Health promotion and psychological interventions for adolescent and young adult cancer survivors: a systematic literature review
Open accessAbstract
Background The effects of cancer and treatment have severe and long lasting negative impacts on quality of life. Adolescents and Young Adults (AYA) have high survival rates but may not reach their full life potential because of these consequences. This review aims to identify, appraise and synthesise the effects of health promotion and psychological interventions for AYA after cancer treatment.Methods The review was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Included studies were identified though a range of electronic databases through to May 2016. Studies were critically appraised using the Cochrane Risk of Bias tool.Results Seventeen studies, comprising a total of 2314 participants aged 13-39years were included in this review. Participants in 15 studies were survivors of childhood cancer, with only two studies specifically recruiting survivors of cancer diagnosed during young adulthood. Ten studies were randomised controlled trials (RCTs); the remaining seven were before and after studies. The quality of studies was variable across all appraised domains; risk of bias was evident in regards to recruitment, measures of exposure and outcomes, confounding factors, attrition and lost-to follow-up. Studies evaluated a range of health promotion and psychological interventions to improve health related and process outcomes. Eleven studies reported modest positive outcomes, with psychological and physical activity interventions achieving greater success compared to general health promotion interventions.Conclusion This review highlights the lack of high-quality studies for optimising the health and well-being of AYA cancer survivors. No conclusive evidence favouring specific interventions were identified, although recommendations for future studies are made. Interventions delivered face-to-face and those that facilitate peer-to-peer support hold promise. Harnessing social media and technology to deliver interventions is likely to increase and these modes of delivery require further investigations.
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Research on psychosocial interventions for cancer survivors has often targeted depression, anxiety, emotional distress, negative affect, or fear of cancer recurrence rather than positive outcomes such as well-being.
“research on psychosocial interventions for cancer survivors has often targeted depression, anxiety, emotional distress, negative affect, or fear of cancer recurrence as outcomes – rather than positive outcomes, such as well-being [11, 12].”
From A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process (2024) · cites this paper as [12]
The Discussion (page unavailable) says most studies in the psychological-intervention group focused on promoting healthy behaviours, and only two recruited patients with clinically significant distress for psychological support. The Psychological interventions section does report anxiety and depression outcomes in some studies, but the review does not support the claimed emphasis on negative outcomes rather than well-being or other positive outcomes. (LLM, conf=0.84)
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Experimental — accuracy not yet measuredExisting interventions largely target depression, anxiety, or fear of cancer recurrence as outcomes rather than well-being or other positive outcomes.
“existing interventions largely targeting depression, anxiety, or fear of cancer recurrence as outcomes – rather than well-being or other positive outcomes [11, 12]”
From A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process (2024) · cites this paper as [12]
The Discussion (page not available) says that most studies in the psychological-intervention group focused on health behaviours for a healthy lifestyle; only two recruited patients with clinically significant distress for psychological support. The Target outcomes section lists anxiety and depression among several outcomes, but does not support the claim that interventions largely targeted those outcomes or fear of cancer recurrence rather than well-being or other positive outcomes. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredThe majority of survivorship intervention research has involved face-to-face sessions delivered by clinical psychologists, psychiatrists, and social workers in clinic- or hospital-based settings, supplemented with intervention booster sessions via phone or internet.
“The majority of survivorship intervention research has involved face-to-face sessions delivered by clinical psychologists, psychiatrists, and social workers in clinic- or hospital-based settings, supplemented with intervention booster sessions via phone or internet [9, 12].”
From A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process (2024) · cites this paper as [12]
The Attributes of studies section (page unavailable) reports that 9 of 17 interventions (53%) were delivered face-to-face, with telephone and workbooks used as boosters. It describes internet delivery as a primary mode in three studies, not as a booster, and does not establish that most sessions were delivered by the named professionals in clinic or hospital settings. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe existing literature has limited attention to the common and pressing psychosocial needs among YAs with different cancer diagnoses and during longer-term survivorship.
“limited attention to the common and pressing psychosocial needs among YAs with different cancer diagnosis and during their longer-term survivorship journey [12]”
From A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process (2024) · cites this paper as [12]
The Discussion (page unavailable) says research on AYAs after cancer treatment is limited and that post-treatment psychological effects appear largely neglected, supporting the claim about psychosocial needs in survivorship. It distinguishes survivors by age at diagnosis, but does not establish the claimed gap across different cancer diagnoses or types. (LLM, conf=0.83)
Experimental — accuracy not yet measuredA 2017 systematic review identified only 17 studies testing psychological or health promotion interventions for adolescent and young adult survivors.
“a 2017 systematic review identified only 17 studies testing psychological or health promotion interventions for adolescent and YA survivors.”
None of the 17 studies were psychological interventions for individuals diagnosed in young adulthood.
“none of which were psychological interventions for individuals diagnosed in young adulthood [12].”
Of the 10 randomized controlled trials, 2 focused on individuals diagnosed in young adulthood.
“2 of which focused on individuals diagnosed in young adulthood”
Of the 17 studies in the 2017 systematic review, 10 were randomized controlled trials.
“Only 10 of these studies were randomized controlled trials (RCTs)”
There is limited use of scalable approaches, like digital health and health coaching, in interventions for YA survivors.
“limited use of scalable approaches, like digital health [9, 12, 46] and health coaching [48]”
From A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process (2024) · cites this paper as [12]
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References 45 · Cited by 97
Research works printed but not linked: 2
- [4]4. Turner V. Chapter III: Variations on a Theme of Liminality. Secular ritual, Assen: Gorcum. 1977:36-52.
- [7]7. Erikson EH. Childhood and society (Rev. ed.). New York: Norton; 1963.
- Authors
- Bradford, N. K., & Chan, R. J.
- Affiliations
- Children's Health Queensland Hospital and Health Service (AU)
- Queensland University of Technology (AU)
- Corresponding author
- Bradford, Natalie Katrina
- Venue
- Cancer Treatment Reviews
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 55
- Pages
- 57-70
- ISSN
- 0305-7372 (ISSN-L)
- OpenAlex
- W2592225888
- Cited by
- 97
- References
- 45
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 17 · 2023: 12 · 2022: 5 · 2021: 19 · 2020: 10 · 2019: 12 · 2018: 9 · 2017: 1
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer Treatment Reviews (publishedVersion)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc-nd)
- Griffith Research Online (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- adolescent and young adult cancer survivors, health promotion interventions, psychological intervention, childhood cancer survivors, quality of life, physical activity interventions, peer support, social media interventions, technology-based interventions
- MeSH terms
- Adult Survivors of Child Adverse Events, Adolescent, Adult, Health Promotion, Health Status, Humans, Neoplasms, Quality of Life, Health Behavior, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Young Adult, Controlled Before-After Studies
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