Abstract B028: Beyond digital reach, a systematic review of what makes digital behavior change interventions effective for cancer control among Latina(o) adults

Abstract

Latina(o) adults, the second-largest population group in the United States, face persistent disparities across cancer prevention, screening, diagnostic follow-up, and survivorship. Digital behavior change interventions (DBCIs) are promoted as scalable equity tools. Prior reviews have covered portions of this literature, typically one modality or one screening behavior, among minoritized populations in aggregate. We extended synthesis to the full cancer-control continuum for Latina(o) adults and treated theoretical mechanism and depth of cultural tailoring as predefined analytic domains. Following PRISMA 2020 and PICOS guidance, we searched seven databases (PubMed, Embase, Scopus, CINAHL, APA PsycInfo, Web of Science, ERIC) for peer-reviewed English, Spanish, or Portuguese articles from January 2000 to March 2025 evaluating digital or technology-supported interventions for cancer control among Hispanic or Latina(o) adults. Two reviewers independently screened, extracted, and appraised methodological quality using a 16-item checklist, with senior-reviewer adjudication. Theoretical foundations and cultural tailoring were abstracted as predefined domains for a narrative synthesis. From 2,830 records, 30 studies met criteria (97% [29/30] United States-based, sample sizes 7 to 84,823). Methodological quality was high in 57% (17/30), and inter-rater agreement reached 90.05%. Effectiveness traveled with intervention architecture rather than digital delivery. Favorable outcomes, 43% (13/30), concentrated where a digital component was tethered to a discrete clinical action and reinforced by human or workflow support. Live-call reminders outperformed automated or text-only contact for fecal immunochemical test (FIT) completion, 32.3% versus 26.0%, combined automated plus live reminders reached 35.7%, a customized Spanish-language SMS program lowered colonoscopy no-show and late-cancellation rates, 14% versus 21%, and text reminders layered onto parental education raised HPV vaccine-series completion. Stand-alone digital education and reminder messaging produced predominantly null effects, and in the single unfavorable result, 3% (1/30), text reminders added to usual care lowered cervical cancer screening completion versus usual care alone. Cultural adaptation most often stopped at language, with deeper tailoring beyond translation in only 37% (11/30). A named theory appeared in 43% (13/30), and formal mechanism testing in only 7% (2/30). DBCIs have reached multiple points along the cancer-control continuum for Latina(o) adults, yet the channel matters less than what the channel is connected to. The field should move from digitized health education toward culturally responsive, action-oriented navigation systems that pair digital reach with bilingual human support, low-literacy design, clinical-workflow integration, and prespecified, tested mechanisms. Absent this shift, digital tools risk widening rather than narrowing cancer inequities among Latina(o) communities. Generative AI assisted refining this abstract. Enmanuel A. Chavarria, Muxin Anna. Han, Ankitha Kumar, Shenita R. Peterson, Don Operario, Cam Escoffery. Beyond digital reach, a systematic review of what makes digital behavior change interventions effective for cancer control among Latina(o) adults [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B028.