Following Facebook's introduction of the "Like" in 2009, CaringBridge (a nonprofit health journaling platform) implemented a "Heart" symbol as a single-click reaction affordance in 2012. In 2016, Facebook expanded its Like into a set of emotion-based reactions. In 2021, CaringBridge likewise added three new reactions: "Prayer", "Happy", and "Sad." Through user surveys ($N=808$) and interviews ($N=13$), we evaluated this product launch. Unlike Likes on mainstream social media, CaringBridge's single-click Heart was consistently interpreted as a simple, meaningful expression of acknowledgement and support. Although most users accepted the new reactions, the product launch transformed user perceptions of the feature and ignited major disagreement regarding the meanings and functions of reactions in the high stakes context of health crises. Some users found the new reactions to be useful, convenient, and reducing of caregiver burden; others felt they cause emotional harms by stripping communication of meaningful expression and authentic care. Overall, these results surface tensions for small social media platforms that need to survive amidst giants, as well as highlighting crucial trade-offs between the cognitive effort, meaningfulness, and efficiency of different forms of Computer-Mediated Communication (CMC). Our work provides three contributions to support researchers and designers in navigating these tensions: (1) empirical knowledge of how users perceived the reactions launch on CaringBridge; (2) design implications for improving health-focused CMC; and (3) concrete questions to guide future research into reactions and health-focused CMC.

翻译：在Facebook于2009年推出“赞”之后，CaringBridge（一个非营利性健康日记平台）在2012年实现了“心”符号作为一种单击反应影响的可行性。 2016年，Facebook将其赞扩展为基于情感的反应集。 2021年，CaringBridge同样添加了三个新反应：“祈祷”、“快乐”和“悲伤”。 通过用户调查（$N=808$）和访谈（$N=13$），我们对该产品进行了评估。 与主流社交媒体上的赞不同，CaringBridge的单击心被始终解释为简单而富有意义的确认和支持表达。尽管大多数用户接受了新反应，但产品发布转变了用户对该功能的看法，并引发了关于在高风险健康危机背景下反应的意义和功能的重大分歧。一些用户认为新反应是有用的，方便的，减轻了照顾者的负担；而其他人则认为它们通过剥夺交流的有意义的表达和真实关怀而造成情感伤害。总的来说，这些结果揭示了需要在巨头中生存的小型社交媒体平台的紧张关系，并突出了不同形式的计算机中介通信（CMC）之间的认知努力，寓意和效率之间的重要权衡。我们的工作为研究人员和设计师提供了三个贡献，帮助他们在航海中应对这些紧张关系：（1）用户如何看待CaringBridge上的反应发射的实证知识；（2）改善健康重点CMC的设计影响；并（3）引导未来研究反应和健康重点CMC的具体问题。