Iris Kanera

94 Chapter 4 Predictors of a higher number of modules used Using a higher number of modules was predicted by a higher number of red/orange MRA (β = .136, p = .009), and by a higher perceived personal relevance (β = .150, p = .014). Moreover, having a partner was significantly related with a lower number of modules used (β = -.256, p = .044; Appendix 4.3). Predictors of a higher appreciation of the overall KNW A higher appreciationwith the overall KNWwas significantly predicted by a higher perceived personal relevance (β = .623, p = .000; Appendix 4.4). None of the demographic and cancer- related variables, or the number of red/orange MRA, or number of modules used predicted a higher overall appreciation of the KNW intervention. Predictors of a higher perceived personal relevance None of the demographic and cancer-related characteristics significantly predicted the perceived personal relevance of the KNW content, indicating that the KNW content was rated comparably personal relevant among individuals with different demographic and cancer-reacted characteristics (Appendix 4.5). DISCUSSION The present process evaluation of the web-based KNW evaluated the automated guidance toward the KNW modules and subsequent module use, and the appreciation of this intervention. Despite the noncommittal nature of the KNW, more than 85% of the participants used one or more of the eight modules, and there was clear interest in all eight modules. This result confirms the need for wide-ranging support among early cancer survivors. Interestingly, automated referrals to specific modules were related to a higher number of modules used. Moreover, the complex KNW was highly appreciated and perceived as personal relevant by early cancer survivors. The MRA aimed to guide the respondents toward the appropriate modules by giving feedback about current problem areas and needs. Cancer survivors themselves might not have noticed some of these needs and the MRA may have raised awareness about these topics. The importance of increasing awareness is theoretically grounded as described by Weinstein and Sandman (1992) in their Precaution Adoption Process Model. That model includes a sequence of five stages within behavior change: unaware of the issue , aware of the issue but not personally engaged , engaged and deciding what to do , planning to act but not yet having acted , and acting . Prior research confirmed that a considerable number of colorectal cancer survivors were unaware of healthy diet recommendations, and older cancer