Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jun 08, 2026)
Date Submitted: Feb 25, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Acceptability and preliminary effectiveness of a Massive Open Online Course for Women with Breast Cancer
ABSTRACT
Background:
Digital health literacy and person-centred care interventions can enhance understanding of online health information and empower patients, optimizing healthcare. Massive Open Online Courses (MOOCs) can provide flexible access and adapted educational resources and are a useful self-care strategy to chronic patients.
Objective:
This study aimed to assess the acceptability and preliminary effectiveness of the MOOC “Active: Empower Yourself Against Breast Cancer” (original title in Spanish: “Activas: Empodérate frente al cáncer de mama”).
Methods:
The MOOC was developed through a co-creation process involving patients, healthcare professionals, and health science researchers and was designed to improve digital health literacy, health literacy, knowledge, self-care, and person-centred care among women at different stages of breast cancer, breast cancer survivors (currently disease-free), and their families/caregivers. Seventy-nine Spanish-speaking participants were recruited using convenience sampling, of whom forty-three completed all MOOC units and assessed its acceptability.
Results:
Primary outcomes included changes in self-perceived digital health literacy and health literacy after completing the MOOC, measured with the eHealth Literacy Scale (eHEALS) and the Health Literacy Survey European Questionnaire–16 items (HLS-EU-Q16). Knowledge gained in each unit and overall acceptability, based on the Technology Acceptance Model, were also evaluated. Significant improvements were observed in HL (HLS-EU-Q16, P=.0027) and DHL (eHEALS, P=.007). The average rating of the MOOC was 8.9 out of 10. Most participants reported high acceptability regarding language, content, relevance, activities, and alignment with the stated objectives.
Conclusions:
The MOOC appears to be a feasible strategy to improve the digital health literacy, knowledge, self-care, and person-centred care challenges in women with breast cancer, showing high acceptability. Further research with larger and more diverse samples is warranted. Clinical Trial: The study was retrospectively registered in Clinical Trials.gov (NCT06635239) on October 4th, 2024.
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