JMIR Publications

ABSTRACT

Background:

The number of cancer survivors in Switzerland is increasing. Many face challenges in dealing with health-related information and navigating the healthcare system. Digitalization offers new care and support opportunities, but effective use requires digital and navigational health literacy (HL) and self-management skills.

Objective:

This study aimed to assess these competencies among cancer survivors in Switzerland, compare them to the general population, and identify vulnerable subgroups.

Methods:

A cross-sectional online survey was conducted using validated scales from the Health Literacy Survey 2019-2021 (HLS19), measuring digital HL, interaction with digital devices, frequency of use of digital resources, and navigational HL. Self-management skills were assessed with the Health Education Impact Questionnaire. HLS19 scores were compared to data from the general Swiss population and a subpopulation with chronic diseases provided by the Federal Office of Public Health, using Mann-Whitney-U tests, Chi-square tests, and independent t-tests. Regression analyses identified associations with socio-demographic and clinical factors.

Results:

131 cancer survivors (74.8% female, 35% aged 50-59, 41% with breast cancer) completed the survey. Only 28% had high digital HL. Digital resources were used 1-3 times per week. Compared to both the general population and people with chronic diseases, cancer survivors had significantly higher scores in digital interaction and digital resource use (p ≤ .002), while no differences in digital or navigational HL were found. Self-management skills were generally high, particularly in 'health service navigation' and 'constructive attitudes' (median score: 3.6/5), but lower in 'emotional distress' (median score: 3.2). Digital HL was significantly associated with higher education (p =.003) and social support (p = .02); navigational HL with financial deprivation (p = .03) and being born in Switzerland (p = .003); self-management scales with financial deprivation (p < .001 - .02), education (p = .002 -.049), and social support (p ≤ .001 - .005).

Conclusions:

Cancer survivors in Switzerland report low digital and navigational HL, comparable to the general population, while self-management skills were overall strong. Support strategies should target individual and systemic factors to improve cancer survivors’ ability to access and use digital health resources. Future research should include a more representative sample to validate these findings.