The Intersection of Digital Literacy, Cultural Trust, and Generational Divides in the Adoption of Tele-Oncology Services Among Indigenous Populations

• Sunday Sunday

  Ladoke Akintola University of Technology

  Author

Indigenous populations worldwide experience disproportionately higher cancer mortality rates and significant disparities in accessing timely oncological care, largely due to geographic isolation, healthcare workforce shortages, and systemic barriers rooted in colonial legacies. Tele-oncology presents a transformative opportunity to bridge these gaps, yet adoption rates remain significantly lower among Indigenous communities despite demonstrated clinical efficacy. This study investigates the multidimensional barriers and enablers of tele-oncology adoption among Indigenous populations, with particular focus on the intersection of digital literacy, cultural trust, and generational divides. Employing a mixed-methods sequential explanatory design across three Indigenous communities in remote regions, the research surveyed 287 participants and conducted 45 in-depth interviews. Results revealed that digital literacy (β = 0.41, p < 0.001) and cultural trust (β = 0.38, p < 0.001) emerged as the strongest independent predictors of tele-oncology acceptance, explaining 67.3% of variance in adoption intention. Critically, a significant three-way interaction was identified: younger generations (18–40 years) demonstrated 2.4× higher adoption rates (89.4%) compared to older generations (41+ years, 37.2%), but this gap narrowed substantially when culturally trusted intermediaries facilitated initial consultations and when digital literacy training incorporated Indigenous knowledge systems. These findings challenge the prevailing technology-centric implementation models and argue for a relational framework that positions cultural safety, intergenerational knowledge transfer, and community co-design as foundational rather than peripheral to tele-oncology deployment. The study contributes a validated Culturally-Responsive Tele-Oncology Adoption Framework (CR-TOAF) and offers actionable recommendations for health systems, policymakers, and technology developers.

• PDF

Copyright (c) 2026 Sunday Sunday (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.