Efficacy of technology-based psychosocial interventions on quality of life and psychological outcomes in adolescent and young adult survivors of childhood cancer: a systematic review and meta-analysis of randomized controlled trials.
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PURPOSE: Adolescent and young adult (AYA) survivors of childhood cancer remain at risk of psychological distress and reduced quality of life (QoL). We evaluated the efficacy of technology-based psychosocial interventions on QoL and psychological outcomes in this population. METHODS: PubMed, CINAHL, Cochrane Library, PsycINFO, Embase, Scopus, and Web of Science were searched for randomized controlled trials (RCTs) published between 2015 and 2025. Outcomes were QoL, anxiety, depression, distress, and emotional well-being. Risk of bias was assessed with RoB 2. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled with random-effects models (RevMan Web); heterogeneity (I2), subgroup analyses by assessment timing and leave-one-out sensitivity analyses were performed (PROSPERO: CRD420251248328). RESULTS: Ten RCTs (747 participants) were included. Technology-based interventions were associated with a small but statistically significant improvement in overall QoL (SMD = 0.24, 95% CI 0.09 to 0.39, p = 0.001); the effect was not significant post-intervention but was small-to-moderate at 6-24-month follow-up (SMD = 0.36, 95% CI 0.11 to 0.60, p = 0.004). A small-to-moderate reduction in anxiety was observed (SMD = - 0.35, 95% CI - 0.65 to - 0.05, p = 0.02), whereas effects on depression (SMD = - 0.31), distress (SMD = - 0.04), and emotional well-being (SMD = 0.20) were not statistically significant. CONCLUSION: Technology-based psychosocial interventions were associated with modest but statistically significant improvements in QoL and anxiety among AYA survivors of childhood cancer, with evidence of sustained benefits over time. Effects on broader psychological domains were more variable; larger, theory-driven trials with standardized outcomes are needed.