JMIR Publications

ABSTRACT

Background:

Cancer survivorship is a growing public health concern in China, where survivors face ongoing physical, psychological, and social challenges. Mobile health (mHealth) services, delivered through mobile devices and applications, have emerged as potential tools to support self-management, facilitate access to care, and improve quality of life. However, evidence on the prevalence, usage patterns, and determinants of mHealth adoption among Chinese cancer survivors remains limited.

Objective:

To examine the prevalence and patterns of mHealth use among adult cancer survivors in China and to identify sociodemographic and clinical factors associated with adoption.

Methods:

A cross-sectional survey was conducted between February 13 and September 21, 2024, at four tertiary cancer care centers. Adult cancer survivors were recruited using convenience sampling. Data were collected via structured face-to-face questionnaires covering sociodemographic and clinical characteristics, mHealth use, functional needs, concerns, and satisfaction. Descriptive analyses summarized participant characteristics and mHealth use. Differences between groups were tested with chi-square analyses. Multivariable logistic regression was applied to identify factors independently associated with mHealth adoption.

Results:

Of 1273 distributed questionnaires, 1152 were valid (response rate 90.5%). The mean age was 55.7 years, and 52.0% were women. Overall, 364 survivors (31.6%) reported using mHealth services. Users most often accessed services weekly (32.7%) or monthly (34.6%), for an average of 21.6 minutes per session, primarily via WeChat health platforms (66.9%). Common functions included appointment booking (82.6%) and online consultation (66.9%). Survivors expressed high demand for clinical guidance (85.7%), communication with providers (84.0%), and lifestyle support (80.8%). Concerns centered on privacy (60.2%), inaccurate illness judgment (55.5%), and data inaccuracy (52.5%). Multivariable analysis showed that mHealth use was more likely among survivors aged 40–59 years (OR 1.703, 95% CI 1.205–2.396), aged ≥60 years (OR 1.497, 95% CI 1.104–2.094), those with undergraduate (OR 2.298, 95% CI 1.503–3.497) or postgraduate education (OR 2.812, 95% CI 1.503–5.198), higher household income (OR 1.896, 95% CI 1.205–2.995), widowed/divorced marital status (OR 1.402, 95% CI 1.004–2.003), living alone (OR 1.603, 95% CI 1.102–2.298), and those dissatisfied with treatment (OR 2.204, 95% CI 1.403–3.397). Sex, residence, cancer type, comorbidities, and treatment modality were not significant predictors.

Conclusions:

Approximately one-third of Chinese cancer survivors reported mHealth use, with sociodemographic and psychosocial factors playing stronger roles than clinical factors. Survivors showed strong interest in more interactive and clinically integrated functions but reported concerns about privacy, data accuracy, and system interoperability. These findings highlight both the potential and the challenges of expanding mHealth in survivorship care. Interventions tailored to education and income levels, social circumstances, and treatment experiences, along with stronger integration into hospital systems, are needed to promote equitable and sustainable adoption.