Impact of social determinants of health on positive psychological outcomes among adolescent and young adult childhood cancer survivors: A mixed methods systematic review

초록

Purpose: Adolescent and young adult childhood cancer survivors (AYA CCS) face unique psychological challenges influenced by social determinants of health (SDoH) that extend beyond individual resilience. This review examines how SDoH impact positive psychological outcomes, using the Healthy People 2030 framework. Methods: A mixed methods systematic review was conducted, and the findings were reported in accordance with the PRISMA guidelines. Searches were performed across PubMed, CINAHL, MEDLINE, EMBASE, PsycINFO, and RISS to identify studies exploring the relationship between SDoH and positive psychological outcomes among AYA CCS. A convergent, integrated approach was used for data synthesis. Results: Fifteen studies (12 quantitative and 3 qualitative) were included. The most frequently addressed SDoH domain was social and community context. Support from family, peers, institutions, and cultural or faith-based communities was consistently associated with outcomes such as post-traumatic growth, resilience, and wellbeing. Trusting relationships with healthcare providers were also identified as important. No study addressed neighborhood or built environment factors. Conclusion: Positive psychological outcomes in AYA CCS are strongly influenced by interpersonal, institutional, and cultural support systems. While family support remains critical, broader supports such as healthcare access, education, and employment are essential for autonomy and well-being. Cultural and spiritual factors also serve as key resources for meaning-making. Future research should comprehensively examine SDoH to inform equitable and developmentally appropriate psychosocial interventions for this population.

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