Health promotion and psychological interventions for adolescent and young adult cancer survivors: A systematic literature review.
BACKGROUND
The effects of cancer and treatment have severe and long lasting negative impacts on quality of life. Adolescents and Young Adults (AYA) have high survival rates but may not reach their full life potential because of these consequences. This review aims to identify, appraise and synthesise the effects of health promotion and psychological interventions for AYA after cancer treatment.


METHODS
The review was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Included studies were identified though a range of electronic databases through to May 2016. Studies were critically appraised using the Cochrane Risk of Bias tool.


RESULTS
Seventeen studies, comprising a total of 2314 participants aged 13-39years were included in this review. Participants in 15 studies were survivors of childhood cancer, with only two studies specifically recruiting survivors of cancer diagnosed during young adulthood. Ten studies were randomised controlled trials (RCTs); the remaining seven were before and after studies. The quality of studies was variable across all appraised domains; risk of bias was evident in regards to recruitment, measures of exposure and outcomes, confounding factors, attrition and lost-to follow-up. Studies evaluated a range of health promotion and psychological interventions to improve health related and process outcomes. Eleven studies reported modest positive outcomes, with psychological and physical activity interventions achieving greater success compared to general health promotion interventions.


CONCLUSIONS
This review highlights the lack of high-quality studies for optimising the health and well-being of AYA cancer survivors. No conclusive evidence favouring specific interventions were identified, although recommendations for future studies are made. Interventions delivered face-to-face and those that facilitate peer-to-peer support hold promise. Harnessing social media and technology to deliver interventions is likely to increase and these modes of delivery require further investigations.
Queensland Youth Cancer Service, Childrens Health Queensland, Brisbane, Australia. Electronic address: Natalie.Bradford@health.qld.gov.au.
Natalie Katrina
NK
Bradford
School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia; Cancer Nursing Professorial Precinct, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Raymond Javan
RJ
Chan
D000293:Adolescent; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D065187:Controlled Before-After Studies; D015438:Health Behavior; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult
Adolescent and Young Adult; Cancer; Health and well-being; Interventions; Quality of life; Survivorship