JMIR Publications

ABSTRACT

Background:

Despite elevated recurrence risks associated with modifiable lifestyle factors, many cancer survivors do not adhere to health promotion recommendations. Digital health interventions hold promise for supporting behavior change, but few studies involve survivors in intervention design, potentially limiting real-world effectiveness. Understanding cancer survivors' preferences and support needs is crucial for developing effective digital health behavior change interventions.

Objective:

To understand cancer survivors’ pre-enrollment perspectives on support needs and preferences regarding optimal treatment features in digital health behavior change interventions.

Methods:

We conducted in-depth semi-structured interviews with 16 cancer survivors who were contemplating participating in a multiple behavior change intervention pilot study. Participants were asked about their past experiences with behavior change and to envision ideal intervention features relative to their survivorship journey. This study followed an inductive thematic analysis framework, and findings were reported from a self-determination theory perspective. Six researchers were involved in the coding process to ensure analytical rigor.

Results:

The study identified four main themes about needs and preferences for digital behavior change interventions. These primarily mapped onto three psychological needs from Self-Determination Theory: (1) competence through technology-enabled tracking, skill development, and expert accessibility; (2) autonomy through personalized, flexible program design acknowledging existing knowledge; and (3) relatedness through human-centered systems featuring health promotionists and healthcare team integration. A fourth sub-theme emerged that highlights participants’ desire for integrated, comprehensive care systems that connected behavior change programs with broader healthcare ecosystems rather than functioning as standalone digital programs.

Conclusions:

The study identified four main themes about needs and preferences for digital behavior change interventions. These primarily mapped onto three psychological needs from Self-Determination Theory: (1) competence through technology-enabled tracking, skill development, and expert accessibility; (2) autonomy through personalized, flexible program design acknowledging existing knowledge; and (3) relatedness through human-centered systems featuring health promotionists and healthcare team integration. A fourth sub-theme emerged that highlights participants’ desire for integrated, comprehensive care systems that connected behavior change programs with broader healthcare ecosystems rather than functioning as standalone digital programs.