JMIR Publications

ABSTRACT

Background:

Head and Neck Cancer (HNC) patients face significant challenges in accessing coordinated care due to the complex, multimodal nature of their treatment and the impact on vital functions. The COVID-19 pandemic disrupted cancer care delivery while simultaneously accelerating digital health adoption. Mobile health (mHealth) applications offer potential solutions for remote symptom tracking, patient-provider communication, and care continuity, yet adoption among HNC patients remains limited due to age-related digital divides and accessibility concerns.

Objective:

This study aimed to investigate the collateral effects of the COVID-19 pandemic on HNC patients and explore their attitudes toward mobile health applications as adjuncts to cancer care.

Methods:

A survey-based study was conducted at the Julius Maximilian University of Wuerzburg between January 2023 and May 2024. A total of 355 HNC patients were recruited and completed the structured "Cancer and Covid-19" survey via the Corona Health App or paper-based format. The 25-question survey assessed sociodemographic information, pandemic impact on diagnosis/treatment/follow-up, and interest in mHealth applications. Descriptive statistics and bivariate Pearson correlations were used for analysis.

Results:

The cohort included 261 males (74%) and 94 females (26%) with a median age of 67 years. Most participants (74%) reported no pandemic impact on their cancer care, though 20% experienced disruptions primarily in follow-up examinations and treatment monitoring. Only 10% currently used health apps, but 57% expressed willingness to adopt mHealth technologies. Younger patients, those with higher education, and participants more affected by the pandemic showed greater openness to digital health solutions. Key barriers included age, digital literacy, and perceived usefulness, while preferred app features included physician interaction (45%) and data sharing with researchers (43%).

Conclusions:

While the COVID-19 pandemic had limited direct impact on HNC care delivery at this institution, it revealed significant interest in mHealth applications among patients. However, substantial barriers remain, particularly among older adults with lower digital literacy. Future mHealth interventions should focus on improving digital literacy, addressing privacy concerns, demonstrating clinical utility, and developing personalized, accessible solutions to optimize cancer care delivery for this vulnerable population.