Investigating the early uptake of digital self-management interventions amongst Dutch cancer survivors using nationwide registry data-the OncoAppstore case.

PURPOSE: Digital self-management interventions can aid cancer survivors with psychosocial, emotional, physical, and lifestyle support needs, but usage is relatively low due to a lack of awareness and reimbursement. Additionally, there are concerns about e-health exacerbating existing health disparities. To enhance the uptake of digital self-management interventions, the OncoAppstore was launched-a landing page on a well-known Dutch platform that offers cancer survivors credits to purchase these interventions. It is unknown to what extent the nature of the OncoAppstore will influence uptake and appeal to a diverse group of cancer survivors. The current study therefore aimed to explore sociodemographic, clinical, income, and healthcare usage factors associated with its early uptake among survivors.

METHODS

OncoAppstore usage data were combined with nationwide registry data from Statistics Netherlands, the Netherlands Cancer Registry, and Dutch Hospital Data. Data were analysed descriptively, and differences between OncoAppstore users and non-users were statistically tested using chi-square tests, Fisher's exact tests, and Mann-Whitney U tests.

RESULTS

OncoAppstore users tended to have higher educational levels and incomes and were more likely to be female, younger on average, and more often of Dutch origin compared to non-users. Users had higher primary and specialist mental healthcare expenditures and lower expenditures on total healthcare, general practitioner, hospital, and pharmaceutical care.

CONCLUSION

The early users of the OncoAppstore appear to be a selective group of cancer survivors as they are primarily individuals with high socioeconomic status. Thus, consistent with other e-health research, the same user patterns are observed. Future research should investigate whether this trend persists after a longer period and what is needed to better reach underrepresented groups.