Online Interventions to Improve Mental Health of Pediatric, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis

Abstract

Objective: Over the last 10 years, online interventions to improve mental health have increased significantly. This study's primary objective was to determine the effectiveness of online interventions in improving the mental health of pediatric, adolescent, and young adult (PAYA) cancer survivors. The secondary objective was to identify the independent variables associated with online intervention efficacy for mental health improvement.Methods: On June 25–30, 2021, we searched the Medline, PsycINFO, EMBASE, and Cochrane databases for eligible English language publications that reported randomized controlled trials of online interventions aimed at improving mental health among PAYA cancer survivors. The results were analyzed using a systematic review and a three-level meta-analysis.Results: Thirteen studies met the inclusion criteria. In six (42%) studies, the intervention focused on physical activity enhancement, while ten (77%) studies used self-directed interventions. Online interventions were more efficacious, compared to control conditions, in improving sleep g = 0.35 (95% CI 0.04–0.66) and psychological well-being g = 0.32 (95% CI 0.09–0.56), but not for reducing the symptoms of depression g = 0.17 (95% CI −0.13 to 0.47), anxiety g = 0.05 (95% CI −0.15 to 0.25), and pain g = 0.13 (95% CI −0.13 to 0.39).Conclusion: Online interventions were generally effective in improving mental health in PAYA cancer survivors, although negative results were found in some critical outcomes. More high-quality evidence is needed for definite conclusions to be drawn. The study protocol was registered in PROSPERO (CRD42021266276).

Digital health and telehealth in cancer care: a scoping review of reviews

“…The remaining 134 reviews met eligibility criteria and were included in the synthesis. 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 …”

Psychological Outcomes in Adolescent and Young Adult Cancer Survivors

“…A recent systematic review and meta-analysis examined online interventions to improve the mental health of pediatric and AYA survivors. 12 Only 13 studies met inclusion criteria, six of which focused on physical activity enhancement. Overall, the 13 online interventions reviewed were efficacious at improving sleep and general well-being, but not at reducing symptoms of depression, anxiety, and pain.…”

Understanding the multilevel factors influencing the implementation of digital health interventions for supportive care in Adolescents and Young Adult (AYA) cancer survivorship: determinants of adopting mindfulness-based mobile applications

“…For example, a social worker or psychologist might assess survivors’ psychosocial functioning and provide a psychosocial care plan during their clinic visits [ 9 ]. Furthermore, providers can promote supportive care through digital health interventions as they are cost-effective [ 10 ] and efficacious in alleviating stress and improving well-being among young adult cancer survivors [ 11 ]. Most AYA cancer survivors own a mobile phone, regularly use mobile apps, and are interested in accessing supportive care information via mobile apps [ 12 , 13 ] which make digital health interventions appealing options.…”