Digital Trends, Digital Literacy, and E-Health Engagement Predictors of Breast and Colorectal Cancer Survivors: A Population-Based Cross-Sectional Survey

Abstract

Introduction: Advances in information and communication technology (ICT) and post-COVID-19 tectonic changes in healthcare delivery have made it possible for cancer survivors to obtain disease-related information for remote management online rather than through healthcare providers. To comprehend and evaluate health information, digital literacy is crucial. Objectives: This study examined cancer survivors’ information-seeking behaviour, information sources, digital health literacy, and digital trends, as well as potential determinants of e-health information receptivity and online resource use. Methods: A national 30-item cross-sectional survey using a representative random sample of cancer survivors from Jordan’s cancer registry was conducted. Chi-square tests established categorical variable relationships. Using the mean and standard deviation, we calculated the Likert scale’s ordinal data average. A p-value < 0.05 was statistically significant. Logistic regression identified predictors of interest in late-trajectory information acquisition and use of e-health platforms (apps, portals) for cancer self-management. Results: Lower digital literacy and electronic searching were associated with older age and lower income, education, and employment status (p ≤ 0.001). Digital literacy independently predicted m-health app use for remote management and interest in cancer supportive care information. Digitally literate survivors preferred the use of digital platforms (p ≤ 0.001). Information acquisition barriers included “reliability” (26%, n = 25) and “health information trustworthiness” (16.2%, n = 25). Following treatment completion, Internet-seeking behaviour decreased significantly when compared to the early cancer trajectory. Conclusion: Our findings imply that Jordanian cancer survivors’ low digital literacy may hinder information acquisition and technology-enabled cancer care. Digital interventions for cancer survivors should be adaptable to varying levels of digital health literacy. Healthcare policymakers should recognise digital inequities and devise focused initiatives to bridge the digital divide while responding to the urgent need to digitalise cancer care delivery.

Cancer literacy among Jordanian colorectal cancer survivors and informal carers: Qualitative explorations

“…The format used enabled them to exchange ideas and generated meaningful discussions ( 28 , 29 ). The FGs were carried out as a follow-up to a previous study, which showed that DHL was the only independent predictor of eHealth app use and information receptivity among CRC survivors ( 15 ). In addition, previous work identified that CRC survivors' age as an independent factor in determining their use of online information ( 4 ).…”

“…Additionally, the digitalization of healthcare systems brought digital health literacy “DHL” as a new dimension of HL. “eHealth literacy” evolved into “digital health literacy” and is now used interchangeably ( 14 , 15 ). In 2006, Norman and Skinner ( 14 ) defined eHealth literacy as the ability to search, receive, comprehend, and evaluate health information online to solve health issues ( 14 ).…”

“…In 2006, Norman and Skinner ( 14 ) defined eHealth literacy as the ability to search, receive, comprehend, and evaluate health information online to solve health issues ( 14 ). HL underpins DHL, which involves managing Internet sourced information and disease self-management using digitally available resources ( 14 , 15 ). Norman and Skinner ( 14 ) in 2006 defined DHL as a meta-competency with six sub-competences: analytical skills (literacy, numeracy, media, and information literacy) and context-specific abilities (HL, computer literacy, and scientific literacy).…”

“…Further, new communication technologies and the increasing complexity of health systems have made it feasible for people to get health information instantly and continually, and “e-health literacy” is posing a challenge for patients, informal caregivers, local and international health governing bodies ( 8 ). Patients with low HL are more prone to have a fatalistic attitude toward cancer and its prevention ( 24 ), and they also have greater unmet information needs ( 4 , 11 , 15 ). Low HL has also been linked to avoiding medical visits and uncertainty regarding screening ( 10 , 24 , 25 ), which may contribute to screening avoidance.…”

“…In order to improve the present healthcare system, qualitative approaches would provide valuable insights to better understand CRC patients and their ICs interactions with the healthcare system in connection to the many facets of HL. This is partly because, despite the rise of digital health information, patients still need to understand and process information to use it correctly ( 15 ). The outcomes of this study may inform the creation of evidence-based e-health interventions and educational opportunities customized to varied levels of HL to improve HL in CRC patients and their ICs.…”