Iris Kanera

4 81 Use and appreciation of the Kanker Nazorg Wijzer Conclusions The Cancer Aftercare Guide in general and more specifically its modules were well used and highly appreciated by early cancer survivors. Indications were found that the module referral advice might be a meaningful intervention component to guide the users in following a preferred selection of modules. These results indicate that the fully automated web-based Cancer Aftercare Guide provides personal relevant and valuable information and support for early cancer survivors. Therefore, this intervention can complement usual cancer aftercare and may serve as a first step in a stepped-care approach. BACKGROUND Recovery from cancer and its treatment can be challenging for cancer survivors. A variety of physical, psychosocial, and lifestyle difficulties might impede the resumption of previous daily life activities (Bluethmann et al., 2015). Cancer aftercare guidelines for oncology professionals recommend paying attention to the early detection and recognition of psychological distress, fatigue, pain, problems with daily activities, lifestyle risks, and also to stimulating self-care within the first year after completing the primary curative cancer treatment (Comprehensive Cancer Centre the Netherlands, 2011b; Runowicz et al., 2016). Further, due to the aging population and improved cancer care, the population of cancer survivors is growing while complaints, needs, and preferences of cancer survivors can vary individually over the different subjects and time (Given&Given, 2013; Kanera et al., 2016a;The Netherlands Cancer Registry, 2017; Willems et al., 2016). For these reasons, fully automated, computer tailored web-based cancer aftercare interventions may be suitable for providing a large number of cancer survivors with personalized advice at relatively low costs (Kohl, Crutzen, & de Vries, 2013). Moreover, online solutions fit well with the increasing numbers of cancer survivors who search the Internet for health-related information, especiallywith those survivors who do not seek face-to-face guidance or treatment (Chou et al., 2011; Ritterband & Tate, 2009). Web-based interventions might be appropriate to be integrated as a first step in stepped care approach as it offers a low intensive intervention first before referring to interventions that are more intensive. Such first-step, low-intensive interventions might be sufficient to meet the personal needs of a large proportion of survivors with relatively mild complaints and are less costly (Krebber et al., 2012). In addition, web-based interventions can comprise relevant information as written text, videos, animations, interactive features, hyperlinks, while personalization of the content is possible by applying computer tailoring (Broekhuizen et al., 2012; de Vries & Brug, 1999; Noar et al., 2007). The web-based intervention Kanker Nazorg Wijzer (Cancer Aftercare Guide, KNW) is a fully automated intervention that aims to increase survivors’ quality of life (QoL) by providing psychosocial support as well as promoting positive lifestyle changes, and targets cancer