University of Michigan School of Social Work, Ann Arbor, Michigan, USA.
University of Houston Graduate College of Social Work; and The University of Texas MD Anderson Cancer Center Department of Health Disparities Research, Houston, Texas, USA.
J Adolesc Young Adult Oncol. 2022 Feb;11(1):6-16. doi: 10.1089/jayao.2021.0012. Epub 2021 May 6.
Technology-assisted interventions are essential in supporting cancer survivors' psychosocial outcomes, especially for childhood, adolescent, and young adult (AYA) cancer survivors, a tech-savvy generation. This study aims to systematically evaluate review and meta-analyze technology-assisted interventions for childhood and AYA cancer survivors. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, the study team used a pre-set of key words and searched studies across 11 electronic databases and 4 professional websites, and conducted a manual search of reference lists from published reviews. Meta-analysis of small sample size corrected Hedges' was conducted using meta-regression with robust variance estimation. Final analysis included a total of 28 clinical trials, including 237 effect sizes reported an overall statistically significant treatment effect of technology-assisted psychosocial interventions for childhood and AYA cancer survivors, = 0.382, 95% confidence interval (CI) 0.243 to 0.521, < 0.0001. Subgroup analysis revealed that distraction-based interventions and interventions for psychosocial and emotional health were overall statistically significant, whereas interventions for childhood and AYA cancer survivors' cancer knowledge outcomes and physical and functional health outcomes were statistically nonsignificant. Moderator analysis found intervention target was a significant moderator. Technology-assisted interventions for childhood and AYA cancer survivors were overall effective across domains of survivorship outcomes. Favorable evidence was found primarily for childhood cancer survivors with limited support for AYA cancer survivors. Although existing technology-assisted interventions are overall promising, research support for cancer survivors from different age groups and with different psychosocial challenges varies and should be considered individually.
技术辅助干预对于支持癌症幸存者的心理社会结局至关重要,尤其是对于儿童、青少年和青年期(AYA)癌症幸存者这一精通技术的群体。本研究旨在系统评估和荟萃分析针对儿童和 AYA 癌症幸存者的技术辅助干预措施。研究团队遵循系统评价和荟萃分析的首选报告项目(PRISMA)指南,使用预设的关键词在 11 个电子数据库和 4 个专业网站上搜索研究,并对已发表综述的参考文献进行了手动搜索。采用稳健方差估计的元回归对小样本量校正的 Hedges' 进行了荟萃分析。最终分析共纳入 28 项临床试验,报告了 237 个效应量,总体上表明技术辅助心理社会干预对儿童和 AYA 癌症幸存者具有统计学显著的治疗效果, = 0.382,95%置信区间(CI)0.243 至 0.521, < 0.0001。亚组分析显示,基于分散注意力的干预和针对心理社会和情绪健康的干预总体上具有统计学意义,而针对儿童和 AYA 癌症幸存者癌症知识结局以及身体和功能健康结局的干预则无统计学意义。调节分析发现干预目标是一个显著的调节因素。技术辅助干预对儿童和 AYA 癌症幸存者的生存结局各个领域总体上是有效的。主要发现对儿童癌症幸存者有利,但对青年期癌症幸存者的支持有限。尽管现有的技术辅助干预总体上很有前景,但针对不同年龄组和具有不同心理社会挑战的癌症幸存者的研究支持各不相同,应单独考虑。