Mobile Health, Technology Engagement and Communicative Health Literacy in Older Adult Cancer Survivors

Background: The number of cancer survivors over the age of 65 will exceed 11 million within the next year. Most of these survivors will require treatment, many over extended periods of time. With the shift to outpatient episodic cancer care, the increasing complexity of cancer treatment, and short provider-patient visits, the cancer survivor is expected to take an active role in managing their health. Health technology engagement, including mobile health (mHealth) applications may improve health self-management and improve health communication skills (communicative health literacy). Methods: This descriptive correlational study explored the impact of mobile health (mHealth) application use on health technology engagement and communicative health literacy in patients with Myelodysplastic Syndromes (MDS) as a model for mHealth use in older adult cancer survivors. Systematic review of extant literature provided the foundation for derivation of a proposed theoretical framework. Development of a virtual research platform using MDS Manager© as a prototype mHealth application preceded the study. Sixty-five MDS patients were recruited through the MDS Foundation, an International advocacy organization focused on support for patients and caregivers living with MDS. Survey Monkey surveys were completed online at baseline by all participants. Results: The median age of participants was 79 years (range 57-91). Although generalizability of the findings is limited by the small sample (n=65) of highly educated, more affluent MDS patients, a strong association between existing use of mHealth and the probability of continued use was noted (p<0.05). Additionally, the intention to continue engagement with mHealth applications was significantly higher among MDS Manager© users (p< .05). Most patients in this study felt empowered, engaged, and were generally proactive about their health implying improved communicative health literacy. There was no association between baseline mHealth use and communicative health literacy. Conclusion: This study supports the use of mHealth by older adult cancer survivors. However, research relative to mHealth use in older adult cancer survivors to improve communicative health literacy and health self-management is in its nascent phase and will require continued study