Exploring the Adoption of Mobile Health Apps Among Patients with Head and Neck Cancer After the COVID-19 Pandemic: Secondary Analysis of Cross-Sectional Survey

Background: Patients with head and neck cancer (HNC) face significant challenges in accessing coordinated care due to the complexity and multimodality of their treatment and the impact on vital functions. The COVID-19 pandemic has disrupted cancer care while accelerating the adoption of digital health solutions. Mobile health (mHealth) apps offer potential solutions for remote symptom monitoring, communication between patients and providers, and continuity of care. Nevertheless, their acceptance among patients with HNC remains limited due to age-related digital divides and concerns about accessibility. Objective: The aim of this study was to investigate the impact of the COVID-19 pandemic on patients with HNC and to explore their attitudes toward mHealth apps as a supplement to cancer treatment. Methods: A secondary analysis of a cross-sectional survey was conducted between January 2023 and May 2024 at Julius Maximilian University of Würzburg in Germany. A total of 355 patients with HNC were recruited and completed the structured "Cancer and COVID-19" survey via the Corona Health app or in paper form. The 25-question survey assessed sociodemographic information, the impact of the pandemic on diagnosis/treatment/aftercare, and interest in mHealth apps. Descriptive statistics and bivariate correlations were used for the analysis. Results: The cohort comprised 261 (74%) men and 94 (26%) women with an average age of 67 (SD 11.5) years. Most participants (n=264, 74%) stated that the pandemic had no impact on their cancer treatment, although 20% (n=71) experienced disruptions, particularly in follow-up appointments and treatment monitoring. Only 10% (n=36) currently used health apps, but 57% (n=203) expressed a willingness to use mHealth technologies. Younger patients, patients with higher education, and participants who were more affected by the pandemic showed greater openness to digital health solutions. The most significant barriers included age, digital literacy, and perceived usefulness, while preferred app features included interaction with physicians (n=160, 45%) and data sharing with researchers (n=153, 43%). Conclusions: Although the COVID-19 pandemic had only a limited direct impact on HNC care at the institution at hand, it revealed significant patient interest in mHealth apps. However, significant barriers remain, particularly among older adults with lower digital literacy. Future mHealth initiatives should focus on improving digital literacy, addressing privacy concerns, demonstrating clinical benefits, and developing personalized, accessible solutions to optimize cancer care for this vulnerable population.