Advancing digital health literacy in cancer care: Recommendations from two nominal group technique workshops in the TRANSiTION project

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Background: Cancer is a major cause of mortality and morbidity in Europe, with increasing focus on integrating digital health tools to ensure safe, patient-centred, and equitable oncology care. However, gaps in digital health literacy among healthcare professionals limit the effective use of these innovations. In response to these challenges, the TRANSiTION project was launched to develop a comprehensive training framework in digital health literacy for the oncology workforce. Within this framework, the present study aimed to identify and prioritise the digital health literacy training needs of clinical and non-clinical cancer care professionals across Europe. Methods: This qualitative study used the Nominal Group Technique (NGT) within two user experience (UX) design workshops. A total of 44 professionals participated, purposively sampled to capture diverse expertise in oncology and digital health. The first workshop (n = 34) was composed predominantly of non-clinical professionals, while the second (n = 10) involved mainly clinical professionals directly engaged in cancer care. Recommendations generated during the workshops were analysed descriptively, and participant contributions were consolidated in real time to support the identification and prioritisation of training needs. Results: Across both workshops, five shared priorities were highlighted: (1) ethics, particularly data protection, trust, and responsible use of digital tools; (2) integration of telemedicine to empower patients, provided it fosters safety and confidence; (3) development of user-friendly, accessible, and adaptable training interfaces; (4) addressing the digital divide, especially for rural populations, older adults, and low-resource regions; and (5) continuous training for cancer professionals, with formal recognition of digital skills as core competencies. Conclusions: This study identified actionable priorities to guide the development of a digital health literacy training framework for oncology professionals. Embedding ethics, usability, equity, and continuous training into professional development can strengthen workforce readiness, enhance patient empowerment, and improve outcomes across Europe. These findings provide a foundation for the TRANSiTION framework and for future strategies to integrate digital health literacy into cancer care.

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