User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review

Mendu et al. created and tested a culturally tailored virtual patient educator for Hispanic women to improve cervical cancer and human papillomavirus education using an iterative, UCD.

“Mendu et al [18] created and tested a culturally tailored virtual patient educator for Hispanic women to improve cervical cancer and human papillomavirus education using an iterative, UCD.”

• cites [18] sourceSupported

A human-centered mobile and web application (mPCL) in Tanzania extended functionality beyond patient-facing use to support coordinated palliative care among patients, caregivers, and local health workers.

“a human-centered mobile and web application (mPCL) [23] in Tanzania, which extended functionality beyond patient-facing use to support coordinated palliative care among patients, caregivers, and local health workers.”

• cites [23] sourceSupported

OncoKompas [13] and MijnAVL [21] involved cancer survivors directly in iterative prototype testing to refine content, navigation features, and overall functionality.

“Tools such as OncoKompas [13] and MijnAVL [21] exemplify this approach, with cancer survivors directly involved in iterative prototype testing to refine content, navigation features, and overall functionality.”

• cites [13] sourcePartly supported

  The Introduction (page unavailable) says cancer survivors tested an OncoKompas prototype for usability and content quality, and that their feedback led to user-interface adjustments. It does not identify changes to navigation features; it attributes improvements in tailoring and usefulness to health care professionals’ feedback. This verdict concerns OncoKompas, not MijnAVL, which has a separate citation. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites [21] sourceSupported

Salako et al [42] brought together researchers, clinicians, and technology developers to review remote symptom monitoring for palliative cancer care in Africa.

“For example, Salako et al [42] brought together researchers, clinicians, and technology developers to review remote symptom monitoring for palliative cancer care in Africa.”

• cites [42] sourceSupported

Nabelsi and Plouffe [28] engaged nurse navigators and interfacility teams to refine a web-based coordination platform designed to improve oncology and nononcologic thoracic surgery care pathways.

“Nabelsi and Plouffe [28] engaged nurse navigators and interfacility teams to refine a web-based coordination platform designed to improve oncology and nononcologic thoracic surgery care pathways.”

• cites [28] sourcePartly supported

  The Methods (Study Design and Settings; page not provided) describe participatory workshops with nurses and other stakeholders whose input was incorporated into the platform prototype. The Results (Objective 2; page not provided) describe recruiting nurse navigators at both facilities and refining the interfacility care pathway and platform. Our copy does not establish that the workshop nurses were nurse navigators or explicitly describe the platform itself as web-based; it describes the workshops and a later survey as web-based. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

SmartSurvivor by Baseman et al [39] explored mHealth options for survivorship care, explicitly embedding patient perspectives into the functionality and usability of the tool.

“Similarly, SmartSurvivor by Baseman et al [39] explored mHealth options for survivorship care, explicitly embedding patient perspectives into the functionality and usability of the tool.”

• cites [39] sourcePartly supported

  The Methods (Testing; page unavailable) say breast cancer survivors tested SmartSurvivor and commented on its features, navigation, and ease of use. The Discussion (Principal Findings; page unavailable) identifies changes for further development based on the pilot. This supports the claim that the study brought patient perspectives to bear on functionality and usability, but not that those perspectives had already been embedded in the tool’s implemented design. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

Aronoff-Spencer et al [43] described a human-centered participatory design approach that engaged patients, caregivers, and community stakeholders to support rural patients experiencing distress during cancer treatment.

“Aronoff-Spencer et al [43] also described a human-centered participatory design approach that engaged patients, caregivers, and community stakeholders to support rural patients experiencing distress during cancer treatment.”

• cites [43] sourceSupported

The mPCL project by Ho et al [23] incorporated local health workers in Tanzania to co-design a mobile platform for palliative care, ensuring cultural and contextual relevance in a low-resource setting.

“Similarly, the mPCL project by Ho et al [23] incorporated local health workers in Tanzania to co-design a mobile platform for palliative care, ensuring cultural and contextual relevance in a low-resource setting.”

• cites [23] sourceSupported

Education and information functions may be insufficient for addressing the psychosocial, financial, or logistical barriers that many patients face.

“These functions may improve self-efficacy and patient activation [49], but they may be insufficient for addressing the psychosocial, financial, or logistical barriers that many patients face [50].”

• cites [50] sourcePartly supported

  The Introduction identifies stigma, poor health-system infrastructure, and transportation as barriers to care, while the Results (Telecommunications) distinguishes emotional support from informational support. These passages support the concern that information alone may not address psychosocial or logistical needs, but the review does not establish that education and information functions are insufficient or address financial barriers in this comparison. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

StressProffen [22] and CMyLife [14] illustrate how iterative design can expand navigation beyond tracking to include psychosocial support and relational care.

“Tools such as StressProffen [22] and CMyLife [14] illustrate how iterative design can expand navigation beyond tracking to include psychosocial support and relational care.”

• cites [22] sourceSupported
• cites [14] sourceSupported

Basch et al [46] leveraged patient-reported outcomes to enhance communication between patients and clinicians, transforming symptom monitoring into a navigation mechanism for timely intervention and treatment adjustment.

“For example, Basch et al [46] leveraged patient-reported outcomes to enhance communication between patients and clinicians, transforming symptom monitoring into a navigation mechanism for timely intervention and treatment adjustment.”

• cites [46] sourcePartly supported

  The Digital ePRO System and Questions section (page unavailable) describes alerts to nurses for severe or worsening symptoms, symptom-management pathways, and reports used to guide discussions and care. The paper also reports that patients perceived improved discussions with clinicians. It does not establish that the system led to timely interventions or treatment adjustments; it says clinicians were not required to take particular actions in response to the reports or alerts. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

The iterative development of the prevention web applications supports their potential to enhance risk understanding and healthy behavior.

“Similarly, an iterative development process of a cancer prevention web application by Carrera et al [45] and the prevention-focused web application described by Anders et al [32] incorporated repeated cycles of feedback that shaped tutorials and interactive features, supporting its potential to enhance risk understanding and healthy behavior.”

• cites [45] sourcePartly supported

  The Iterative development section describes repeated formative evaluations whose feedback refined the cancer-prevention app’s content, functionality, and risk visualizations. The Conclusion says its risk-communication features show promise for improving risk comprehension and motivating behavior change. However, the Discussion describes tutorials as a user recommendation, not a feature already shaped or incorporated through those cycles. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites [32] sourcePartly supported

  The Introduction (Objectives; page unavailable) discusses iterations of app testing, and the Discussion (Conclusions; page unavailable) says patient feedback will inform further development. But the Introduction (Background; page unavailable) identifies Enable as a smartphone app supporting breast cancer therapy, not a cancer-prevention web application. The cited passages do not support claims that feedback shaped tutorials or that the app could improve risk understanding and healthy behavior. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Education and information functions may improve self-efficacy and patient activation.

“These functions may improve self-efficacy and patient activation [49], but they may be insufficient for addressing the psychosocial, financial, or logistical barriers that many patients face [50].”

• cites [49] sourcePartly supported

  The Results sections on self-efficacy and patient activation report improvements with some interactive digital tools, and “Elements addressed to patients” says these tools provide information. The review does not establish that the education or information functions specifically produced those improvements; it assesses the tools as a whole. Page numbers are unavailable in our copy. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

Iterative development of MijnAVL presented by Kuijpers et al [21] led to usability improvements, including the addition of FAQs and hyperlinks to improve patient experience.

“Likewise, iterative development of MijnAVL presented by Kuijpers et al [21] led to usability improvements, including the addition of FAQs and hyperlinks to improve patient experience.”

• cites [21] sourceSupported

Most digital tools were designed for patients (33/36, 91.7%).

“most digital tools were designed for patients (33/36, 91.7%)”

Few participatory or co-design workshops were used.

“few participatory or co-design workshops.”

Discovery and implementation phases were rarely included.

“Discovery and implementation phases rarely included.”

Appointment scheduling and tracking was reported in 7/36 (19.4%) studies.

“appointment scheduling and tracking (7/36, 19.4%)”

Single-study contexts included brain, cervical, chronic myeloid leukemia, colorectal, esophageal, head and neck, melanoma and renal cell carcinoma, and multiple myeloma (n=1, 2.8% each).

“single-study contexts included brain, cervical, chronic myeloid leukemia, colorectal, esophageal, head and neck, melanoma and renal cell carcinoma, and multiple myeloma (n=1, 2.8% each).”

The application of UCD/HCD in digital cancer navigation tools remains limited across cancer types, regions, and functions.

“However, their application remains limited across cancer types, regions, and functions.”

Caregivers were considered in 6/36 (16.7%) studies.

“caregivers (6/36, 16.7%)”

Web portals and mobile apps were overwhelmingly used.

“Web portals and mobile apps were overwhelmingly used”

A total of 36 studies met the inclusion criteria for review.

“A total of 36 studies met the inclusion criteria for review, as shown in Figure 1.”

Care coordination was reported in 20/36 (55.6%) studies.

“along with care coordination (20/36, 55.6%)”

Patient-to-provider communication was reported in 21/36 (58.3%) studies.

“overall care system navigation or access to care and patient-to-provider communication (21/36, 58.3% each)”

Navigation functions were most frequently conceptualized as education and information provision (23/36, 63.9%).

“navigation functions were most frequently conceptualized as education and information provision (23/36, 63.9%).”

Mobile apps were reported in 17/36 (47.2%) studies.

“closely followed by mobile apps (17/36, 47.2%)”

Canada had 3/36 (8.3%) studies.

“and Canada (3/36, 8.3%)”

Symptom management was reported in 2/36 (5.6%) studies.

“symptom management (2/36, 5.6%)”

Thirty-six studies met the inclusion criteria.

“A total of 36 studies met the inclusion criteria.”

Iterative prototyping and usability testing were the most common design processes.

“Iterative prototyping and usability testing were most common.”

A smaller proportion of studies presented only a conceptual design without testing a specific tool (3/36, 8.3%).

“A smaller proportion presented only a conceptual design without testing a specific tool (3/36, 8.3%)”

Web platforms were the most common type of proposed digital tools, reported in 18 (50%) studies.

“Web platforms were the most common type of proposed digital tools, reported in 18 (50%) studies”

Participatory design and implementation evaluation were underused in the included studies.

“participatory design and implementation evaluation were underused”

Most digital tools were designed for clinicians or providers (25/36, 69.4%).

“clinicians or providers (25/36, 69.4%)”

The Netherlands had 7/36 (19.4%) studies.

“followed by the Netherlands (7/36, 19.4%)”

Overall care system navigation or access to care was reported in 21/36 (58.3%) studies.

“overall care system navigation or access to care and patient-to-provider communication (21/36, 58.3% each)”

There was limited coverage of financial, logistical, or psychosocial barriers.

“Limited coverage of financial, logistical, or psychosocial barriers.”

Patient-to-patient communication was reported in 3/36 (8.3%) studies.

“patient-to-patient communication (3/36, 8.3%)”

Interviews and surveys were the most frequently used design methods.

“Interviews and surveys were most frequently used”

Iterative prototyping and usability testing were the most common UCD/HCD methods in the included studies.

“Iterative prototyping and usability testing were the most common”

Nearly half of the studies were conducted in the United States (17/36, 47.2%).

“nearly half of the studies were conducted in the United States (17/36, 47.2%)”

Few integrated or multimodal systems were used.

“Few integrated or multimodal systems.”

Patient navigators were considered in 2/36 (5.6%) studies.

“patient navigators (2/36, 5.6%)”

In total, 16 studies met the inclusion criteria and were retained for qualitative synthesis.

“In total, 16 studies met the inclusion criteria and were retained for qualitative synthesis.”

Tools focused primarily on education and communication.

“focused primarily on education and communication.”

Emotional or psychosocial support was reported in 11/36 (30.6%) studies.

“emotional or psychosocial support (11/36, 30.6%)”

End-user feedback sessions and surveys were reported in 22.2% (8/36) of studies.

“End-user feedback sessions and surveys were reported in 22.2% (8/36) of studies, while focus groups appeared in 13.9% (5/36).”

UCD/HCD use has been concentrated on evaluating usability and satisfaction outcomes as markers of navigation success.

“Based on our findings from currently available literature, their use has been concentrated to three main functions: (1) evaluating usability and satisfaction outcomes as markers of navigation success, (2) centering patient perspectives as the primary driver of design decisions, and (3) using iterative cycles of prototyping and testing to refine tools.”

User satisfaction was reported in 26/36 (72.2%) of studies.

“Across included studies, outcomes most often reflected usability (28/36, 77.8%) and user satisfaction (26/36, 72.2%), with these measures commonly serving as proxies for the overall success of cancer care navigational tools.”

Patient engagement appeared in 13/36 (36.1%) of studies.

“Navigation effectiveness was reported less frequently (17/36, 47.2%), while patient engagement appeared in just over one-third of studies (13/36, 36.1%).”

Design or strategy insights were assessed in 8/36 (22.2%) of studies.

“Broader outcomes such as clinical use (9/36, 25%), design or strategy insights (8/36, 22.2%), and health professional engagement (6/36, 16.7%) were less assessed.”

Testing was used in 63.8% (23/36) of studies.

“Testing was used in 63.8% (23/36) of studies, reflecting a strong emphasis on evaluating and refining tools once developed.”

Co-design workshops were reported in 1/36 (2.8%) of studies.

“Participatory design sessions (2/36, 5.6%) and co-design workshops (1/36, 2.8%) were comparatively rare.”

Usability was reported in 28/36 (77.8%) of studies.

“Across included studies, outcomes most often reflected usability (28/36, 77.8%) and user satisfaction (26/36, 72.2%), with these measures commonly serving as proxies for the overall success of cancer care navigational tools.”

Stakeholder engagement in UCD/HCD processes varied in scope and depth.

“Across included studies, stakeholder engagement in UCD/HCD processes varied in scope and depth.”

Across the reviewed studies, inclusion of diverse stakeholders such as clinicians, caregivers, and navigators was less common compared to patient-only approaches.

“Across the reviewed studies, inclusion of diverse stakeholders such as clinicians, caregivers, and navigators was less common compared to patient-only approaches.”

UCD/HCD use has been concentrated on centering patient perspectives as the primary driver of design decisions.

“Based on our findings from currently available literature, their use has been concentrated to three main functions: (1) evaluating usability and satisfaction outcomes as markers of navigation success, (2) centering patient perspectives as the primary driver of design decisions, and (3) using iterative cycles of prototyping and testing to refine tools.”

Studies that incorporated multiple stakeholder groups identified additional factors affecting navigation design, including workflow alignment, caregiver responsibilities, and infrastructure limitations.

“Studies that incorporated multiple stakeholder groups identified additional factors affecting navigation design, including workflow alignment, caregiver responsibilities, and infrastructure limitations.”

Collaboration and coordination were addressed in 3/36 (8.3%) of studies.

“Even more rarely, studies addressed feasibility and implementation logistics (5/36, 13.9%), collaboration and coordination (3/36, 8.3%), or educational value (2/36, 5.6%).”

Other approaches (direct observation, field trials, iterative design, journey mapping, pilot-testing, system usage data) each appeared once (1/36, 2.8% each).

“Other approaches, such as direct observation, field trials, iterative design, journey mapping, pilot-testing, and system usage data, each appeared only once (1/36, 2.8% each).”

Design and prototyping phases were more frequently represented (19/36, 52.7%).

“Design and prototyping phases were more frequently represented (19/36, 52.7%), often involving the development of functional prototypes and working systems.”

Implementation was the least represented phase (7/36, 19.4%).

“Implementation was the least represented phase (7/36, 19.4%), indicating that relatively few studies extended user-centered approaches into deployment, integration, or evaluation of digital navigation tools within routine clinical workflows.”

Across included studies, UCD/HCD approaches were most often applied as practical design strategies rather than overarching frameworks for navigation.

“Across included studies, UCD/HCD approaches were most often applied as practical design strategies rather than overarching frameworks for navigation.”

Navigation effectiveness was reported in 17/36 (47.2%) of studies.

“Navigation effectiveness was reported less frequently (17/36, 47.2%), while patient engagement appeared in just over one-third of studies (13/36, 36.1%).”

Across included studies, UCD/HCD approaches were reported at multiple phases of the design cycle, including discovery, design and prototyping, testing, and implementation.

“Across studies included, UCD/HCD approaches were reported at multiple phases of the design cycle, including discovery, design and prototyping, testing, and implementation.”

Only a limited number of studies assessed system-level or implementation-related outcomes, such as timeliness, collaboration, or equitable access.

“Only a limited number of studies assessed system-level or implementation-related outcomes, such as timeliness, collaboration, or equitable access.”

Overall, reviewed studies primarily measured outcomes related to usability and user satisfaction, with fewer examining broader aspects such as navigation effectiveness, coordination, or sustainability.

“Overall, the reviewed studies primarily measured outcomes related to usability and user satisfaction, with fewer examining broader aspects such as navigation effectiveness, coordination, or sustainability.”

Only a small number of studies reported using co-design workshops, journey mapping, or multistakeholder sessions.

“Only a small number of studies reported using co-design workshops, journey mapping, or multistakeholder sessions.”

Equity, timeliness, and continuity were rarely evaluated.

“Equity, timeliness, and continuity rarely evaluated.”

Health professional engagement was assessed in 6/36 (16.7%) of studies.

“Broader outcomes such as clinical use (9/36, 25%), design or strategy insights (8/36, 22.2%), and health professional engagement (6/36, 16.7%) were less assessed.”

Focus groups appeared in 13.9% (5/36) of studies.

“End-user feedback sessions and surveys were reported in 22.2% (8/36) of studies, while focus groups appeared in 13.9% (5/36).”

Most studies engaged patients as the primary voice in the design process, often through semistructured interviews and surveys.

“Most studies engaged patients as the primary voice in the design process, often through semistructured interviews and surveys.”

Discovery-phase activities were reported in fewer than half of the studies (17/36, 47.2%).

“Discovery-phase activities, such as needs assessments, contextual inquiry, and early exploration of user workflows, were reported in fewer than half of the studies (17/36, 47.2%).”

Usability and satisfaction were the most used metrics.

“Usability and satisfaction were the most used metrics.”

Clinical use was assessed in 9/36 (25%) of studies.

“Broader outcomes such as clinical use (9/36, 25%), design or strategy insights (8/36, 22.2%), and health professional engagement (6/36, 16.7%) were less assessed.”

Interviews were the most frequently used UCD/HCD design method (25/36, 69.4%).

“Interviews were the most frequently used approach (25/36, 69.4%), followed by usability testing (16/36, 44.4%).”

80% (29/36) of studies reported use of more than 1 UCD/HCD design method across the design process.

“A variety of UCD/HCD design methods were reported across the included studies, with 80% (29/36) of the studies reporting the use of more than 1 method across the design process.”

UCD/HCD use has been concentrated on using iterative cycles of prototyping and testing to refine tools.

“Based on our findings from currently available literature, their use has been concentrated to three main functions: (1) evaluating usability and satisfaction outcomes as markers of navigation success, (2) centering patient perspectives as the primary driver of design decisions, and (3) using iterative cycles of prototyping and testing to refine tools.”

Few studies assessed navigation effectiveness, coordination, or clinical outcomes.

“Few studies assessed navigation effectiveness, coordination, or clinical outcomes.”

Across included studies, UCD/HCD was frequently operationalized as an iterative cycle in which prototypes were tested and refined in response to user feedback.

“Across included studies, UCD/HCD was frequently operationalized as an iterative cycle in which prototypes were tested and refined in response to user feedback.”

Educational value was addressed in 2/36 (5.6%) of studies.

“Even more rarely, studies addressed feasibility and implementation logistics (5/36, 13.9%), collaboration and coordination (3/36, 8.3%), or educational value (2/36, 5.6%).”

Participatory design sessions were reported in 2/36 (5.6%) of studies.

“Participatory design sessions (2/36, 5.6%) and co-design workshops (1/36, 2.8%) were comparatively rare.”

Less commonly reported design methods included content analysis, scenarios, stakeholder consultations, and thematic analysis (2/36, 5.6% each).

“Less commonly reported design methods included content analysis, scenarios, stakeholder consultations, and thematic analysis (2/36, 5.6% each).”

Feasibility and implementation logistics were addressed in 5/36 (13.9%) of studies.

“Even more rarely, studies addressed feasibility and implementation logistics (5/36, 13.9%), collaboration and coordination (3/36, 8.3%), or educational value (2/36, 5.6%).”

Usability testing was used in 16/36 (44.4%) of studies.

“Interviews were the most frequently used approach (25/36, 69.4%), followed by usability testing (16/36, 44.4%).”

Usability and user satisfaction measures commonly served as proxies for the overall success of cancer care navigational tools.

“Across included studies, outcomes most often reflected usability (28/36, 77.8%) and user satisfaction (26/36, 72.2%), with these measures commonly serving as proxies for the overall success of cancer care navigational tools.”

UCD/HCD approaches in cancer navigation were mainly used to ensure that patient-facing tools are usable and acceptable.

“In summary, UCD/HCD approaches in cancer navigation were mainly used to ensure that patient-facing tools are usable and acceptable.”

Some studies conceptually broadened navigation toward empowerment and communication.

“Some studies conceptually broadened navigation toward empowerment and communication.”

Caregivers, navigators, and clinicians were rarely included in the development of tools.

“However, caregivers, navigators, and clinicians were rarely included, which may leave workflow and coordination barriers underexplored.”

Overall, UCD/HCD was most often applied to patient-facing tools during prototyping and usability evaluation, with comparatively less attention to early discovery phases and downstream implementation in routine care settings.

“Overall, UCD/HCD was most often applied to patient-facing tools during prototyping and usability evaluation, with comparatively less attention to early discovery phases and downstream implementation in routine care settings.”

Even fewer studies included measures of equity, timeliness, or continuity of care.

“Moreover, even fewer included measures of equity, timeliness, or continuity of care.”

Most reviewed studies relied on traditional UCD/HCD design methods (ie, interviews, surveys, and usability testing applied midcycle) with limited reporting of upstream discovery or downstream implementation.

“Most reviewed studies relied on traditional UCD/HCD design methods (ie, interviews, surveys, and usability testing applied midcycle) with limited reporting of upstream discovery or downstream implementation.”

Discovery and routine care implementation were rarely discussed.

“Discovery and routine care implementation were rarely discussed, which may limit both innovation and sustainability.”

UCD/HCD approaches have supported the development of education and communication functions responsive to patient needs.

“While UCD/HCD approaches have supported the development of education and communication functions responsive to patient needs, future applications could also extend to the broader spectrum of navigation services that shape equity, access, and continuity of care.”

Rather than limiting navigation to scheduling or wayfinding, studies framed it as a broader process of information exchange, communication, and care coordination.

“Rather than limiting navigation to scheduling or wayfinding, studies framed it as a broader process of information exchange, communication, and care coordination.”

UCD/HCD in cancer navigation has been applied most extensively to adult cancers in high-income settings.

“Findings demonstrate that UCD/HCD in cancer navigation has been applied most extensively to adult cancers in high-income settings.”

Most tools were developed directly with patient input.

“At the stakeholder level, most tools were developed directly with patient input, demonstrating the strength of UCD/HCD in capturing and centering lived experience.”

This pattern reflects how UCD/HCD has been applied primarily to informational and communicative aspects of navigation, while more complex or resource-intensive functions remain underexplored.

“This pattern reflects how UCD/HCD has been applied primarily to informational and communicative aspects of navigation, while more complex or resource-intensive functions remain underexplored.”

Several studies applied UCD/HCD approaches to reconceptualize what "navigation" means in cancer care, beyond creating tools for discrete functions.

“Beyond creating tools for discrete functions, several studies applied UCD/HCD approaches to reconceptualize what “navigation” means in cancer care.”

Fewer studies addressed system-level barriers, equity, cancer-specific navigational needs, and global applicability.

“These efforts appear to have improved alignment between navigational tools and patient needs; however, fewer studies addressed system-level barriers, equity, cancer-specific navigational needs, and global applicability.”

Relatively few studies address the broader coordination, equity, and implementation challenges that define navigation in real-world oncology settings.

“While these contributions are notable, relatively few studies address the broader coordination, equity, and implementation challenges that define navigation in real-world oncology settings.”

UCD/HCD approaches enhance the usability and patient relevance of digital cancer navigation tools.

“UCD/HCD approaches enhance usability and patient relevance of digital cancer navigation tools.”

The distribution of target user groups highlights a strong emphasis on patient-facing tools in the current literature, with comparatively limited attention to caregivers and patient navigators.

“This distribution highlights a strong emphasis on patient-facing tools in the current literature, with comparatively limited attention to caregivers and patient navigators.”

UCD was applied primarily to midcycle for usability evaluation.

“UCD applied primarily to midcycle for usability evaluation.”

The distribution of digital tool types suggests that research has largely concentrated on familiar digital formats (ie, web platforms and mobile apps), with comparatively limited integration of newer modalities such as conversational agents or artificial intelligence-driven chatbots.

“This distribution suggests that research has largely concentrated on familiar digital formats (ie, web platforms and mobile apps), with comparatively limited integration of newer modalities such as conversational agents or artificial intelligence–driven chatbots, which were categorized as digital health modalities within this review.”

Human-centered approaches can extend beyond individual patients' needs to reflect the complex, multiactor systems that shape cancer care.

“These examples demonstrate how human-centered approaches can extend beyond individual patients’ needs to reflect the complex, multiactor systems that shape cancer care.”

The iterative responsiveness of UCD/HCD ensured that navigation tools were grounded in real-world needs and experiences.

“This responsiveness ensured that navigation tools were grounded in real-world needs and experiences.”

Participatory techniques aimed at involving users and stakeholders throughout the design process remain limited in current cancer navigation research.

“This indicates that participatory techniques aimed at involving users and stakeholders throughout the design process remain limited in current cancer navigation research.”

These efforts appear to have improved alignment between navigational tools and patient needs.

“These efforts appear to have improved alignment between navigational tools and patient needs; however, fewer studies addressed system-level barriers, equity, cancer-specific navigational needs, and global applicability.”

The strength of evidence underlying individual findings could not be assessed.

“Given this, the strength of evidence underlying individual findings could not be assessed.”

The development of most tools directly with patient input demonstrates the strength of UCD/HCD in capturing and centering lived experience.

“At the stakeholder level, most tools were developed directly with patient input, demonstrating the strength of UCD/HCD in capturing and centering lived experience.”

The rarity of discussion of discovery and routine care implementation may limit both innovation and sustainability.

“Discovery and routine care implementation were rarely discussed, which may limit both innovation and sustainability.”

Overreliance on consultative design methods risks capturing only surface-level usability preferences while overlooking systemic challenges such as workflow misalignments, caregiver burdens, or sociotechnical barriers.

“Overreliance on consultative design methods risks capturing only surface-level usability preferences while overlooking systemic challenges such as workflow misalignments, caregiver burdens, or sociotechnical barriers [53].”

• cites [53] sourceNot checked — no full text of the source

The rare inclusion of caregivers, navigators, and clinicians may leave workflow and coordination barriers underexplored.

“However, caregivers, navigators, and clinicians were rarely included, which may leave workflow and coordination barriers underexplored.”

Inclusion criteria required explicit mention of UCD or HCD, which may have excluded studies using participatory approaches under different terminology.

“While the dual-review process enhanced rigor, inclusion criteria required explicit mention of UCD or HCD, which may have excluded studies using participatory approaches under different terminology.”

The concentration of studies in high-income countries and adult cancer populations limits generalizability to low- and middle-income settings or underrepresented cancer types.

“Moreover, most studies were conducted in high-income countries and focused on adult cancer populations, limiting generalizability to low- and middle-income settings or underrepresented cancer types.”

These patterns may limit both the scalability and sustainability of current tools.

“These patterns may limit both the scalability and sustainability of current tools.”

The narrow scope of outcomes risks producing tools that are usable but not transformative for access, coordination, or sustainability.

“This narrow scope risks producing tools that are usable but not transformative for access, coordination, or sustainability.”

Limiting participatory design primarily to patients could risk overlooking system-level and workforce perspectives needed for real-world implementation.

“Limiting participatory design primarily to patients could risk overlooking system-level and workforce perspectives needed for real-world implementation.”

UCD and HCD approaches have demonstrated value in shaping digital cancer navigation tools that are usable, acceptable, and responsive to patient needs.

“UCD and HCD approaches have demonstrated value in shaping digital cancer navigation tools that are usable, acceptable, and responsive to patient needs; however, their current application remains narrow, concentrated in adult cancers, high-income settings, and informational functions.”

The evidence from this review suggests that UCD/HCD has been most impactful when applied iteratively, embedding patient perspectives to refine tools that improve engagement, communication, and self-management.

“The evidence from this review suggests that UCD/HCD has been most impactful when applied iteratively, embedding patient perspectives to refine tools that improve engagement, communication, and self-management.”