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4 97 Use and appreciation of the Kanker Nazorg Wijzer combined with receiving personalized feedback on problem areas (by the MRA), and the additional KNW features, might already have raised awareness and provided other valuable information to achieve benefits among module non-users. Overall, the high appreciation rate indicates that the broad design and the tailored information of the KNW seem to fit well with the needs of early cancer survivors, in which, however, breast cancer survivors were overrepresented. Limitations Some limitations need to be addressed. First, providing data on completion of the separate themes and specific activities within the modules, and on completion of the evaluation sessions was not possible due to the module design. This information might be interesting for future studies, and therefore we recommend future interventions to study detailed participation of intervention modules in more depth than the current study. Second, within the present study, it was not possible to compare the relationships between the MRA and module use to a control group, which did not receive the MRA. Consequently, these associations need to be interpreted with caution, as it is conceivable that without the MRA, some of the same modules would have been used. Future experimental research might explore the specific effects of a similar automated referral system on subsequent choices. Third, this eHealth intervention requires respondents to have computer skills and health literacy, such as competences to access, understand, appraise, and applying the health information provided (Sørensen et al., 2012). However, since eHealth literacy was not assessed in this study, it is not possible to estimate the extent to which this might have influenced initial recruitment, and the use and appreciation of the KNW. Fourth, mainly middle-aged, female breast cancer survivors who scored fairly well on QoL and depression participated in the present study, which might be a too selective group to represent the general cancer survivor population. During recruitment, mainly breast cancer outpatient clinics participated, and besides that, five-year survival rates of breast cancer is relatively high (The Netherlands Cancer Registry, 2017). Unless mostly females with higher socioeconomic status are reached in web-based interventions in general, interpretations of the present findings should be viewed with caution (Kohl et al., 2013). CONCLUSIONS The general KNW and the KNW modules were substantially used and highly appreciated by early cancer survivors, thus confirming the need for wide-ranging support among this target group. Results indicate that the MRA may be seen as a meaningful key component of the fully automated KNW intervention by guiding users to follow a preferred selection of modules, given their current complaints and identified needs. Moreover, the overall