Objectives/purpose: The efficacy of digital psycho-oncology interventions may be impacted by low engagement. One solution to this is human support. This systematic review aimed to synthesize the modality, dosage, and focus of guidance in the current literature.
Sample and Setting: Randomised controlled trials (RCTs) recruiting adult (≥18 years) cancer patients undergoing or completed treatment to evaluate individual or group online psycho-oncological programs, utilising CBT or third-wave frameworks, where the online program is the core therapeutic component, and where guidance is supplementary.
Procedures: Five electronic databases were searched for RCTs published from January 2000 to July 2024. Abstracts and full text articles were doubled screened for eligibility. Extracted data included participant and study characteristics, online therapy and human support characteristics, and study outcomes. This study was prospectively registered via PROSPERO (CRD42024480841).
Results: Of the 8083 records screened, 33 studies were included. Support modality included written (n=10), email (n=6), phone (n=4) or face to face (n=3). Twenty studies used a combination of modalities. Dosage varied greatly; the majority allowed participants to opt-in to receive support. Where dosage was set, it was predominantly weekly. There was no consensus regarding the number of human support contacts (n=24/33; M±SD=6.10±4.20, range 1—12).The focus of support was therapeutic in 21/33 studies (all CBT/third wave) ; technical (n=13/33), or peer support (4/33), such as through discussion forums.
Conclusion and clinical implications: There are differences in the operationalisation of human support across digital psycho-oncology studies. This variability makes it difficult to draw conclusions regarding the optimal dose or modality. A meta-analysis of the impact of modality and dosage of human support on engagement is planned and will be presented.