Determinants of motivation and adherence to a web application for health behaviour change: A qualitative study with cancer survivors.

Abstract

Given the increasing number of cancer survivors, eHealth may be an effective means to improve lifestyle-related behaviours. Limited data are available on the use of eHealth by post-cancer patients. The present study aimed to analyse the contexts of use to identify the determinants of cancer survivors' adherence and motivation to use a web application offering nutrition and physical activity coaching. Individual semi-structured interviews were conducted with cancer survivors who participated in an 8-week online program for health behaviour change. The interviews were analysed using thematic analysis. Fifteen patients with a mean (SD) age of 62 (4.2) years completed the interview. Four themes relating to the environment and context of use were identified: digital use, social relations, health, and digital health interventions. Participants were familiar with digital tools through their professional work. Their motivation and adherence to the program improved through social relations; notably, a supportive family in addition to a trusted prescriber, continuity in the care pathway, and an appropriate choice of design features in the digital health intervention. With cancer survivorship, individuals no longer define themselves as sick but still need support to envisage the future more serenely. Cancer survivorship plays a special role in people's adherence to online interventions for health behaviour change in addition to the influence of their social relations and health environment.