Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 12, 2021
Date Accepted: Oct 14, 2021
Demographic and Psychosocial Characteristics Associated with Use of a Prostate Cancer Survivorship Website: Implications from a Multi-site RCT
ABSTRACT
Background:
Many prostate cancer (PC) survivors suffer from disease and treatment-related symptomatology in both the physical and psychosocial domains. While the benefits and barriers to using web-based resources for cancer patients are well-documented, less research has focused on the personal characteristics important for efficient tailoring and targeting of information that are associated with usage.
Objective:
We used the Cognitive-Social Health Information Processing (C-SHIP) framework to guide our exploration of personal characteristics associated with use of PROGRESS, an informational PC survivorship website that addresses physical, emotional, interpersonal and practical concerns relevant for PC survivors.
Methods:
PC survivors (N = 217) were randomized to the intervention arm (PROGRESS) of a randomized controlled trial (RCT). Of those randomized to the intervention arm, 84 used PROGRESS and 133 did not use PROGRESS. Multivariable analyses evaluated demographic and psychosocial characteristics (e. g. style of coping, health literacy, self-efficacy, and affective states of depression, anxiety and fatigue) associated with website use.
Results:
A larger proportion of non-Hispanic White (42.5%), compared to Black (22.5%) participants used PROGRESS (p < .001). Further, PROGRESS users were older in age (p < .001), had a monitoring style of coping (p = .01) and were less depressed (p = .0004), anxious (p = .02) and fatigued (p < .001) than non-users. Education, income, health literacy, blunting style of coping, self-efficacy, and treatment type (radiation therapy or surgery) were not significantly related to use. On multivariable analyses, race (OR = .28, p < .001), age (OR = 1.05, p < .001), monitoring style of coping (OR = 1.27, p = .02), and overall mood (OR = .98, p < .001) remained significant.
Conclusions:
A combination of monitoring and low levels of negative affect were associated with website use. Additionally, users were older, Non-Hispanic White survivors. To ensure that important survivorship-relevant information reaches users, future efforts need to focus on enhancing patient engagement combined with approaches to increase the emotional support for survivors, particularly for younger, Black patients. Clinical Trial: NCT02224482
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