This cross-sectional study analyzed data from the Health Information National Trends Survey (HINTS), a nationwide representative survey of US adults aged 18 years and older in 2020 and 2022. HINTS has been conducted periodically since 2003. HINTS collects information on access to and usage of health-related information, health-related behaviors such as perceptions, knowledge of disease and cancer screening as well as telehealth among US adults. The HINTS uses a complex sampling design to ensure the representativeness of the adult population in the United States. The survey uses a sampling frame provided by Marketing Systems Group of addresses in the United States. To enhance the response rate and ensure the sample’s representativeness, HINTS conducts several follow-up mailings for nonrespondents. Detailed information about the methodology, sampling, and weighting is available on the web [27]. This study is reported following the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines [28].

This study included adults aged 18 and older in the United States. Using consistent weighting algorithms, we merged data from HINTS 5 (Cycle 4, 2020) and HINTS 6 (2022) to increase the precision of estimates and power of this study. This resulted in a total population of 10,117 respondents from the 2 surveys. Individuals’ cancer-seeking behavior was assessed through a single question: Have you ever looked for information about cancer from any source? The response options were “yes” or “no.” Those who answered “yes” were classified as having sought cancer-related information. Hence, this study included 4770 participants who actively sought cancer-related information in the analysis.

The administration of HINTS received approval from the institutional review board at Westat Inc and was designated as exempt by the National Institutes of Health Office of Human Subjects Research (45 CFR 46.104 and Project # 6632.03.51) [27]. This exemption applies to this study. HINTS data are accessible to the public, and additional information regarding the survey methodology is available on the HINTS website. This study’s participants were deidentified and there was no patient contact.

This study aimed to investigate the use of digital health and wellness apps among seekers of cancer information and identify factors predicting their use. Our results indicate a high prevalence of app usage among individuals seeking cancer information (81%), highlighting the potential of public health interventions to promote cancer prevention measures (for example, screening) and treatment through these platforms. Age and education emerged as the most significant predictors, with younger and more educated individuals showing a greater inclination toward the usage of these apps.

This finding aligns with similar studies [23,31], including one carried out among the Dutch population, which showed that younger age groups and individuals with higher education are more likely to use mHealth apps [32]. The reason may be that older patients generally describe themselves as not highly skilled in the use of mobile phones and other mobile devices [33]. In addition, older adults may face barriers such as a lack of trust in the apps, concerns about data privacy, and fear of misdiagnosis [34]. Moreover, other factors, such as age-related reduction in health functions such as memory, vision, and touch sensitivity, may hinder the effective use of mobile health apps [35]. The age disparity in mobile app use implies that older adults may experience worsened health outcomes and limited access to cancer health information due to lower engagement with digital tools. To address this, mobile apps can be designed to be more user-friendly for older adults, and digital health education programs should be implemented to encourage their adoption. Consistent with the Pew survey, which found that women were more likely to use health apps, gender differences were also observed in this study, with females being more likely to use health and wellness apps [36].

In a previous study, higher incomes were correlated with digital technology ownership and usage [37]. Our study found a similar association in which participants with household incomes greater than or equal to US $50,000 were more likely to use digital and wellness apps than participants with less than US $50,000. This suggests that income may strongly influence the use of digital and wellness apps even when other factors are considered. The finding that seekers of cancer information who met weekly recommendations for physical activity were more likely to use mHealth apps compared to those who engaged in less physical activity is consistent with previous studies [23,38]. This implies using health apps may enhance the achievement of physical activity health goals which has the potential to prevent chronic diseases [39].

Engaging in health information-seeking behavior, such as downloading mHealth apps, is acknowledged as a crucial activity during the “preparation stage” that may lead to changes in health behavior [40]. Use of the internet was found to be consistently associated with the usage of health and wellness apps among seekers of cancer information in our study. A similar study found that most internet users indicated a greater likelihood of using at least one eHealth tool to address a health issue over 12 months with a preference for YouTube videos, a peer-to-peer support website, or a smartphone app [41]. This implies that using the internet has the potential to empower individuals, enabling them to play a more active role in their health care and fostering changes in health information–seeking behavior by providing easy access to mHealth apps. Previous studies have shown that increased exposure to internet use and other web-based activities promotes the seeking of health information on the web [42]. The findings of our study confirm the impact of the internet on the use of health and wellness apps. Overall, our findings underscore the potential of mobile digital wellness and health apps in supporting cancer awareness and management.

Technological interventions in cancer, specifically those using mobile digital wellness and health apps hold great promise to enhance patient outcomes and improve quality of life. Understanding factors that influence use is vital for creating impactful interventions. Apps should be developed to meet some specific health requirements such as phases of cancer treatment, as personalized intervention content is more likely to engage users and encourage behavioral changes, including social support features that allow users to communicate with caregivers, health care professionals, or individuals with similar health challenges will also go a long way toward heightening app usage and serve as a useful tool for interventions. Social support networks within the app can help users feel more connected and encouraged to share their experiences. Language and cultural differences should be considered to guarantee applicability and accessibility to a wide range of people. Enhanced engagement and effectiveness can also be achieved by providing content in multiple languages and taking cultural norms into account.

The major strength of our study was the comprehensive dataset we used. The samples used are fully representative of the noninstitutionalized US population, which enhances the generalizability of our results. Another strength of our study is its targeted population, specifically focusing on individuals who actively seek cancer information. This dataset was created by combining information from multiple survey cycles which boosted the sample size, thereby increasing the power and precision of our study. Additionally, the use of preexisting data minimized selection bias and allowed for proper comparisons with the existing literature. Finally, the consistency of our results with prior research further validates the reliability of our findings.

Despite the strengths of our study, it has limitations that warrant due consideration, the dataset used for our study was harmonized data from different HINTS cycles which were obtained from self-administered questionnaires. This method of data collection may introduce information bias, emphasizing the importance of more rigorous study designs in establishing causal relationships. Prospective studies and clinical trials are recommended to further explore the factors influencing digital health and wellness app usage among the general population and seekers of cancer information, and their impact on health outcomes among diverse populations. Additionally, our study did not take into account health literacy, provider recommendations, or health motivation. These factors should be considered in future research on the use of health and wellness apps. Another limitation of our study is the lack of data on the specific types of cancer information sought by participants. While this did not impact our goal of exploring factors influencing the use of mobile health and wellness apps among those seeking cancer information, there is a need for the HINT’s researchers to include a variable that focuses on the type of cancer information for further exploration by future studies.

This study evaluated various factors that could impact the use of mobile health and wellness apps among cancer information seekers. Among the factors assessed; age, education, household income, use of the internet, history of cancer, and optimal health status were significantly linked to app usage. The results from this study suggest that individuals who have cancer could benefit remarkably from health apps, however, they were least likely to use the apps when compared to other factors. These apps may have the potential to address health care challenges, reduce disparities, and empower patients to manage their health more efficiently. Interventions can be tailored to enhance app use and improve health outcomes as we used retrospectively collected data in this cross-sectional study.