Key factors in developing effective digital health promotion tools for cancer prevention and health behavior change in adolescence through a multi-country survey

Objectives: Primary cancer prevention through behavior change in adolescence, a crucial period for shaping lifelong health habits, presents a major public health challenge across Europe. Addressing this, the SUNRISE project aims to tackle the challenge of primary cancer prevention in adolescents by developing and implementing an innovative, digitally-enhanced life-skills program tailored to diverse socio-economic, cultural, and environmental backgrounds by incorporating various Digital Health Promotion (DHP) tools to foster sustainable health behavior change in adolescents. The present study aims to identify key requirements and features that should be considered while developing effective DHP tools, based on a multi-stakeholder survey conducted across seven European countries. Methods: The survey was conducted on 505 stakeholders (students, parents, and educators), from seven European countries to assess a set of key features for effective DHP tools for their importance on a five-point likert scale. Results: Our findings revealed that seven of the proposed DHP tools’ features were identified as important considering all the stakeholder groups, while significant differences in the importance of certain features across different stakeholder groups and countries were identified. Students, as primary users, demonstrated distinct preferences, which often diverged from educators and parents, suggesting that stakeholders hold distinct priorities driven by their roles and contextual backgrounds. Additionally, country-level variations were notable; for example, Swiss participants rated the proposed features, in general, as of lower importance than the Spanish respondents. Conclusions: These insights emphasize the necessity of developing adaptable and context-sensitive DHP tools that reflect the diverse needs and preferences of adolescents across Europe. The large-scale implementation and evaluation of this program will provide valuable data for shaping future digital health interventions aimed at cancer prevention in youth.