Advances in diagnosis and treatment have markedly increased long-term survival for childhood, adolescent, and young adult (CAYA) cancers. Despite high survival rates, many survivors experience persistent physical, psychological, and social sequelae that can reduce quality of life. Family systems perspectives emphasize that survivor outcomes emerge from reciprocal interactions among family members, and caregiving behaviors may shape adjustment.
Family accommodation refers to caregiver behaviors intended to prevent or reduce a child’s distress, including providing excessive reassurance, modifying family routines, or taking over tasks the survivor could perform. Although well-stated in pediatric mental health research—where higher accommodation is linked with greater symptom severity, functional impairment, and poorer treatment response—its role within CAYA cancer survivorship has not been comprehensively examined. Distinguishing family accommodation from related caregiving constructs (for example, parental overprotection, protective buffering, or dependence-promoting behaviors) remains an unresolved issue in cancer contexts.
The proposed scoping review is intended as a foundational effort to map existing evidence on family accommodation in CAYA cancer survivors and to inform development of family-centered interventions and future empirical work.
The primary objective is to map and synthesize how family accommodation has been conceptualized, measured, and linked to the health, health-related behaviors, and mental health of CAYA cancer survivors.
Secondary objectives are to:
The review is intentionally broad to capture a diverse literature base and to clarify how the construct has been operationalized across studies.
This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews and will be reported according to the PRISMA extension for scoping reviews (PRISMA-ScR). A scoping approach, rather than a systematic review, was selected because of anticipated heterogeneity in study designs, definitions, measurement approaches, and outcomes.
The review protocol was preregistered on the Open Science Framework (OSF). At the time of manuscript resubmission, title and abstract screening had been completed and full-text review was underway; data extraction and synthesis had not yet begun. Any amendments to the protocol will be recorded with rationale and reported in the final review.
Population: Studies including individuals diagnosed with cancer between birth and 39 years of age and their family members will be eligible. Eligible family members include parents, legal guardians, siblings, spouses or partners, and other informal caregivers identified by study authors. Studies at any point along the survivorship trajectory—from diagnosis through treatment and post-treatment follow-up—are included. Studies of mixed-age cancer populations are eligible only if CAYA-specific data are reported or can be extracted separately. Studies focused on terminal diagnoses or palliative/end-of-life care will be excluded.
Exposure: The review will include studies examining family accommodation—behaviors such as excessive reassurance, modification of routines, or assuming tasks to reduce distress—or conceptually related constructs (e.g., parental overprotection, protective buffering, family rules and routines, caregiving adaptations, dependence-promoting behaviors). Studies that focus solely on general emotional support or medically necessary caregiving will be excluded.
Outcomes: No specific outcomes are required for inclusion to maximize the scope of the review. The authors plan to capture outcomes related to survivor health, health-related behaviors, mental health, caregiver emotional well-being, and measures used to assess family accommodation.
The review will consider a broad range of empirical study designs: randomized and non-randomized controlled trials, before-and-after and interrupted time-series studies, prospective and retrospective cohort studies, case-control studies, analytical and descriptive cross-sectional studies, case series, and qualitative designs (including phenomenology, grounded theory, ethnography, and qualitative description). Relevant systematic reviews will not be included as primary evidence but their reference lists will be screened to identify additional primary studies. Gray literature, case studies, and opinion papers will not be considered.
An initial limited MEDLINE search was used to identify keywords and index terms, which informed the full search strategy. In collaboration with an information specialist, comprehensive searches will be run in Medline ALL, Embase Classic + Embase, Emcare, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycInfo (all via OvidSP), and Scopus (Elsevier). Searches will cover each database from inception to October 2024. The search strategies combine controlled vocabulary and text-word terms relevant to family accommodation and CAYA cancer survivorship.
Screening will follow the predefined inclusion criteria; at the time of protocol reporting, title/abstract screening was complete and full-text review was in progress. Data extraction and synthesis were pending. The authors will extract data on conceptualization, measurement tools, study design, population characteristics, settings (healthcare, home, community), outcomes related to survivors and caregivers, and any reported links between family accommodation and clinical or psychosocial outcomes. Findings will be mapped descriptively and synthesized to identify gaps, measurement approaches, and potential implications for intervention development.
The protocol was preregistered on the Open Science Framework (OSF). Any amendments to the protocol will be documented with rationale and reported in the final scoping review to ensure transparency.
By synthesizing how family accommodation has been defined, measured, and associated with outcomes in CAYA cancer survivorship research, this scoping review aims to provide a foundation for intervention planning and future empirical studies. Clarifying measurement approaches and distinguishing accommodation from related caregiving constructs may support development of family-centered survivorship care and strategies to address behaviors that could impede survivor adjustment.