Adolescent and young adult (AYA) survivors of childhood cancer remain at elevated risk for psychological distress and reduced quality of life (QoL). Technology-based psychosocial interventions offer scalable, accessible approaches to support this population, but the magnitude and durability of benefit across psychological outcomes have been uncertain. This systematic review and meta-analysis synthesized randomized controlled trials (RCTs) to evaluate the efficacy of technology-delivered psychosocial interventions on QoL and selected psychological outcomes in AYA survivors of childhood cancer.
The authors searched multiple electronic databases — PubMed, CINAHL, Cochrane Library, PsycINFO, Embase, Scopus, and Web of Science — for RCTs published between 2015 and 2025. Trial selection targeted randomized controlled trials that tested technology-based psychosocial interventions in adolescent and young adult survivors of childhood cancer and reported outcomes for QoL, anxiety, depression, distress, or emotional well-being. The review protocol was registered in PROSPERO (CRD420251248328).
Ten randomized controlled trials met inclusion criteria, comprising a pooled sample of 747 participants. Individual trial details (intervention formats, duration, platforms used, participant ages and cancer types) were part of the included studies; the abstract does not report these trial-level specifics. Risk of bias for included trials was assessed with the RoB 2 tool.
Primary outcomes pooled in the meta-analysis were overall quality of life, anxiety, depression, distress, and emotional well-being. Effect sizes were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Random-effects meta-analyses were conducted using RevMan Web. Heterogeneity was quantified with I2, and the authors conducted subgroup analyses by assessment timing (for example, immediate post-intervention versus longer-term follow-up) as well as leave-one-out sensitivity analyses to test robustness.
Across the 10 included RCTs (747 participants), technology-based psychosocial interventions were associated with a small but statistically significant improvement in overall QoL. The pooled effect size was SMD = 0.24 (95% CI 0.09 to 0.39; p = 0.001). This indicates a modest improvement in standardized QoL scores favoring technology-delivered psychosocial support compared with control conditions.
When outcomes were examined by timing, the pooled effect for QoL was not statistically significant immediately post-intervention, whereas at longer follow-up intervals (6–24 months) the benefit increased to a small-to-moderate effect. At 6–24 month follow-up the pooled SMD was 0.36 (95% CI 0.11 to 0.60; p = 0.004). These findings suggest that improvements in QoL may consolidate or become more detectable over time rather than appearing immediately after intervention delivery.
Pooled analyses for anxiety demonstrated a small-to-moderate reduction associated with technology-based interventions (SMD = −0.35; 95% CI −0.65 to −0.05; p = 0.02). This result reached statistical significance, indicating reduced standardized anxiety scores in intervention groups.
Effects on other psychological domains were more variable and did not reach statistical significance in pooled analyses reported in the abstract. Specifically:
These findings indicate that while anxiety and QoL showed measurable improvement, pooled effects for depression, general distress, and emotional well-being were inconclusive in the available RCT evidence.
Risk of bias across included RCTs was assessed using RoB 2. The review applied random-effects models and reported that heterogeneity (I2) and sensitivity analyses, including leave-one-out approaches, were performed. The abstract does not provide detailed I2 values or trial-level bias categorizations; those details are available in the full article. Subgroup analyses by assessment timing revealed differential effect sizes for QoL over time.
The meta-analysis concludes that technology-based psychosocial interventions are associated with modest but statistically significant improvements in QoL and anxiety among AYA survivors of childhood cancer, with evidence of sustained benefit at 6–24 month follow-up for QoL. Effects on broader psychological outcomes such as depression, distress, and emotional well-being were variable and did not show consistent, statistically significant pooled benefits.
The authors emphasize the need for larger, theory-driven trials that use standardized outcome measures and consistent reporting to better define which intervention components, delivery platforms, and populations derive the greatest benefit. Standardization of measures and longer follow-up would clarify durability and clinical relevance of observed effect sizes.
Because this meta-analysis used data drawn from previously published trials, the authors reported that the study did not require new ethical approval or informed consent. The authors declared no competing interests.
Note: This summary and rewrite are based exclusively on the information provided in the PubMed abstract and associated bibliographic details. Trial-level specifics and full heterogeneity or bias data were not reported in the abstract and would require consultation of the full text for additional detail.