Abstract
Beyond physical challenges, cancer can cause psychological and cognitive challenges for patients, caregivers, and family members. Digital health interventions show promise in addressing these issues. However, evidence on their applicability in daily cancer care is limited. The objective of this systematic review is to evaluate the internal and external validity of digital health interventions targeting psychological and cognitive impairments in cancer patients, caregivers, and family members, using the RE-AIM framework. This systematic review was conducted following the PRISMA guidelines, using Pubmed/MEDLINE, Scopus, and PsychINFO databases. Data were extracted using data forms based on the RE-AIM framework. The methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS). A total of 191 studies involving 29.907 patients and caregivers met the inclusion criteria. Included studies were randomized controlled trials and nonrandomized studies of interventions related to digital health, using an online or hybrid format. The reach, implementation, and effectiveness domains were most frequently reported, while adoption and maintenance were the most unreported domains within the RE-AIM framework. Despite reporting on reach, effectiveness, and implementation, limited data on external validity restricts the impact and scalability of digital health interventions in cancer care. Future research should endeavor to address current challenges and improve the use of digital health interventions in cancer care.