Acceptability and preliminary effectiveness of a massive open online course for women with breast cancer

Digital health literacy and person-centred care interventions can enhance understanding of online health information and empower patients, optimizing healthcare. Massive Open Online Courses (MOOCs) can provide flexible access and adapted educational resources and are a useful self-care strategy to chronic patients. This study aimed to assess the acceptability and preliminary effectiveness of the MOOC “Active: Empower Yourself Against Breast Cancer” (original title in Spanish: “Activas: Empodérate frente al cáncer de mama”), developed through a co-creation process involving patients, healthcare professionals, and health science researchers. The course was designed to improve digital health literacy, health literacy, knowledge, self-care, and person-centred care among women at different stages of breast cancer, breast cancer survivors (currently disease-free), and their families/caregivers. Seventy-nine Spanish-speaking participants were recruited using convenience sampling, of whom forty-three completed all MOOC units and assessed its acceptability. Primary outcomes included changes in self-perceived digital health literacy and health literacy after completing the MOOC, measured with the eHealth Literacy Scale (eHEALS) and the Health Literacy Survey European Questionnaire–16 items (HLS-EU-Q16). Performance on the knowledge quizzes included in each unit and overall acceptability, based on the Technology Acceptance Model, were also evaluated. Significant improvements were observed in HL (HLS-EU-Q16, p = 0.0027) and DHL (eHEALS, p = 0.0007). The average rating of the MOOC was 8.9 out of 10. Most participants reported high acceptability regarding language, content, relevance, activities, and alignment with the stated objectives. The MOOC appears to be a feasible strategy to improve the digital health literacy, knowledge, self-care, and person-centred care challenges in women with breast cancer, showing high acceptability. Further research with larger and more diverse samples is warranted. The study was retrospectively registered in Clinical Trials.gov (NCT06635239) on October 4th, 2024.