A growing number of online health communities offer individuals the opportunity to receive information, advice, and support from peers. Recent studies have demonstrated that these new online contacts can be important informational resources, and can even exert significant influence on individuals' behavior in various contexts. However little is known about how people select their health contacts in these virtual domains. This is because selection preferences in peer networks are notoriously difficult to detect. In existing networks, unobserved pressures on tie formation--such as common organizational memberships, introductions to friends of friends, or limitations on accessibility--may mistakenly be interpreted as individual preferences for interacting/not interacting with others. We address these issues by adopting a social media approach to studying network formation. We study social selection using an in vivo study within an online exercise program, in which anonymous participants have equal opportunities for initiating relationships with other program members. This design allows us to identify individuals' preferences for health contacts, and to evaluate what these preferences imply for members' access to new kinds of health information, and for the kinds of social influences to which they are exposed. The study was conducted within a goal-oriented fitness competition, in which participation was greatest among a small core of active individuals. Our results show that the active participants displayed indifference to the fitness and exercise profiles of others, disregarding information about others' fitness levels, exercise preferences, and workout experiences, instead selecting partners almost entirely on the basis of similarities on gender, age, and BMI. Interestingly, the findings suggest that rather than expanding and diversifying their sources of health information, participants' choices limited the value of their online resources by selecting contacts based on characteristics that are common sources of homophily in offline relationships. In light of our findings, we discuss design principles that may be useful for organizations and policy makers trying to improve the value of participants' social capital within online health programs.
