# Investigating the early uptake of digital self-management interventions amongst Dutch cancer survivors using nationwide registry data—the OncoAppstore case

## TL;DR

This study explores why some cancer survivors in the Netherlands use a digital platform called OncoAppstore, finding that users tend to be wealthier and more educated.

## Contribution

The study provides new insights into the early adoption patterns of digital self-management interventions among cancer survivors in the Netherlands.

## Key findings

- OncoAppstore users tend to have higher educational levels and incomes compared to non-users.
- Users were more likely to be female, younger, and of Dutch origin.
- Users had higher mental healthcare expenditures but lower general healthcare expenditures.

## Abstract

Digital self-management interventions can aid cancer survivors with psychosocial, emotional, physical, and lifestyle support needs, but usage is relatively low due to a lack of awareness and reimbursement. Additionally, there are concerns about e-health exacerbating existing health disparities. To enhance the uptake of digital self-management interventions, the OncoAppstore was launched—a landing page on a well-known Dutch platform that offers cancer survivors credits to purchase these interventions. It is unknown to what extent the nature of the OncoAppstore will influence uptake and appeal to a diverse group of cancer survivors. The current study therefore aimed to explore sociodemographic, clinical, income, and healthcare usage factors associated with its early uptake among survivors.

OncoAppstore usage data were combined with nationwide registry data from Statistics Netherlands, the Netherlands Cancer Registry, and Dutch Hospital Data. Data were analysed descriptively, and differences between OncoAppstore users and non-users were statistically tested using chi-square tests, Fisher’s exact tests, and Mann–Whitney U tests.

OncoAppstore users tended to have higher educational levels and incomes and were more likely to be female, younger on average, and more often of Dutch origin compared to non-users. Users had higher primary and specialist mental healthcare expenditures and lower expenditures on total healthcare, general practitioner, hospital, and pharmaceutical care.

The early users of the OncoAppstore appear to be a selective group of cancer survivors as they are primarily individuals with high socioeconomic status. Thus, consistent with other e-health research, the same user patterns are observed. Future research should investigate whether this trend persists after a longer period and what is needed to better reach underrepresented groups.