What Features Do Older Cancer Survivors Want in Web-based Healthy Lifestyle Interventions? A Qualitative Descriptive Study (Preprint)

BACKGROUND With the growing number of older cancer survivors, it is imperative to optimize the reach of interventions that promote healthy lifestyles. Because internet use is growing rapidly among older adults, web-based delivery holds considerable promise for increasing the reach of such interventions. However, few studies have explored the views of older cancer survivors on this approach and potential variations in these views by gender and/or rural and urban residence. Objectives: Explore older cancer survivors’ views regarding features of web-based healthy lifestyle interventions based on gender and rural/urban residence to inform the design of the web-based Aim, Plan, and Act on Lifestyles (AMPLIFY) Survivor Health diet and exercise program. OBJECTIVE Explore older cancer survivors’ views regarding features of web-based healthy lifestyle interventions based on gender and rural/urban residence to inform the design of the web-based Aim, Plan, and Act on Lifestyles (AMPLIFY) Survivor Health diet and exercise program. METHODS Using a qualitative descriptive approach, we conducted 10 focus groups with 57 cancer survivors recruited from hospital cancer registries in one southeastern U.S. state. Data were analyzed using inductive thematic and content analyses with NVivo 12.5. RESULTS 29 male and 28 female urban and rural dwelling Black and White survivors, mean age 65 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, while women were more likely to trust physicians’ recommendations. Male and rural survivors wanted the information to be tailored on cancer type and age group. Privacy, usability, interaction frequency, and session length were noted as important for engaging older cancer survivors with a web-based program. Female and rural participants liked the interactive nature and visual appeal of e-learning sessions. Learning from experts, an attractive design, flexible schedule and opportunity to interact with other 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 older cancer survivors’ potential participation. Participants noted importance of technology training preferring individualized help to standardized computer classes. More rural survivors acknowledged the need to learn how to use a computer. The receipt of regular feedback about progress was noted as encouragement toward goal achievement, while women were particularly interested in receiving immediate feedback to stay motivated. CONCLUSIONS Important considerations for designing web-based healthy lifestyle interventions for older cancer survivors include program quality, participants’ privacy, ease of use, attractive design, and a prominent role of a health care provider and content expert. Cancer survivors’ preferences based on gender and residence should be considered to promote program participation.