Abstract CN5
Background
Digital health has potential to transform cancer support and empower self-management, yet those who cannot engage in digital health are at risk of exclusion. Patients with head and neck cancer (HNC) face unique challenges with communication (e.g. difficulty with voice or speech) and may benefit from digital health interventions. However, lack of access to devices, low confidence or interest to use technology, and low digital health literacy may substantially impact the uptake of digital health. Little is known about digital inequalities in patients with HNC. This study aimed to identify risks of digital exclusion and barriers to digital inclusion in patients with HNC at a UK cancer centre.
Methods
A cross-sectional survey of patients undergoing HNC treatment, between December 2021 and February 2022. The 22-item survey collected patient demographics (age, gender, ethnicity, level of education, and work status) and assessed the prerequisites for digital devices and internet use: access, skills, confidence, motivation, engagement, and preferences for digital services (e.g. smartphone apps to support cancer treatment). Surveys were completed on paper or a web-based platform. Patient and public involvement representatives contributed to item development.
Results
Ninety-nine surveys were completed. Most participants reported using a smartphone (80%) and the internet (89%). Smartphone use was associated with working age, higher level of education, and higher confidence using devices. A minority used a non-smart phone (16%) or no devices at all (2%). Barriers to internet use included lack of interest, affordability, or poor connection. Fifty-six per cent said digital health was important, yet 37% were uncertain about the benefits. Despite 63% using mobile health apps, paper-based information regarding cancer and treatment was the most preferred option.
Conclusions
Whilst patients with HNC had good access to mobile devices and the internet, there is evidence of a digital divide between certain groups. Training, equipment, and support is needed to help patients engage with an innovative way of receiving health information. Further work is planned to establish a programme of digital health to support this patient group, and to undertake a process evaluation of its implementation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Guy's & St Thomas' NHS Foundation Trust.
Funding
Guy's Cancer Charity.
Disclosure
V. Lavender: Non-Financial Interests, Institutional, Member of the Board of Directors: UKONS. All other authors have declared no conflicts of interest.