Iris Kanera

80 Chapter 4 ABSTRACT Background A fully automated computer tailored web-based self-management intervention, Kanker Nazorg Wijzer (Cancer Aftercare Guide), was developed to support early cancer survivors to adequately cope with psychosocial complaints and to promote a healthy lifestyle. The KNW self-management training modules target the following topics: return to work, fatigue, anxiety and depression, relationships, physical activity, diet, and smoking cessation. Participants were guided to relevant modules by personalized module referral advice that was based on participants’ current complaints and identified needs. The aim of this study was to evaluate the adherence to the module referral advice, examine the intervention module use and its predictors, and describe the appreciation of the intervention and its predictors. Additionally, we explored predictors of personal relevance Methods This process evaluation was conducted as part of a randomized controlled trial. Early cancer survivors with various types of cancer were recruited from 21 Dutch hospitals. Data from online self-report questionnaires and logging data were analyzed from participants allocated to the intervention condition. Chi-square tests were applied to assess the adherence to themodule referral advice, negative binominal regression analysis was used to identify predictors of module use, multiple linear regression analysis was applied to identify predictors of the appreciation, and ordered logistic regression analysis was conducted to explore possible predictors of perceived personal relevance. Results From the respondents ( N = 231; mean age 55.6, SD 11.5; 79.2% female), 98.3% were referred to one or more KNW modules ( M = 2.9, SD = 1.5), and 85.7% visited at least one module ( M =2.1, SD = 1.6). Significant positive associations were found between the referral to specific modules (range 1-7) and the use of corresponding modules. The likelihood of visiting modules was higher when respondents were referred to those modules by the module referral advice. Predictors of visiting a higher number of modules were a higher number of module referrals (β = .136, p = .009) and a higher perceived personal relevance (β = .150, p = .014), while having a partner was significantly related with a lower number of modules used (β = -.256, p = .044). Overall appreciation was high ( M = 7.5, SD = 1.2; scale 1-10) and was significantly predicted by a higher perceived personal relevance (β = .623, p = .000). None of the demographic and cancer-related characteristics significantly predicted the perceived personal relevance.