% less likely. Posters
describing cancers of the esophagus/larynx, colon, and brain
were more likely to receive informational support than those
with breast, blood/bone, or thyroid/neuroendocrine cancers.
Although preexisting support (χ2(3) = 6.02; p = ns) did not
emerge as significant, pairwise comparisons revealed that
posters who described negative support from their network
were 151% more likely to receive informational support
than those reporting a positive support network (p < .04).
Moreover, posters who described no support network were
65% more likely to receive informational support than those
with a positive support network, although this was nearly
significant (p = .09). Identifiability (χ2(2) = 4.57; p = ns) was
not significant.
When narrative categories were included (Model 6),
positive reappraisal (χ2(1) = 8.2; p < .01) emerged as a sig-
nificant predictor of informational support (RQ5). Posters
who provided a positive reappraisal of their situation were
168% more likely to receive informational support in a
given comment than those who did not include this feature.
Explanations of the diagnosis experience (χ2(1) = 0.49;
p = ns), problem solving (χ2(1) = 1.45; p = ns), audience
checkup (χ2(1) = 0.1; p = ns) mortality (χ2(1) = 0.00; p = ns),
and humor (χ2(1) = 0.48; p = ns) were not significant.
Discussion
Through a content analysis of cancer-related Imgur dis-
course, this project examined the relationship between narra-
tive features in 117 cancer-related Imgur posts and support
provision in 2511 corresponding comments. Building upon
previous social support work (Chou et al., 2011; Dunkel-
Schetter et al., 1987; Hale et al., 2018; Kuiper & McHale,
2009; Liu et al., 2013; Martin & Lefcourt, 2004), six narra-
tive features were examined, including explanations of the
diagnosis experience, agentive problem solving, positive
reappraisal, pleads for the audience to get a checkup (e.g.,
cancer screening), references to mortality, and humor. In
addition, four types of social support were identified, as out-
lined by the MDSS (Neuling & Winefield, 1988)—reassur-
ing, empathic, informational, and tangible support. This
project responds to recent calls for research evaluating ante-
cedents to support provision and support emergence across
social media platforms (Meng et al., 2017; Rains et al.,
2015), finding that the inclusion of narrative elements in
cancer-related Imgur posts significantly predicted the gener-
ation of support in responding comments. Because the Imgur
platform differs culturally and architecturally from other
well-researched sites like YouTube (Frohlich & Zmyslinski-
Seelig, 2012; Hale et al., 2018; Liu et al., 2013) and
Facebook, which has received the bulk of previous scholarly
attention (Buehler et al., 2019; Gage-Bouchard et al., 2017;
High et al., 2014; Vitak & Ellison, 2013), the results of this
study are well-positioned for comparison with previous
findings.
The results of this study suggest that the typical response
to an Imgur post about cancer is supportive, as approximately
75.6% of comments in this dataset contained at least one form
of support. Reassuring support manifested most commonly
(in approximately 53% of comments), followed by empathic,
informational, and tangible support types. This pattern is con-
sistent with that found by B. J. Hale et al. (2018), although
reassuring and empathic support occurred slightly less fre-
quently and informational support emerged more frequently
in Imgur than in YouTube. These findings also agree with pre-
vious support research indicating increased provision of
empathic compared to informational support in response to
cancer patients in other online communities (Blank et al.,
2010; Buis & Whitten, 2011; Love et al., 2012). While reas-
suring support emerged more prominently than empathic and
informational support in both Imgur and YouTube comments
(Hale et al., 2018), this support type has been largely excluded
from previous online cancer-related social support research
(see Rains et al., 2015), and thus the relative prevalence of
this support type is difficult to assess across studies. In addi-
tion, the findings of this study differ notably from a previous
analysis of depression-related Imgur posts (Hale, 2019),
where reassuring support emerged at a similar frequency to
empathic and informational support (and lower levels than
that found here), followed by tangible support. Considered
together, these results agree with the propositions of optimal
matching theory (Cutrona & Russell, 1990; Rains et al.,
2015), as stressor characteristics (i.e., cancer versus depres-
sion) seem to affect the provision of different forms of sup-
port more than the platforms through which support is sought
and provided. Moreover, considered alongside previous
scholarship these findings indicate that empathic and infor-
mational support is generally available across digital plat-
forms (Rains et al., 2015; Zhang et al., 2017). As an additional
note regarding the 24.4% of comments that did not contain
social support, these often included dark humor (e.g., “enjoy
death!”), mean-spirited or hateful content (e.g., “Buck up and
get over it”), questions (e.g., “CT stands for cancer tumors?”),
and irrelevant content (e.g., “Can we deploy it against
Facebook?”), and were typically poorly received by the
community.
As hypothesized, Imgur posters who included an explana-
tion of their diagnosis experience were more likely to receive
empathic support from commenters than those who did not.
Unexpectedly, however, agentive problem solving and posi-
tive reappraisal did not predict empathic support in Imgur
comments. Furthermore, pleads for the audience to receive a

10 Social Media + Society
professional checkup did not relate to empathic support.
These results differ from previous work (Chou et al., 2011;
Dunkel-Schetter et al., 1987; Hale et al., 2018; Liu et al.,
2013) and could be the result of differences in audience
attention and expectations of message detail, where Imgur
posts are generally brief and humorous (promoting brows-
ing), while YouTube vlogs are lengthier and audiences are
expected to remain engaged for a comparatively longer
amount of time. These narrative features may have encour-
aged supportive interaction through the YouTube platform
where detail is comparatively more prioritized than Imgur.
Another possibility is that these narrative features are better
expressed to an audience familiar with the cancer patient’s
situation (e.g., followers, subscribers, or an offline network),
which is a core characteristic of platforms like Facebook and
YouTube, but not central to Imgur. Agentive problem solving
and positive reappraisal indicate a positive or healthy trans-
formation in the poster’s mindset (e.g., “I have decided to
take charge and try something new”; “I have now developed
a new outlook on life”) and thus could have more impact for
familiar and intimate audiences, which are more likely to
provide empathic support (Chou et al., 2011).
Also as hypothesized, references to mortality signifi-
cantly increased the likelihood of empathic support in Imgur
comments. Mortality is a regularly articulated concern for
posters (this feature emerged in nearly 40% of posts), and
sharing fears associated with impending mortality may
facilitate empathy and emotional closeness with the audi-
ence (Bareket-Bojmel & Shahar, 2011), increasing the like-
lihood that commenters will provide empathic support. In
addition, the inclusion of humor significantly decreased the
likelihood of empathic support in comments. One possibil-
ity is that the use of humor by posters prompted humorous
(instead of supportive) responses, reframing the cancer dis-
cussion within normative (i.e., humorous) Imgur discourse
(see Mikal et al., 2014). Put differently, while other narra-
tive features prompted empathic responses, humor may
have signaled different psychosocial needs (e.g., conversa-
tional normalcy) to commenters. However, the causal rela-
tionship between post-level humor and comment-level
support cannot be ascertained from these data.
Although less sensitive to narrative features than empathic
support, two significant findings emerged for reassuring and
informational support. First, Imgur posters who suggested
that the audience should receive a professional checkup (e.g.,
cancer screening) significantly decreased their likelihood of
receiving reassuring support. Perhaps this suggestion was
experienced as an unwelcome imposition (maybe similar to a
public health message), especially from an unknown, and
potentially anonymous source, hindering commenters’ will-
ingness to provide reassuring support. Alternatively, the
inclusion of this narrative feature may have shifted the dis-
course away from the poster and onto commenters, reducing
the number of comments providing reassuring support.
Second, posters who positively reappraised their situation
increased their likelihood of receiving informational support.
Speculatively, one possibility is that individuals felt more
comfortable providing informational support to the poster
when they provided a positive outlook, potentially indicating
a receptiveness to advice (or perhaps the absence of positive
reappraisal indicates a lack of receptiveness). However, the
causal relationship between these narrative features and sup-
port should be explored in future work.
The relationship between two control categories—identi-
fiability and post subject—and support provision are also
worth expounding. Posters who included “major identifi-
able” features in posts experienced the highest likelihood of
empathic and reassuring support, but the lowest likelihood of
informational support. Conversely, anonymous posters were
the least likely to receive empathic support, while posters
with fewer identifying characteristics received the lowest
level of reassuring and highest level of informational sup-
port. In other words, differences in support are contingent on
identity, a peculiar predictor of supportive engagement, par-
ticularly in digital platforms that host cultures of anonymity
like Imgur and Reddit (Kilgo et al., 2018). Voluntary disclo-
sure of identifying information seems to have important
implications for support provision. In particular, posters who
relinquished their anonymity by sharing an identifiable
image seemed to benefit from increased empathic and reas-
suring support. Next, posters who described the cancer expe-
riences of an animal were significantly more likely to receive
empathic support than those describing their own personal
experience, those of another person, or cancer topically.
Disclosing personal cancer experiences or details about
another person yielded the highest levels of reassuring sup-
port, while discussing cancer as a topic generated the most
informational support. Thus, the relationship between the
poster and cancer (e.g., patient, family member, pet owner)
seems to have further ramifications for support provision.
Considering the importance of empathic support for positive
health outcomes (Iso-Ahola & Park, 1996; Uchino et al.,
1996), it is noteworthy that posters describing the experi-
ences of an animal were most likely to receive this support
type. Perhaps the frequency of cancer in domestic animals
(American Veterinary Medical Association, 2019) and the
increased likelihood that commenters shared the poster’s
experience facilitated empathic responses.
Overall, the results of this study indicate a relationship
between narrative construction and support provision, find-
ing that the inclusion of narrative features in cancer-related
Imgur posts influenced the provision of social support in
comments. Moreover, consistent with previous scholarship,
narrative features primarily predicted empathic support
(Chou et al., 2011; Dunkel-Schetter et al., 1987; Hale et al.,
2018; Liu et al., 2013). Accordingly, this work contributes to
social support research by (1) identifying the supportiveness
of Imgur comments generated in response to messages about
cancer, providing insight into a popular social media plat-
form that has received little previous scholarly attention, (2)
examining the relationship between narrative features in
cancer-related Imgur posts and support provision in

Hale et al. 11
comments, and (3) allowing comparisons of support genera-
tion between Imgur and previously studied sites.
Findings of this study could have implications for a multi-
tude of stakeholders interested in social support provision,
including healthcare professionals, researchers interested in
the use of social media platforms for support, and organiza-
tions interested in designing supportive online platforms for
individuals coping with cancer. First, these results indicate
that supportive feedback about cancer is similar across online
social networks (e.g., Facebook, YouTube, and Imgur).
Recognizing differences in cultural expectations and platform
affordances, alongside cancer patients’ existing social media
presence, may allow for more specific recommendations
about where patients could find support online. For example,
practitioners and caregivers might direct individuals coping
with cancer to Imgur who would benefit from the site’s dis-
tinct functions, including anonymity and humor-based com-
munication. Patients and caregivers that have social anxiety
or prefer to keep their health condition private might find that
Imgur is a comfortable place to connect with others and
acquire support. Second, organizations that advocate, fund-
raise, and create communities for cancer patients and survi-
vors (e.g., Susan B. Komen Breast Cancer Foundation and
Livestrong) often have robust communities on larger social
media sites like Facebook and Twitter. By acknowledging
and building communities in anonymous networks like
Imgur, these organizations could reach broader audiences and
better cater to patient personalities and preferences. Finally,
similar social support findings between architecturally dis-
similar sites like Imgur (a centralized content-oriented pseud-
onymous platform), YouTube (a decentralized “channel”-based
platform with varying levels of anonymity), and Facebook (a
decentralized user-oriented identifiable platform) suggest
generalizable patterns of supportive communication, which is
likely of interest to social support researchers. In particular,
the provision of empathic and informational support to cancer
patients and the sensitivity of empathic support to voluntary
self-disclosure and narrative elements seems consistent across
contemporary digital platforms.
Limitations and Future Directions
A few limitations of this study and opportunities for future
research should be noted. Although the results of this study
indicate significant relationships between narrative features
in Imgur posts and social support in comments, causality
cannot be ascertained from content analysis data.
Nevertheless, the results of this study set the foundation for
further exploration of support provision in niche social net-
works, including the use of narrative features for support
elicitation, as this study reinforces previous scholarship
suggesting that narrative construction can influence sup-
port. Additional examinations of cancer narratives will pro-
vide important points of comparison, especially within
other social media platforms (e.g., Reddit, Tumblr,
Instagram). Specific attention to differences in visual and
textual communication might elucidate important distinc-
tions between support communities and social media cul-
tures, especially comparing platforms that rely heavily on
visual communication (e.g., Imgur and Instagram) to those
more narratively focused. As shown in the findings of this
research, further work within diverse platforms may eluci-
date differences in narrative construction and supportive
communication across digital contexts, and thus should
prove valuable for our understanding of online support
generation.
Conclusion
This study suggests a relationship between narrative con-
struction and social support, as the inclusion of narrative fea-
tures in cancer-related Imgur posts influenced the provision
of support in responding comments. Developing a robust
support network (including online connections) and increas-
ing perceived social capital helps individuals battling dis-
eases and health conditions like cancer facilitate adaptive
coping mechanisms. Accordingly, understanding what fac-
tors facilitate the provision of support in online conversa-
tions could help researchers, healthcare professionals, and
platform designers develop spaces and strategies for eliciting
support and guiding productive conversation about cancer.
Furthermore, exploring supportive communication in small
social networks like Imgur, dwarfed by well-studied plat-
forms like Facebook and YouTube, provides opportunities to
examine both differences and similarities in discussions
about cancer across social media communities. Despite the
distinct differences in peer-to-peer (e.g., Facebook) and con-
tent-based (e.g., Imgur) networks, this study confirms that
the communal response to people posting about cancer tends
to be supportive. Future work should take account of the
growing diversity of online communities, including the con-
nections and support emerging across contemporary social
media platforms.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, author-
ship, and/or publication of this article.
ORCID iDs
Brent J. Hale https://orcid.org/0000-0003-3452-9589
Danielle K. Kilgo https://orcid.org/0000-0001-7637-8964
References
American Veterinary Medical Association. (2019). Cancer in pets.
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12 Social Media + Society
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Author Biographies
Brent J. Hale (PhD, Indiana University) is a recent doctoral graduate
from The Media School at Indiana University. His research interests
include interlocutory and psychological responses to social media
content through commenting, including messages related to health
and politics.
Ryan Collins (MA, University of North Texas) is a doctoral candidate
at Indiana University’s Media School. His research focuses on mar-
keting communications and branding, political communication, and
religiosity.
Danielle K. Kilgo (PhD, University of Texas, Austin) is the John &
Elizabeth Bates Cowles Professor of Journalism, Diversity and
Equality at the Hubbard School of Journalism and Mass Communication
at the University of Minnesota, Twin Cities. Kilgo researches news and
social media’s contribution to uneven power dynamics and diversity
issues in society. Her published work explores how the public per-
ceives and engages with news content published online and within
social media, particularly in contexts such as incidents of police brutal-
ity and social movements against violence and racism.