## 1 Introduction  
Cancer survivorship is a transformative experience that encompasses both physical and psychological challenges [1]. As individuals navigate the complexities of managing their health post-treatment, fostering self-efficacy and patient activation is paramount to achieving optimal health outcomes. Digital health interventions (DHIs), owing to their capacity to personalize, engage, and empower patients, offer considerable promise in addressing these critical aspects of cancer survivorship [2; 3]. Self-efficacy and patient activation are crucial components in cancer survivorship [4]. Self-efficacy refers to an individual's belief in their capacity to perform a specific task or behavior, whereas patient activation pertains to an individual's knowledge, skills, and confidence in managing their health [5]. [PERSON] et al. [6] demonstrated that higher levels of self-efficacy and patient activation correlate with improved outcomes for cancer survivors, including enhanced quality of life, reduced symptomatology, and the adoption of healthier lifestyles. Self-efficacy is a key determinant of health outcomes [7]. Cancer survivors with high self-efficacy are more likely to adhere to treatment regimens, engage in health-promoting behaviors, and effectively manage symptoms [8]. Activated patients assume responsibility for their care, collaborate with healthcare providers, and actively seek out necessary information and support [9]. Traditionally, interventions aimed at promoting self-efficacy and patient activation have relied on in-person counseling and education [10]. While these approaches offer value, they often lack the scalability and accessibility required to accommodate the growing global population of cancer survivors. DHIs provide a personalized, accessible, and continuous approach to enhancing self-efficacy and patient activation among cancer survivors [11]. These interventions have been shown to improve adherence to treatment regimens, increase physical activity, and reduce symptom burden. Furthermore, DHIs can assist survivors in managing stress and anxiety, thereby fostering resilience and promoting overall well-being [12; 13; 14]. Several studies have examined the impact of DHIs on self-efficacy and patient activation. [PERSON] et al. [15] evaluated the effectiveness of a digital health coaching program for patients undergoing surgery. Participants received personalized guidance via a mobile application, focusing on enhancing self-efficacy and lifestyle factors. The results demonstrated significant improvements in both areas, with patients reporting increased confidence in managing their health and adopting healthier behaviors. [PERSON] et al. [16] investigated the efficacy of Oncokompas, a web-based self-management platform, in improving health-related quality of life and reducing symptoms among cancer survivors. The findings indicated that individuals with lower self-efficacy and higher levels of personal control or health literacy exhibited greater improvements. These results suggest that tailoring interventions to address specific needs can enhance their effectiveness in supporting the well-being of cancer survivors. A growing body of evidence indicates that the adoption of healthy lifestyle practices, such as regular physical exercise [17], increased consumption of fruits and vegetables [18],maintaining a healthy weight and body composition [18], smoking cessation [19], and engagement in cognitive behavioral therapy [20], can positively influence cancer prognosis. However, many cancer survivors face significant challenges in adhering fully to these recommendations [19]. Previous studies have predominantly focused on either self-efficacy [16, 21, 22] or patient activation [12, 23], rather than integrating both factors within a unified framework. This study distinguishes itself from prior research by adopting a personalized approach to cancer survivorship care.