JMIR Publications

ABSTRACT

Background:

Childhood cancer remains the leading cause of disease-related death among children and adolescents worldwide, despite increasing survival rates. Survivors often face long-term physical and psychological side effects. In response, mobile health (mHealth) has emerged as a promising tool to support pediatric oncology patients. However, adoption and sustained use of mHealth interventions vary, often due to usability, accessibility, acceptability, feasibility, and user satisfaction challenges.

Objective:

This systematic review aims to synthesize existing literature on the usability, accessibility, acceptability, feasibility, user satisfaction, and overall user experience of mHealth interventions in pediatric oncology.

Methods:

This systematic review was conducted according to ENTREQ and PRISMA guidelines. Studies were identified through a comprehensive database search (Medline, Embase, Web of Science, Cochrane CENTRAL, and Google Scholar) performed by a medical information specialist. Screening and selection were independently performed by three reviewers using Rayyan. Data extraction included intervention characteristics, participant demographics, and reported outcomes. Thematic analysis was used to synthesize the reported outcomes across the included studies. The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist.

Results:

Of 12,620 studies identified, 13 were included in this systematic review. Thematic analysis of the included studies revealed four themes, each encompassing multiple subthemes. These were: Empowerment and Participation in Care, Engagement Through Design and Motivation, Usability and User Experience, Informational Support and Peer Connection, and System-Level Limitations and Disconnects. Children and adolescents were found to play an active role in their care, using mHealth applications to track symptoms, support self-management, and enhance adherence. Design and personalization features—such as narrative elements, gamification, and visual appeal—played a key role in sustaining engagement. Usability was influenced by factors including digital literacy, clarity of instructions, and intuitive navigation, with notable differences across age groups. mHealth tools were also valued for their capacity to deliver trusted, peer-mediated information and foster meaningful connections with others facing similar health journeys.

Conclusions:

mHealth interventions show a promising role in supporting pediatric cancer care, particularly by enhancing engagement, empowerment, and overall user experience. However, their effectiveness depends on user-centered, developmentally appropriate design and more diverse, long-term research to ensure they align with the real-world needs of pediatric oncology patients.