Features That Middle-aged and Older Cancer Survivors Want in Web-Based Healthy Lifestyle Interventions: Qualitative Descriptive Study

• Published in: JMIR cancer 2021-10, Vol.7 (4), p.e26226-e26226
• Main Authors: Ivankova, Nataliya V, Rogers, Laura Q, Herbey, Ivan I, Martin, Michelle Y, Pisu, Maria, Pekmezi, Dorothy, Thompson, Lieu, Schoenberger-Godwin, Yu-Mei M, Oster, Robert A, Fontaine, Kevin, Anderson, Jami L, Kenzik, Kelly, Farrell, David, Demark-Wahnefried, Wendy
• Format: Article
• Language: English
• Subjects: Cancer; Data collection; Discussion groups; Exercise; Feedback; Focus groups; Gender; Health behavior; Internet; Intervention; Lifestyles; Middle age; Online instruction; Original Paper; Physical fitness; Rural areas; Smartphones
• ISSN: 2369-1999; 2369-1999
• DOI: 10.2196/26226

With the increasing number of older cancer survivors, it is imperative to optimize the reach of interventions that promote healthy lifestyles. Web-based delivery holds promise for increasing the reach of such interventions with the rapid increase in internet use among older adults. However, few studies have explored the views of middle-aged and older cancer survivors on this approach and potential variations in these views by gender or rural and urban residence. The aim of this study was to explore the views of middle-aged and older cancer survivors regarding the features of web-based healthy lifestyle programs to inform the development of a web-based diet and exercise intervention. Using a qualitative descriptive approach, we conducted 10 focus groups with 57 cancer survivors recruited from hospital cancer registries in 1 southeastern US state. Data were analyzed using inductive thematic and content analyses with NVivo (version 12.5, QSR International). A total of 29 male and 28 female urban and rural dwelling Black and White survivors, with a mean age of 65 (SD 8.27) years, shared their views about a web-based healthy lifestyle program for cancer survivors. Five themes emerged related to program content, design, delivery, participation, technology training, and receiving feedback. Cancer survivors felt that web-based healthy lifestyle programs for cancer survivors must deliver credible, high-quality, and individually tailored information, as recommended by health care professionals or content experts. Urban survivors were more concerned about information reliability, whereas women were more likely to trust physicians' recommendations. Male and rural survivors wanted information to be tailored to the cancer type and age group. Privacy, usability, interaction frequency, and session length were important factors for engaging cancer survivors with a web-based program. Female and rural participants liked the interactive nature and visual appeal of the e-learning sessions. Learning from experts, an attractive design, flexible schedule, and opportunity to interact with other cancer survivors in Facebook closed groups emerged as factors promoting program participation. Low computer literacy, lack of experience with web program features, and concerns about Facebook group privacy were important concerns influencing cancer survivors' potential participation. Participants noted the importance of technology training, preferring individualized help to standardized com