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 their psychosocial, emotional, physical, and lifestyle support needs, but usage is relatively low due to 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 is a landing page on a well-known Dutch platform that provides cancer survivors with credit 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 analyzed descriptively, and differences between OncoAppstore users and the general population of cancer survivors (GenPop) 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, were more likely to be female, younger on average, and more often of Dutch origin compared to GenPop. 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.