Digital and Navigational Health Literacy in Swiss Cancer Survivors Compared With the General Population: Cross-Sectional Questionnaire Study

Abstract

Abstract Background 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. Objective This study aimed to assess the competencies of cancer survivors in Switzerland, compare them with those of the general population, and identify vulnerable subgroups. Methods A cross-sectional online survey was conducted using validated scales from the Health Literacy Survey 2019‐2021 (HLS), 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). HLSscores 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-Whitneytests, chi-square tests, and independenttests. Regression analyses identified associations of sociodemographic and clinical factors with digital and navigational HL and self-management skills. Results 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 (≤.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. Conclusions 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.