Technology in exercise-based cancer rehabilitation: a cross-sectional study of receptiveness and readiness for e-Health utilization in Danish cancer rehabilitation

Figures & data

Table 1. Socio-demographic characteristics of the overall study population and stratified for receptiveness towards technology.

	All^Table Footnotea	Receptiveness towards technology
		Receptive	Unreceptive	p Value^Table Footnoteb
Sociodemographic characteristics
N	305 (100)	216 (70.8)	88 (28.9)
Sex				.083
Female, n (%)	216 (70.8)	159 (73.6)	56 (63.6)
Male, n (%)	89 (29.2)	57 (26.4)	32 (36.4)
Age, median [IQR]	60.0 [50.5-69.0]	58.0 [47.0-67.0]	65.0 [58.0-73.0]	<.001
Highest attained level of education,^Table Footnotec n (%)				<.001
Comprehensive school	32 (10.5)	17 (7.9)	15 (17.0)
Short education	111 (36.5)	70 (32.4)	41 (46.6)
Medium education	86 (28.3)	64 (29.6)	22 (25.0)
Long education	75 (24.7)	65 (30.1)	10 (11.4)
Cohabitation status, n (%)				.006
Alone	120 (39.3)	74 (34.4)	45 (51.1)
With spouse and/or children	185 (60.7)	142 (65.7)	43 (48.9)
Disease-related characteristics
Diagnosis (ICD10), n (%)				.466
lip, oral cavity and pharynx (DC00–DC14)	12 (3.9)	9 (4.2)	3 (3.4)
digestive organs (DC15–DC26)	39 (12.8)	23 (10.6)	15 (17.0)
Lung (DC33–DC34)	28 (9.2)	20 (9.3)	8 (9.1)
Breast (DC50)	121 (39.7)	93 (43.1)	28 (31.8)
Prostate (DC61)	17 (5.6)	12 (5.6)	5 (5.7)
Female genital organs (DC51–DC58)	18 (5.9)	14 (6.5)	4 (4.5)
Lymphoid, hematopoietic and related tissue (DC81–DC96)	38 (12.5)	23 (10.6)	15 (17.0)
Other^Table Footnoted	32 (10.5)	22 (10.2)	10 (11.4)
Additional chronic conditions, n (%)				.012
no additional conditions	149 (48.9)	117 (54.7)	32(36.4)
1 additional condition	96 (31.5)	62 (29.0)	33(37.5)
2+ additional conditions	58 (19.0)	35 (16.4)	23(26.1)
Behavioral characteristics
Daily physical activity, n (%)				.201
<30 min a day	48 (15.7)	29 (13.4)	18 (20.5)
30–60 min a day	148 (48.5)	111 (51.4)	37 (42.0)
>60 min a day	109 (35.7)	76 (35.2)	33 (20.5)
Wish to be more active, n (%)				.035
Yes	252 (82.6)	185 (85.6)	66 (75.0)
No	26 (8.5)	13 (6.0)	13 (14.8)
Maybe	27 (8.9)	18 (8.3)	9 (10.2)
Smoking habits, n (%)				.002
Current	25 (8.2)	10 (4.6)	15 (17.0)
Never	102 (33.4)	75 (34.7)	26 (29.5)
Earlier	178 (58.4)	131 (60.6)	47 (53.4)
Owns smartphone, n (%)	249 (81.6)	196 (90.7)	52 (59.1)	<.001
Owns ordinary mobile phone (not smartphone) or no mobile phone, n (%)	56 (18.4)	21 (9.8)	35 (39.8)	<.001
Purpose of using technology,^e n (%)
Exercise	60 (19.7)	54 (25.0)	6 (6.8)	<.001
Work	138 (45.2)	112 (51.9)	26 (29.5)	<.001
Information seeking	269 (88.2)	205 (94.9)	63 (71.6)	<.001
Communicating with family/friends	257 (84.3)	194 (89.8)	62 (70.5)	<.001
Entertainment	225 (73.8)	172 (80.0)	53 (60.2)	<.001

IQR: interquartile range.

^aPercentages do not always sum to 100 due to missing data.

^bp Value from Mann–Whitney U test (continuous variables) or the Pearson χ² test (frequencies).

^cComprehensive school equivalent to International Standard Classification of Education 2011 (ISCED-2011) levels 1 and 2, or European Qualifications Framework (EQF) level 2; short education equivalent to ISCED-2011 and EQF levels 3, 4 and 5; medium education equivalent to ISCED-2011 and EQF level 6 and; long education equivalent to ISCED-2011 and EQF levels 7 and 8.

^dCancers of the respiratory and intrathoracic organs except lung (DC30–DC32, DC35–DC39), bone and articular cartilage (DC40–DC41), skin (DC43–DC44), mesothelial and soft tissue (DC45–DC49), male genital organs except prostate (DC60, DC62–DC63), urinary tract (DC64–DC68), eye, brain and other parts of central nervous system (DC69–DC72), thyroid and other endocrine glands (DC73–DC75) and ill-defined/unspecified cancers (DC76–DC80).

^eMultiple answers allowed.

Table 2. Mean READHY scores stratified for participants’ receptiveness towards technology.

	Receptiveness towards technology
	Receptive	Unreceptive	Mann–Whitney U test
READHY score^Table Footnotea	Median [IQR]	Median [IQR]	p Value
HeiQ3 Self-monitoring and insight	3.00 [2.67-3.33]	3.00 [2.67-3.25]	.969
HeiQ4 Constructive attitudes and approaches	3.00 [2.80-3.60]	3.20 [2.80-3.80]	.153
HeiQ5 Skills and technique acquisition	3.00 [2.75-3.25]	3.00 [2.75-3.25]	.615
HeiQ8 Emotional distress^b	2.83 [2.33-3.33]	3.00 [2.19-3.50]	.504
HLQ1 Feeling understood and supported by healthcare providers	3.00 [3.00-3.75]	3.00 [2.75-3.75]	.791
HLQ4 Social support for health	3.60 [3.00-4.00]	3.40 [3.00-3.80]	.201
eHLQ1 Using technology to process health information	2.80 [2.50-3.20]	2.40 [1.40-2.60]	<.001
eHLQ2 Understanding of health concepts and language	3.00 [2.80-3.40]	3.00 [2.80-3.40]	.082
eHLQ3 Ability to actively engage with digital services	3.00 [2.80-3.60]	2.60 [1.60-3.20]	<.001
eHLQ4 Feel safe and in control	3.00 [2.80-3.60]	3.00 [2.80-3.60]	.663
eHLQ5 Motivated to engage with digital services	2.80 [2.40-3.20]	2.20 [1.80-2.80]	<.001
eHLQ6 Access to digital services that work	3.00 [2.67-3.17]	2.67 [2.17-3.00]	<.001
eHLQ7 Digital services that suit individual needs	2.75 [2.25-3.00]	2.50 [2.00-2.75]	<.001

^aRange 1 (strongly disagree)–4 (strongly agree).

^bReverse scored. High score means low level of distress.

IQR: interquartile range; HeiQ: Health Education Impact Questionnaire; HLQ: Health Literacy Questionnaire; eHLQ: eHealth Literacy Questionnaire.

Table 3. Four READHY profiles identified by cluster analysis.

		READHY profiles
		1	2	3	4
READHY score
	HeiQ dimensions (self-management/distress)	Low	Low	High	High
	HLQ dimensions (support)	Low	Low	High	High
	eHLQ dimensions (eHealth literacy)	Low	Medium	Medium	High

High, medium and low illustrates the average level of READHY scores relative to the other profiles.

HeiQ: Health Education Impact Questionnaire; HLQ: Health Literacy Questionnaire, eHLQ: eHealth Literacy Questionnaire.

Table 4. Sociodemographic characteristics of the four READHY profiles based on cluster analysis.

	READHY profiles
Variable	1	2	3	4	p Value^Table Footnotea
Receptiveness toward technology, n (%)					<.001
Receptive	9 (23.7)	98 (83.1)	42 (63.6)	64 (84.2)
Unreceptive	29 (76.3)	20 (16.9)	24 (36.4)	12 (15.8)
Sociodemographic characteristics
n (%)	38 (12.5)	119 (39.0)	66 (21.6)	76 (24.9)
Sex					.898
Female, n (%)	25 (65.8)	86 (72.3)	47 (71.2)	54 (71.1)
Male, n (%)	13 (34.2)	33 (27.7)	19 (28.8)	22 (28.9)
Age, median [IQR]	69.0 [58.5-77.5]	59.0 [50.8-68.3]	63.5 [51.0-69.0]	56.5 [43.0-66.0]	<.001^Table Footnotec
Highest attained level of education,^Table Footnoteb n (%)					.021
Comprehensive school	9 (23.7)	11 (9.2)	6 (9.1)	5 (6.6)
Short education	18 (47.4)	44 (37.0)	22 (33.3)	23 (30.3)
Medium education	8 (21.1)	38 (31.9)	18 (27.3)	22 (28.9)
Long education	3 (7.9)	26 (21.8)	20 (30.3)	26 (34.2)
Cohabitation status, n (%)					.004
Alone	25 (65.8)	42 (35.3)	22 (33.3)	27 (35.5)
With spouse and/or children	13 (34.2)	77 (64.7)	44 (66.7)	49 (64.5)
Disease-related characteristics
Additional chronic conditions, n (%)					.003
No additional conditions	8 (21.1)	58 (48.7)	34 (53.1)	46 (60.5)
1 Additional condition	15 (39.5)	39 (32.8)	21 (32.8)	18 (23.7)
2+ Additional conditions	15 (39.5)	22 (18.5)	9 (14.1)	12 (15.8)
Behavioral characteristics
Daily physical activity, n (%)					.047
<30 min a day	4 (10.5)	19 (16.0)	16 (22.1)	7 (9.2)
30–60 min a day	19 (50.0)	65 (54.6)	22 (24.2)	38 (50.0)
>60 min a day	15 (39.5)	35 (29.4)	28 (42.4)	31 (40.8)
Wish to be more active, n (%)					.761
Yes	29 (76.3)	100 (84.0)	55 (83.3)	63 (82.9)
No	5 (13.2)	7 (5.9)	6 (9.1)	8 (10.5)
Maybe	4 (10.5)	12 (10.1)	5 (7.6)	5 (6.6)
Smoking habits, n (%)					<.001
Current	8 (21.1)	5 (4.2)	8 (12.1)	3 (3.9)
Never	11 (28.9)	29 (24.4)	27 (40.9)	32 (42.1)
Earlier	19 (50.0)	85 (71.4)	31 (47.0)	41 (53.9)
Owns ordinary mobile phone (not smartphone) or no mobile phone, n (%)	22 (57.9)	6 (7.9)	13 (19,7)	14 (11.9)	<.001
Purpose of using technology,^d n (%)
Exercise	0 (0.0)	19 (16.0)	12 (18.2)	28 (36.8)	<.001
Work	4 (10.5)	59 (49.6)	30 (45.5)	42 (55.3)	<.001
Information seeking	16 (42.1)	115 (96.6)	62 (93.9)	72 (94.7)	<.001
Communicating with family/friends	18 (47.4)	108 (90.8)	54 (81.8)	74 (97.4)	<.001
Entertainment	17 (44.7)	95 (79.8)	48 (73.8)	61 (80.3)	<.001

^ap Value from Kruskal–Wallis H test (continuous variables) or Pearson χ² test (frequencies) between the four profiles.

^bComprehensive school equivalent to International Standard Classification of Education 2011 (ISCED-2011) levels 1 and 2, or European Qualifications Framework (EQF) level 2; short education equivalent to ISCED-2011 and EQF levels 3, 4 and 5; medium education equivalent to ISCED-2011 and EQF level 6 and; long education equivalent to ISCED-2011 and EQF levels 7 and 8.

^cProfile 1 versus profile 4 (p = .000), profile 1 versus profile 2 p = .000), profile 1 versus profile 3 (p = .006,).

^dMultiple answers allowed.

Bold values indicate that the adjusted standardized residual for that cell exceeded the critical value of ±1.96.

IQR: interquartile range.

Figure 1. Proposed model for balanced interventions based on the degree of health technology readiness and receptiveness for technology supported physical exercise.