Digital and Navigational Health Literacy in Swiss Cancer Survivors Compared With the General Population:...

The number of cancer survivors in Switzerland is increasing. Many individuals face challenges in dealing with health-related information and navigating the health care system. Digitalization offers new care and support opportunities, but its effective use requires digital and navigational health literacy (HL) and self-management skills.

This study aimed to assess the competencies of cancer survivors in Switzerland, compare them with those of the general population, and identify vulnerable subgroups.

A cross-sectional online survey was conducted using validated scales from the Health Literacy Survey 2019-2021 (HLS19), measuring digital HL, interaction with digital devices, frequency of use of digital resources, and navigational HL. Self-management skills were assessed with the Health Education Impact Questionnaire (heiQ). HLS19 scores were compared to data from the general Swiss population and a subpopulation with chronic diseases provided by the Federal Office of Public Health, using Mann-Whitney U tests, chi-square tests, and independent t tests. Regression analyses identified associations of sociodemographic and clinical factors with digital and navigational HL and self-management skills.

A total of 131 cancer survivors (74.8% female, 41% with breast cancer) completed the survey. Only 30% reported high digital HL, while self-management skills were generally high, particularly in "health service navigation" (median 3.6, IQR 0.8 on a 4-point Likert scale) and "constructive attitudes" (median 3.6, IQR 1). Compared to the general population, cancer survivors had significantly higher scores in digital interaction and digital resource use (P≤.002), while no differences were observed in digital or navigational HL. Digital and navigational HL, as well as self-management, were consistently associated with education level, social support, and financial deprivation.

Cancer survivors in Switzerland report low digital and navigational HL, comparable to the general population, while self-management skills were strong overall. Support strategies should simultaneously target individual and systemic factors to improve cancer survivors' ability to access and use digital health resources. Future research should include a more representative sample to validate these findings.