1. Introduction
Toolkits have been used to inform and improve health behaviors among various audiences, including healthcare professionals, patients, community and health organizations, policymakers, and the public. The term has been used to describe the bundling of a combination of educational materials, including templates, instruction sheets, literature reviews, videos, and posters, presented in various formats, such as hard copy or web pages [ 1 ]. As defined by the Agency for Healthcare Research and Quality (AHRQ), a toolkit is “an action-oriented compilation of related information, resources, or tools that together can guide users in developing a plan or organizing efforts to conform to evidence-based recommendations or meet specific evidence-based practice standards” [ 2 ]. Toolkits are designed to provide directions that guide users through the development of plans and organizing efforts to perform specific tasks, offering proactive recommendations and tools (e.g., surveys, guidelines, or checklists) [ 3 ]. Toolkits offer an innovative format to present an intervention with greater flexibility of use. They are a packaged group of tools and strategies that present explicit knowledge (e.g., templates, pocket card guidelines, algorithms) and are used to educate and/or facilitate behavior change [ 4 ]. The strategies in the toolkit/toolboxes are intended to be evidence-based, facilitate practice change, and may include methods for guideline implementation, informing policy, training practitioners, and providing quality audit materials [ 4 ]. The goal of the toolkit is for the user to select and use strategies at their discretion, depending on their aims, resources, and context. Toolkits have a popular appeal because they can be easily distributed on the Internet in an engaging and multimodal manner to a wide variety of audiences [ 1 ].
Given their practicality, toolkits could be a promising tool for managing chronic conditions such as cancer, depression, anxiety disorders, multiple sclerosis, dementia, bipolar disorder, and substance use disorders, among others. However, it is essential to examine which components drive effectiveness across different populations. This is especially relevant in behavioral health, as the rise in digital tools [ 5 ] has coincided with growing attention to intervention toolkits in the literature. Yet, a standardized toolkit format has not been established in the health context, underscoring the need for further evaluation and research interventions and implementation. It is also essential to consider diverse populations whose cultural and contextual factors influence how they respond to this type of intervention [ 5 , 6 ], as well as those who have not yet had access to such approaches. Likewise, beyond adapting intervention content, it is equally important to consider adaptation of the implementation process to ensure reach, engagement, and effectiveness [ 7 ].
The appropriateness of the intervention components and reach of toolkits/toolboxes may vary across populations due to differences in context. As such, there is a critical need to ensure that these interventions are inclusive of populations that have been underrepresented in research. For instance, in the cancer care context, cancer is the leading cause of death among Latinos in the United States, in contrast to the general U.S. population, for whom it ranks second [ 8 , 9 ]. Despite some cancers showing lower overall incidence rates among Hispanics/Latinos compared to non-Hispanic Whites, this population experiences disproportionately higher rates of infection-related cancers, including stomach, liver, and cervical cancer [ 10 ]. Latina women, for instance, face a notably higher incidence of cervical cancer compared to non-Hispanic White women, while Hispanic individuals as a whole experience higher rates of liver and gallbladder cancers, many of which are both preventable and linked to modifiable risk factors [ 10 ]. These disparities are compounded by lower rates of early detection, with data showing that Hispanic women are less likely to be diagnosed with breast cancer at a localized stage compared to non-Hispanic White women, reflecting gaps in cancer screening access and follow-through [ 9 , 10 ]. Moreover, the poor clinical outcomes observed in Hispanic/Latino populations are driven not only by biological or behavioral factors but also by deeply rooted structural inequities, including limited access to culturally tailored care, language barriers, lack of health insurance, and lower rates of enrollment in clinical trials, all of which compromise the continuum of cancer care [ 8 , 9 ]. In response to these challenges, toolkits/toolboxes are a promising strategy that may help incorporate educational interventions, streamlining the collection of resources, supporting informed decision-making, facilitating behavior change, and improving access to culturally relevant mental health and cancer care services. Hence, this scoping review’s primary aims are to (1) identify existing toolkits/toolboxes design to address mental health and cancer survivorship, (2) identify the intervention component incorporated in the toolkits/toolboxes, and (3) identify implementation factors of the toolkits/toolboxes, including strategies and delivery. Also, as secondary aims, this review seeks to (1) identify which toolboxes or toolkits include a Hispanic/Latino sample and how the toolkits are adapted to this population, and (2) evaluate the methodological quality of the studies. Findings from this review will inform the future development and adaptation of toolkit-based interventions.
2. Materials and Methods
2.1. Eligibility Criteria
The eligibility criteria established were developed to address the review’s aims. Eligibility was determined based on the characteristics of the intervention as reported by the study authors. Studies were included if they addressed mental health conditions as described by the authors or cancer survivorship issues. Studies had to report the use of a toolbox or toolkit. Studies were eligible if they documented implementation factors such as the delivery method (in person, web-based, app, etc.) and/or implementation strategies of the toolbox or toolkit, employed an experimental or quasi-experimental design, and were written in either Spanish or English. Studies that only described an adaptation of cancer survivorship or mental health toolboxes or toolkits, did not provide toolboxes to the population of interest, or were systematic review articles were excluded. Qualitative studies were excluded, as the purpose of this review was to identify and characterize interventions using toolkits or toolboxes and to examine how these interventions were delivered and implemented within experimental and quasi-experimental study designs, allowing for consistent evaluation of the characteristics of the implemented interventions across studies.
2.2. Information Sources and Search Strategy
This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) [ 11 ] and using the Covidence platform from 14 November 2023 to 12 December 2023. A secondary search was conducted between 31 August and 4 September 2025 to update the review and capture articles published from 2024 to 2025 using the primary databases. The protocol for this scoping review was registered in the Open Science Framework (OSF). This review constituted a search of randomized controlled trials and quasi-experimental single-arm pre–post intervention trials using toolkits/toolboxes specifically addressing adults’ mental health and cancer patients and survivors. The research team first used the following primary databases: EBSCOhost Research Platform (EBSCOhost), PubMed, and Scientific Electronic Library Online (Scielo). Secondly, the team used Google Scholar and the Red de Revistas Científicas de América Latina y el Caribe, España y Portugal (Redalyc). In PubMed, the search strategy was conducted using MeSH (Medical Subject Headings), the National Library of Medicine’s controlled vocabulary thesaurus used for indexing articles in PubMed [ 12 ] and Boolean operators. Keyword-based searches using Boolean operators were employed in the remaining databases. The search included the key terms Hispanic, Latinx, Latino, cancer patients, cancer survivors, cancer caregivers, cancer care, toolkit, toolbox, mental health, and prevention. Lastly, Google Scholar was used, as it helps capture citations that may be missed by primary indexing sources. The search was limited to the first 200 results due to the large volume of records and the non-transparent ranking algorithm. This pragmatic cut-off is consistent with recommended practice for using Google Scholar in evidence synthesis, where screening is typically limited to a manageable number of results because lower-ranked records are less likely to yield additional relevant studies. We also applied basic search operators (e.g., inclusion and exclusion terms) to refine the results. All articles published up to September 2025 were included in this scoping review. To see the full search strategy, see Appendix A .
2.3. Selection of Sources of Evidence
We used Covidence (Veritas Health Innovation, Melbourne, Australia) software to manage all the screening procedures. All reviewers involved in the screening, data charting, and quality appraisal stages hold graduate-level training or established expertise in health sciences, psycho-oncology, behavioral health research, or scientific writing, providing the disciplinary grounding required for rigorous and contextually informed appraisal throughout the review. All titles and abstracts retrieved from the initial search were screened for relevance based on the established inclusion and exclusion criteria. Three independent reviewers (L.P.R., F.M.P. and L.R.R.) screened titles and abstracts based on predefined criteria, resolving discrepancies through discussion or consultation with a third reviewer when needed. Full-text articles were then assessed for eligibility using the same criteria.
2.4. Data Charting and Data Items
Data charting was performed using a standardized form developed a priori and implemented within Covidence, which allows for customized data extraction forms and facilitates independent extraction by multiple reviewers. We created a data charting template in Covidence, which included the study’s characteristics and the review’s outcomes. The data charting procedure followed the same eligibility process, where the data charting was resolved through discussion and consensus of three independent reviewers (L.P.R., F.M.P. and L.R.R.), and a third reviewer (C.P.V. and E.C.F.) resolved any discrepancies. The data items were bibliography, sample size, participants’ nationality/ethnicity, participants’ age, diagnosis, participant type, study design, inclusion criteria, intervention, delivery method, implementation strategy, and toolkit/toolbox intervention components. Although critical appraisal is not mandatory in scoping reviews, we included a methodological quality assessment to provide contextual information regarding the rigor of the identified intervention studies, proving an overview of the methodological strengths and limitations of the existing evidence. To do so, we used a modified version of Downs and Black’s checklist, which was shorten by the authors for feasibility [ 13 ]. This check list is a standardized tool for evaluating methodology quality for both randomized and non-randomized studies. Lastly, two reviewers (L.R.R. and F.M.P) independently conducted the critical appraisal for the quality of the studies, and any disagreement was resolved through discussion with a third reviewer (C.P.V. and E.C.F.).
2.5. Study Framework
The review is guided by the PIO framework (a variant of the PICO framework) [ 14 ], which focuses on Population, Intervention, and Outcomes. In this review, the Population includes cancer patients and survivors, cancer caregivers, and individuals with mental health conditions. The Intervention encompasses cancer survivorship and mental health toolkits or toolboxes. The Outcomes include implementation-related factors, intervention components, and overall study quality. In addition, the Expert Recommendations for Implementing Change (ERIC) framework was incorporated to guide the identification and categorization of implementation strategies relevant to this study [ 15 ].
2.6. Descriptive Analyses and Synthesis
Descriptive data (frequency, percentages, and central distribution statistics) analyses were conducted to evaluate all the study’s outcomes. The team utilized the IBM SPSS version 29 platform to conduct the analyses. Minimal missing data were identified. However, when the mean age of participants was not included, it was coded as missing. These studies were kept in the analysis, as this missing information was minimal and did not impact the main outcomes of the review. Researcher triangulation was conducted to evaluate content in the studies and determine categories regarding the implementation component. The intervention content was evaluated by three coders (J.D.R., G.M.Q., and C.P.V). The identified categories were discussed until consensus was reached. For the mapping of implementation strategies, a thematic analysis was conducted by a single coder using a predefined coding template based on the ERIC framework. Lastly, the team did not conduct a sensitivity analysis given the descriptive nature of the synthesis.
3. Results
3.1. Identification of Studies
A search was conducted across five databases, including EBSCOhost ( n = 38,808), Google Scholar ( n = 9019), PubMed ( n = 6347), Redalyc ( n = 1152, Spanish articles), and Scielo ( n = 1, Spanish articles) ( Figure 1 ). We searched five databases and found 55,327 records. After removing duplicates, 11,558 records remained and were screened based on their abstract. A total of 218 reports were selected for full review. Following a thorough screening process, we identified 33 studies for risk bias evaluation that focused on addressing the needs of adult cancer patients, mental health patients, and cancer survivors within the Hispanic population. These studies utilized toolboxes or toolkits tailored to specifically address mental health or cancer survivorship issues and document their respective delivery methods and implementation strategies.
3.2. General Description of the Studies
The mean age of participants across studies was x ¯ = 48.63 (SD = 24.42). The interventions (toolkits/toolboxes) addressed various themes, including mental health (15/33, 45.5%) [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], wellness in cancer care (12/33, 36.4%) [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], mental health in cancer care (2, 6.1%) [ 43 , 44 ], wellness and mental health (1/33, 3.0%) [ 45 ], substance use disorder (1/33, 3.0%) [ 46 ], wellness (1/33, 3.0%) [ 47 ], and symptom management in cancer care (1/33, 3.0%) [ 48 ].
3.3. Mental Health Diagnosis and Other Psychological Outcomes
Not all mental health- or cancer- and mental health-focused studies disclosed a diagnosis. Most of the samples consisted of depression or depressive symptomatology (14/33, 42.4%) [ 16 , 19 , 20 , 21 , 22 , 24 , 25 , 29 , 30 , 31 , 35 , 36 , 37 , 43 ], followed by anxiety (12/33, 36.3%) [ 16 , 19 , 22 , 24 , 30 , 31 , 36 , 37 , 42 , 43 , 44 , 45 ], severe mental illness (3/33, 9.0%) [ 17 , 18 , 27 ], substance abuse (2/33, 6.0%) [ 27 , 46 ], dementia (1/33, 3.0%) [ 28 ], autism (1/33, 3.0%) [ 26 ], and somatoform disorders (1/33, 3.0%) [ 27 ]. Other psychological and health outcomes that were not diagnosed comprised quality of life (12/33, 36.3%) [ 27 , 29 , 31 , 33 , 34 , 35 , 37 , 38 , 39 , 40 , 42 , 43 ], wellbeing (6/33, 18.1%) [ 16 , 22 , 36 , 38 , 40 , 47 ], distress (4/33, 12.1%) [ 23 , 36 , 40 , 42 ], fatigue (2/33, 6.0%) [ 35 , 42 ], and poor functioning (2/33, 6.0%) [ 24 , 35 ].
3.4. Intervention Components Incorporated and Implementation Factors
The team identified a total of 20 types of intervention components and resources used within the toolkits/toolboxes. Educational (13/33, 39.3%) [ 18 , 25 , 26 , 27 , 28 , 29 , 31 , 34 , 36 , 38 , 41 , 45 , 46 ] and cognitive and behavioral strategies (13/33, 39.3%) [ 16 , 17 , 19 , 20 , 21 , 22 , 25 , 27 , 29 , 30 , 38 , 44 , 45 ] were the most frequently used, followed by self-management (10, 11.6%) [ 18 , 22 , 25 , 27 , 31 , 32 , 39 , 41 , 43 , 48 ].
Other strategies included were psychoeducational (9/33, 27.2%) [ 16 , 17 , 22 , 23 , 24 , 30 , 39 , 43 , 44 ], support (6/33, 18.1%) [ 23 , 25 , 30 , 31 , 34 , 43 ], resources (5/33, 15.1%) [ 26 , 28 , 30 , 34 , 43 ], self-advocacy (4/33, 12.1%) [ 27 , 30 , 33 , 43 ], stress management (4/33, 12.1%) [ 28 , 30 , 36 , 42 ], symptom management (3/33, 9.0%) [ 35 , 43 , 48 ], mindfulness (3/33, 9.0%) [ 40 , 42 , 47 ], cognitive skills (3/33, 9.0%) [ 24 , 33 , 47 ], consultations (2/33, 6%) [ 32 , 37 ], interpersonal skills (2/33, 6.0%) [ 28 , 33 ], self-care (2/33, 6.0%) [ 28 , 39 ], psychosocial skills (2/33, 6%) [ 34 , 38 ], self-compassion (1/33, 3.0%) [ 22 ], coaching (1/33, 3.0%) [ 31 ], provider communication (1/33, 3.0%) [ 39 ], goal-setting (1/33, 3.0%) [ 31 ], and motivational enhancement (1/33, 3.0%) [ 46 ].
In terms of implementation strategies, considerable variability was observed. These are reported in the table due to their complexity and extent (See Table 1 for more information). We identified greater heterogeneity in contrast to the intervention components. Various delivery formats were used, including multiple modalities within the same study. Most papers did not provide a detailed description of their implementation approaches. Although some studies reported implementation processes, few clearly specified the strategies, frameworks, or theoretical basis guiding their approach. Only a small number of studies clearly outlined these elements in the manuscript [ 18 , 28 ] or referred to a previously published implementation of their intervention [ 23 ].
3.5. Inclusion of a Hispanic/Latino Sample and Adaptations
A total of 13/33 (39.3%) reported the inclusion of Hispanics/Latinos in their sample [ 17 , 24 , 26 , 29 , 32 , 34 , 36 , 38 , 40 , 41 , 42 , 44 , 48 ]. Nonetheless, out of the 13 studies that reported a Hispanic/Latino sample, a total of 8/33 (61.5%) reported a sample size of 10% to 1.7% [ 17 , 24 , 26 , 32 , 34 , 38 , 40 , 48 ]. Lastly, 4/33 (12.1%) [ 29 , 31 , 41 , 44 ] included implementation strategies that were aimed at tailoring their intervention to the Hispanic/Latino population.
In terms of tailoring intervention to the needs of Hispanics/Latinos, most interventions promoted adaptability [ 29 , 31 , 41 , 44 ] through the development or translation of intervention material into Spanish, including measurements in Spanish [ 29 , 31 , 41 , 44 ]. Additionally, some intervention materials or curricula were adapted to be culturally appropriate or to demonstrate cultural sensitivity [ 31 , 41 ]. One study supported adaptability using an advisory group composed of patients and providers who guided the development of the material [ 31 ]. Another intervention included an acculturation evaluation and reported the inclusion of bilingual staff [ 41 ]. Lastly, one study reported having facilitators in the community to support cultural competence [ 44 ].
3.6. Data Appraisal
Of the final 33 articles left for the risk bias evaluation, all 33 studies clearly described their hypothesis, aim, or objective and provided a clear description of their primary outcomes in either the introduction or methods section. A total of 32/33 (96.9%) [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ] clearly described their main findings. A total of 30/33 (90.9%) included clearly described patient characteristics [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 48 ] and the intervention [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 , 47 ], and used the main outcome measures [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ].
Regarding the distribution of the principal confounders, 20/33 (60.6%) [ 16 , 19 , 20 , 22 , 23 , 24 , 25 , 27 , 29 , 30 , 31 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 47 ] presented the distribution of each compared group clearly. Moreover, 18/33 (54.5%) [ 17 , 19 , 21 , 23 , 24 , 26 , 29 , 32 , 33 , 34 , 35 , 36 , 38 , 40 , 41 , 42 , 43 , 48 ] described the findings by race/ethnicity. However, 21/33 (63.6%) used randomization to allocate the subjects to the intervention groups [ 16 , 19 , 22 , 23 , 24 , 25 , 27 , 29 , 30 , 33 , 34 , 35 , 36 , 37 , 39 , 41 , 42 , 43 , 45 , 46 , 47 ]. Lastly, only a total of 10/33 (30.3%) [ 16 , 22 , 23 , 24 , 26 , 29 , 36 , 41 , 42 , 43 ] used subjects who were representative of the entire population from which they were recruited.
These findings show that most of the studies present adequate to moderate quality, as they clearly present and describe their objective, patient characteristics, intervention, and main findings. Nonetheless, just over half (54.5%) reported results stratified by race/ethnicity. Additionally, only 30.3% of studies included a sample that was representative of the populations from which the study was conducted, indicating potential concerns regarding external validity. These methodological observations suggest caution is warranted when interpreting their generalizability.
4. Discussion
Toolkits/toolboxes are developed to organize an intervention, deliver an intervention, and guide future dissemination and implementation efforts. The purpose of this scoping review was to examine the components of toolkits/toolboxes in the cancer care and mental context, including the resources, strategies, intervention approaches, and implementation processes incorporated. It also aimed to assess the extent to which these toolkits include Hispanic/Latino populations and account for their specific needs in the development or adaptation process. After the final screening phase of the 218 articles in the scoping review, only 33 studies remained, which can be viewed as a limited amount of literature available regarding the use of toolkits/toolboxes in mental health and cancer care contexts.
Mental health and wellness were the themes most incorporated into mental health and cancer care toolkits, underlying the relevance of integrating intervention components that fit these themes to better serve these populations. The team identified that the most addressed populations were patients with depression and anxiety, highlighting the value of using toolkits to address these mental health concerns. Although several intervention components and resources were observed within toolkits/toolboxes (e.g., self-management techniques, mindfulness, stress management, resources list), a consistent use of education and cognitive behavioral strategies was observed, each of which is strongly supported by existing literature. For instance, psychoeducation strategies for anxiety and depression have been seen to be beneficial for stress control [ 49 , 50 , 51 , 52 ]. Likewise, cognitive behavioral strategies have been proven to be beneficial for a variety of mental health diagnoses and concerns [ 53 ].
In contrast to the consistent use of components and themes, greater heterogeneity was observed in implementation factors, including the strategies employed and their delivery methods. Various delivery formats were used, even within the same studies, where a single toolkit/toolbox was often delivered through multiple modalities. However, it is important to consider how different delivery approaches may affect the target population and, accordingly, conduct prior needs assessments to identify the most appropriate delivery methods. In general, variability may compromise reproducibility and rigor when implementation processes are not clearly reported. In some cases, heterogeneity is not only advantageous but essential, as it is anticipated that interventions will need to be adapted and tailored to address the specific needs of diverse populations. Our findings show that most papers lacked an explicit rationale for their implementation strategies or a detailed implementation plan and omitted important implementation factors such as strategies, frameworks, or theoretical bases guiding their approach. As a result, implementation was often reported narratively rather than systematically. The lack of documentation represents a critical gap in the literature, particularly regarding toolkit standardization. Future efforts should focus on developing standardized protocols for toolkit development that retain flexibility and adaptability, while ensuring that implementation decisions are planned, justified, and clearly documented.
Regarding the applicability of toolkits across cancer types and stages, the evidence reviewed suggests that toolkit-based interventions hold potential across the full cancer care continuum. Patients may experience significant psychological distress at any point from initial diagnosis and active treatment through post-treatment survivorship and palliative care, underscoring the relevance of flexible, accessible interventions at each of these phases [ 54 ]. The studies included in this review spanned a range of cancer diagnoses, including breast, lung, colorectal, gynecologic, hematologic, head and neck, and prostate cancers, reflecting the cross-cutting applicability of toolkit approaches regardless of tumor type. Self-management interventions, a core component of the toolkits identified in this review, have been shown to be feasible not only during survivorship but also during the active treatment phase, where building patients’ self-management capacity may buffer against the psychological and functional burden of treatment [ 43 ]. Furthermore, at the palliative and end-of-life stages, toolkits that address pain management, caregiver support, and psychosocial coping have demonstrated feasibility and acceptability, as illustrated by studies included in this review. The modular format of toolkits, allowing users to select components according to their stage-specific needs, is particularly well suited to this continuum-based approach. Future work should address how toolkit components may need to be adapted not only across cultural groups but also across disease stages, given that the priorities, burdens, and resources of patients shift substantially along the cancer trajectory.
Moreover, a common limitation in many of these studies was the lack of inclusion of subjects that were representative of the entire population, which can compromise the generalizability of the findings and contribute to disparities, particularly for minority groups [ 55 ]. Although many studies reported nationality, some failed to include ethnicity breakdowns or described their findings based on race and/or ethnicity. Additionally, we observed a lack of inclusion of Hispanic/Latino individuals in the cohorts, as only 13 studies included this population, and only 5 of them reported a sample in which Hispanic/Latino participants made up more than 10%. This aligns with data from the US Food and Drug Administration, which shows that Hispanics account for 10% of participants in clinical trials for new drugs, and just 4.6% in trials for novel cancer therapies [ 56 ]. Barriers such as mistrust of the medical system, language challenges, limited access to academic cancer centers, and logistical issues (e.g., transportation, childcare, and work obligations) contribute to this underrepresentation [ 57 ]. Furthermore, the failure to report findings by race and ethnicity, omitted in approximately 45% of studies, further limits the ability to interpret results in a way that addresses disparities [ 58 , 59 ]. Addressing these methodological shortcomings is essential to ensure inclusive, empirically grounded science that can equitably serve all populations.
In light of these considerations, this review provides valuable insights into the use of toolkits/toolboxes for supporting individuals in managing mental health diagnoses and other health outcomes, such as quality of life, wellbeing, distress, and functionality problems. Furthermore, by identifying challenges and potential areas for future development, this work serves as a foundation for improving mental health and cancer care. Identifying methodological issues also contributes to a deeper understanding and development of comprehensive and appropriate toolkits/toolboxes for mental health and cancer patients. Lastly, this scoping review identifies key gaps and opportunities in the application of toolkits within cancer care, particularly those that incorporate behavioral and psychological components. The findings of this scoping review provide a foundation for future research aimed at systematically evaluating the effectiveness of patient-directed toolkits/toolboxes through rigorous systematic reviews and meta-analyses.
5. Strengths and Limitations
Several methodological strengths of this review merit consideration. The search strategy was systematic and pre-registered in the OSF, ensuring transparency and reducing reporting bias. The inclusion of five databases, among them two Spanish-language repositories (Redalyc and Scielo), reflects a deliberate effort to capture literature relevant to Hispanic/Latino populations that may not be indexed on English-language platforms alone. The bilingual search design, encompassing both English and Spanish terms, further strengthened the comprehensiveness of the search. The use of three independent reviewers at each stage of the screening, data charting, and quality appraisal process, with structured consensus procedures for resolving discrepancies, supported methodological rigor. The Downs and Black checklist provided a standardized approach to quality appraisal applicable to both randomized and non-randomized designs, which was appropriate given the heterogeneity of the study designs included. A secondary search conducted through 2025 ensured that recently published literature was captured within the review.
However, a limitation of this review is that the search strategy did not include some recommended databases for systematic reviews and scoping review (e.g., EMBASE, CENTRAL, Scopus). We prioritized PubMed and other databases that index psychological and behavioral interventions and studies involving Hispanic/Latino populations (Redalyc and Scielo), consistent with the focus of this review. While this approach ensured alignment with our research objectives, the exclusion of those databases may have reduced the comprehensiveness of the search and introduced the possibility that relevant studies were not identified. Another limitation of this review is that implementation strategies were identified and classified by a single reviewer using the ERIC framework, which may have introduced classification bias despite the use of standardized definitions.
6. Practical Implications
The findings of this review carry several practical implications for the development, implementation, and dissemination of toolkit-based interventions in cancer care and mental health. First, the evidence supports the development of standardized toolkit protocols that clearly document the rationale for implementation strategies, the theoretical frameworks guiding intervention delivery, and the criteria for component selection. Standardization does not preclude adaptability; rather, it provides a structured foundation from which practitioners can make informed and justified decisions about tailoring interventions to their specific populations and contexts. Toolkits that explicitly document their flexibility parameters alongside their core elements are more reproducible, more evaluable, and more easily disseminated across clinical and community settings.
Second, the low representation of Hispanic/Latino individuals across the identified studies, and the even lower proportion of toolkits that meaningfully incorporated culturally and linguistically appropriate adaptations, highlights a pressing need for the intentional development of toolkit interventions that are designed with and for this population from the outset, rather than adapted as an afterthought. This includes translation into Spanish, engagement of community stakeholders in the development process, incorporation of culturally relevant content, and attention to structural barriers to access such as transportation, literacy, and insurance status.
Third, the findings underscore the value of embedding toolkits within existing cancer care pathways rather than positioning them as standalone add-ons. Integration into survivorship care plans, primary care models, and community health worker programs may improve reach and sustainability. Finally, future research should prioritize reporting by race and ethnicity, ensure adequate representation of minority populations in study samples, and adopt clear implementation frameworks to enable meaningful cross-study comparisons and the eventual development of evidence-based guidelines for toolkit use in oncology settings.
7. Conclusions
This review highlights how toolkits/toolboxes can serve as a key tool for interventions in the cancer care context and the mental health field. It identified key challenges, especially those related to implementation, as well as methodological issues and gaps. In particular, we identified that most of the methodological problems within the toolkit/toolbox studies have implications for underrepresented groups and may contribute to health disparities among them. In particular, the criterion that proved to be most neglected was the underrepresentation of other racial and ethnic minority groups. However, this review identified consistent intervention components and resources that represent promising aspects within the toolkits/toolboxes, including key themes, outcome measures, and evidence-based strategies.
Acknowledgments
Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number 5U01CA290613. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
Supplementary Materials
The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/healthcare14142222/s1 .
Author Contributions
C.P.-V. is the primary author for this manuscript, as she contributed to the methods, results, and discussion sections. C.P.-V. was also involved in the development of this scoping review and the analyses. The first four authors listed (C.P.-V., L.R.-R., F.N.M.-P., L.P.R.) contributed to the writing of the introduction and methods sections of the manuscript. They were also involved in the development of the scoping review. P.d.R.-R., G.N.M.-Q., G.L.-E., J.D.-R., Z.R.-C., C.C.-C., A.P.C., N.T.-B., E.R.-S., J.J., R.C.-M., G.N.A.-P. and E.M.C.-F. contributed to the manuscript by conducting the literature review and developing the discussion section. Additionally, G.N.A.-P. and E.M.C.-F. are the principal investigators of the study, conceptualized the scoping review protocol, provided the conceptual framework implementation guidance and provided mentoring feedback in the development and editing of the manuscript. All authors have read and agreed to the published version of the manuscript.
Institutional Review Board Statement
Not applicable.
Informed Consent Statement
Not applicable.
Data Availability Statement
The complete research search strategy is available in the Appendix A . The study protocol can be accessed at OSF. The complete extraction table and data used for analyses can be found in the Supplementary Materials .
Conflicts of Interest
The authors have no affiliation with any organization with a direct or indirect financial interest in the subject matter discussed in the manuscript submitted.
Appendix A
Search Procedures
This systematic review was conducted in accordance with the PRISMA guidelines and using the Covidence platform from 14 November 2023 to 12 December 2023. All articles published up to 2023 were included in this systematic review. A secondary search was conducted between 31 August and 4 September 2025 to review and capture articles published from 2024 to 2025. This review constituted a search of randomized control trials and quasi-experimental single-arm pre–post intervention trials using toolkits/toolboxes specifically addressing adults’ mental health and cancer patients and survivors.
The research team first used the following databases: PubMed, EBSCOhost, and Scielo.
The search strategy for PubMed includes “mesh”.
(((“Hispanic or Latino”[Mesh]) AND (“mental health”[Mesh])) AND (toolkit[Title/Abstract])) OR (Toolbox[Title/Abstract])
(((“Hispanic or Latino”[Mesh]) AND (“Cancer Survivors”[Mesh])) AND (toolkit[Title/Abstract])) OR (toolbox[Title/Abstract])
(((“Hispanic or Latino”[Mesh]) AND (“cancer patients”)) AND (toolkit[Title/Abstract])) OR (toolbox[Title/Abstract])
((((“Hispanic or Latino”[Mesh]) AND (“Oncologic Care”)) OR (Cancer care)) AND (toolbox[Title/Abstract])) OR (toolkit[Title/Abstract])
((((“Hispanic or Latino”[Mesh]) AND (“Delivery of Health Care”[Mesh])) OR (Cancer care)) AND (toolbox[Title/Abstract])) OR (toolkit[Title/Abstract])
The following keyword search with Boolean operators was used additionally in the databases on PubMed, and were used to search on EBSCOhost and Scielo: ((toolbox) OR (toolkit)) AND (mental health), (((toolbox) OR (toolkit)) AND (mental health)) AND (hispanic), (((toolbox) OR (toolkit)) AND (mental health)) AND (latino), (((toolbox) OR (toolkit)) AND (mental health)) AND (latinx), ((prevention toolbox) OR (prevention toolkit)) AND (mental health), ((toolbox) OR (toolkit)) AND (mental health prevention) ((toolbox) OR (toolkit)) AND (cancer), (((toolbox) OR (toolkit)) AND (cancer)) AND (hispanic), (((toolbox) OR (toolkit)) AND (cancer)) AND (latinx) toolbox OR toolkit AND mental health AND cancer AND implementation, toolbox OR toolkit AND mental health AND cancer AND implementation strategies, toolbox OR toolkit AND mental health AND cancer AND implementation method, toolbox OR toolkit AND mental health AND cancer AND implementation resources, toolbox OR toolkit AND mental health AND cancer survivors AND implementation, toolbox OR toolkit AND mental health AND cancer survivors AND implementation strategies, toolbox OR toolkit AND mental health AND cancer survivors AND implementation method, toolbox OR toolkit AND mental health AND cancer survivors AND implementation resources, toolbox OR toolkit AND mental health AND cancer AND delivery, toolbox OR toolkit AND mental health AND cancer AND delivery method, toolbox OR toolkit AND mental health AND cancer AND delivery strategy, toolbox OR toolkit AND mental health AND cancer survivorship care, cancer patient toolbox AND caregiver toolbox AND implementation, caregiving AND cancer survivor AND mental health and toolkit, cancer survivor AND caregiver toolkit AND implementation, (((cancer survivor) AND (caregiver toolbox)) AND implementation, (((cancer patient) AND (caregiver toolbox)) AND (implementation)), (((cancer patient) AND (caregiver toolbox)) AND (implementation)) AND (mental health), (((cancer toolbox) AND (caregiver toolbox)) AND (mental health)) AND (implementation), ((((caregiver toolbox) AND (cancer)) AND (mental health))) AND (Implementation), ((caregiver toolkit) AND (mental health)) AND (implementation), ((cancer survivor caregiver toolkit) AND (mental health)) AND (implementation), ((cancer survivor toolkit) AND (implementation)), ((cancer toolkit) AND (implementation)), ((mental health toolkit) AND (implementation)), ((mental health toolkit) AND (implementation)) AND (cancer), (mental health toolbox) AND (implementation), (((implementation))) AND (mental health toolbox)
The research team also used the Google Scholar and Redalyc databases. The following keywords were used in the systematic review in the databases of Redalyc: toolbox OR toolkit AND mental health, Hispanic, Latinos (Latinas, Latinx), cancer patients, cancer survivors, cancer caregivers, mental health, NOT children. The following keywords will be used in the systematic review in the Google Scholar database: [+toolkit +toolbox +caregiver +mental health +cancer -children -child -prison -genetic -gene -meta-analysis -systematic review -nursing]
References
1. Barac R. Stein S. Bruce B. Barwick M. Scoping Review of Toolkits as a Knowledge Translation Strategy in Health BMC Med. Inform. Decis. Mak. 2014 14 121 10.1186/s12911-014-0121-7 25539950 PMC4308831
2. Davis M.M. Howk S. Spurlock M. McGinnis P.B. Cohen D.J. Fagnan L.J. A Qualitative Study of Clinic and Community Member Perspectives on Intervention Toolkits: “Unless the Toolkit Is Used It Won’t Help Solve the Problem” BMC Health Serv. Res. 2017 17 497 10.1186/s12913-017-2413-y 28720092 PMC5516321
3. Godinho M.A. Ansari S. Guo G.N. Liaw S.-T. Toolkits for Implementing and Evaluating Digital Health: A Systematic Review of Rigor and Reporting J. Am. Med. Inform. Assoc. 2021 28 1298 1307 10.1093/jamia/ocab010 33619519 PMC8200262
4. Yamada J. Shorkey A. Barwick M. Widger K. Stevens B.J. The Effectiveness of Toolkits as Knowledge Translation Strategies for Integrating Evidence into Clinical Care: A Systematic Review BMJ Open 2015 5 e006808 10.1136/bmjopen-2014-006808 25869686 PMC4401869
5. Löchner J. Carlbring P. Schuller B. Torous J. Sander L.B. Digital interventions in mental health: An overview and future perspectives Internet Interv. 2025 40 100824 10.1016/j.invent.2025.100824 40330743 PMC12051054
6. Soto A. Smith T.B. Griner D. Domenech Rodríguez M. Bernal G. Cultural adaptations and therapist multicultural competence: Two meta-analytic reviews J. Clin. Psychol. 2018 74 1907 1923 10.1002/jclp.22679 30091201
7. Harper Shehadeh M. Heim E. Chowdhary N. Maercker A. Albanese E. Cultural adaptation of minimally guided interventions for common mental disorders: A systematic review and meta-analysis JMIR Ment. Health 2016 3 e44 10.2196/mental.5776 27670598 PMC5057065
8. Fischer R. Bailey Y. Shankar M. Safaeinili N. Karl J.A. Daly A. Johnson F.N. Winter T. Arahanga-Doyle H. Fox R. Cultural challenges for adapting behavioral intervention frameworks: A critical examination from a cultural psychology perspective Clin. Psychol. Rev. 2024 110 102425 10.1016/j.cpr.2024.102425 38614022
9. Kronenfeld J.P. Graves K.D. Penedo F.J. Yanez B. Overcoming disparities in cancer: A need for meaningful reform for Hispanic and Latino cancer survivors Oncologist 2021 26 443 452 10.1002/onco.13729 33594785 PMC8176989
10. American Cancer Society Cancer Facts & Figures for Hispanic/Latino People 2024–2026 American Cancer Society Atlanta, GA, USA 2024
11. Tricco A.C. Lillie E. Zarin W. O’Brien K.K. Colquhoun H. Levac D. Moher D. Peters M.D.J. Horsley T. Weeks L. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation Ann. Intern. Med. 2018 169 467 473 10.7326/M18-0850 30178033
12. Fernández-Altuna M.D.L.Á. Martínez Del Prado A. Arriarán Rodríguez E. Gutiérrez Rayón D. Toriz Castillo H.A. Lifshitz Guinzberg A. Uso de Los MeSH: Una Guía Práctica Investig. Educ. Médica 2016 5 220 229 10.1016/j.riem.2016.02.004
13. Downs S.H. Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions J. Epidemiol. Community Health 1998 52 377 384 10.1136/jech.52.6.377 9764259 PMC1756728
14. Huang X. Lin J. Demner-Fushman D. Evaluation of PICO as a Knowledge Representation for Clinical Questions AMIA Annu. Symp. Proc. 2006 2006 359 363 17238363 PMC1839740
15. Powell B.J. Waltz T.J. Chinman M.J. Damschroder L.J. Smith J.L. Matthieu M.M. Proctor E.K. Kirchner J.E. A Refined Compilation of Implementation Strategies: Results from the Expert Recommendations for Implementing Change (ERIC) Project Implement. Sci. 2015 10 21 10.1186/s13012-015-0209-1 25889199 PMC4328074
16. Bakker D. Kazantzis N. Rickwood D. Rickard N. A Randomized Controlled Trial of Three Smartphone Apps for Enhancing Public Mental Health Behav. Res. Ther. 2018 109 75 83 10.1016/j.brat.2018.08.003 30125790
17. Buck B. Nguyen J. Porter S. Ben-Zeev D. Reger G.M. FOCUS mHealth Intervention for Veterans with Serious Mental Illness in an Outpatient Department of Veterans Affairs Setting: Feasibility, Acceptability, and Usability Study JMIR Ment. Health 2022 9 e26049 10.2196/26049 35089151 PMC8838564
18. Enrique A. Duffy D. Lawler K. Richards D. Jones S. An Internet-delivered Self-management Programme for Bipolar Disorder in Mental Health Services in Ireland: Results and Learnings from a Feasibility Trial Clin. Psychol. Psychother. 2020 27 925 939 10.1002/cpp.2480 32445611 PMC7754375
19. Fitzgeraldson E. Triandafilidis Z. Franklin Y. Palazzi K. Kay-Lambkin F. Fitzpatrick S. Feasibility and Acceptability of a Novel Online Program for Mental Health Carers Int. J. Psychol. Res. 2023 16 41 55 10.21500/20112084.5733 37547866 PMC10402641
20. Fogarty A.S. Proudfoot J. Whittle E.L. Clarke J. Player M.J. Christensen H. Wilhelm K. Preliminary Evaluation of a Brief Web and Mobile Phone Intervention for Men with Depression: Men’s Positive Coping Strategies and Associated Depression, Resilience, and Work and Social Functioning JMIR Ment. Health 2017 4 e33 10.2196/mental.7769 28798009 PMC5571234
21. Kratz A.L. Alschuler K.N. Williams D.A. Ehde D.M. Development and Pilot Testing of a Web-Based Symptom Management Program for Multiple Sclerosis: My MS Toolkit Rehabil. Psychol. 2021 66 224 232 10.1037/rep0000375 33539138
22. Lambert J. Loades M. Marshall N. Higson-Sweeney N. Chan S. Mahmud A. Pile V. Maity A. Adam H. Sung B. Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial J. Med. Internet Res. 2025 27 e58164 10.2196/58164 39888663 PMC11829182
23. Lobban F. Akers N. Appelbe D. Chapman L. Collinge L. Dodd S. Flowers S. Hollingsworth B. Johnson S. Jones S.H. Clinical Effectiveness of a Web-Based Peer-Supported Self-Management Intervention for Relatives of People with Psychosis or Bipolar (REACT): Online, Observer-Blind, Randomised Controlled Superiority Trial BMC Psychiatry 2020 20 160 10.1186/s12888-020-02545-9 32290827 PMC7158157
24. Lorenzo-Luaces L. Howard J. Efficacy of an Unguided, Digital Single-Session Intervention for Internalizing Symptoms in Web-Based Workers: Randomized Controlled Trial J. Med. Internet Res. 2023 25 e45411 10.2196/45411 37418303 PMC10362424
25. McCusker J. Cole M.G. Yaffe M. Strumpf E. Sewitch M. Sussman T. Ciampi A. Lavoie K. Platt R.W. Belzile E. A Randomized Trial of a Depression Self-Care Toolkit with or without Lay Telephone Coaching for Primary Care Patients with Chronic Physical Conditions Gen. Hosp. Psychiatry 2015 37 257 265 10.1016/j.genhosppsych.2015.03.007 26003664
26. Nicolaidis C. Raymaker D. McDonald K. Kapp S. Weiner M. Ashkenazy E. Gerrity M. Kripke C. Platt L. Baggs A. The Development and Evaluation of an Online Healthcare Toolkit for Autistic Adults and Their Primary Care Providers J. Gen. Intern. Med. 2016 31 1180 1189 10.1007/s11606-016-3763-6 27271730 PMC5023610
27. O’Keeffe D. Hickey D. Lane A. McCormack M. Lawlor E. Kinsella A. Donoghue O. Clarke M. Mental Illness Self-Management: A Randomised Controlled Trial of the Wellness Recovery Action Planning Intervention for Inpatients and Outpatients with Psychiatric Illness Ir. J. Psychol. Med. 2016 33 81 92 10.1017/ipm.2015.18 30115140
28. Smith C.W. Graves B.A. Implementation and Evaluation of a Self-Care Toolkit for Caregivers of Families with Dementia J. Am. Assoc. Nurse Pract. 2021 33 831 837 10.1097/JXX.0000000000000469 32740332
29. Wells K.B. Jones L. Chung B. Dixon E.L. Tang L. Gilmore J. Sherbourne C. Ngo V.K. Ong M.K. Stockdale S. Community-Partnered Cluster-Randomized Comparative Effectiveness Trial of Community Engagement and Planning or Resources for Services to Address Depression Disparities J. Gen. Intern. Med. 2013 28 1268 1278 10.1007/s11606-013-2484-3 23649787 PMC3785665
30. Yaffe M.J. McCusker J. Lambert S.D. Haggerty J. Meguerditchian A.N. Pineault M. Barnabé A. Belzile E. Minotti S. De Raad M. Self-Care Interventions to Assist Family Physicians with Mental Health Care of Older Patients during the COVID-19 Pandemic: Feasibility, Acceptability, and Outcomes of a Pilot Randomized Controlled Trial PLoS ONE 2024 19 e0297937 10.1371/journal.pone.0297937 38358971 PMC10868770
31. Bennett M.I. Mulvey M.R. Campling N. Latter S. Richardson A. Bekker H. Blenkinsopp A. Carder P. Closs J. Farrin A. Self-Management Toolkit and Delivery Strategy for End-of-Life Pain: The Mixed-Methods Feasibility Study Health Technol. Assess. 2017 21 1 292 10.3310/hta21760 29265004 PMC5757185
32. Cairo J. Williams L. Bray L. Goetzke K. Perez A.C. Evaluation of a Mobile Health Intervention to Improve Wellness Outcomes for Breast Cancer Survivors J. Patient-Centered Res. Rev. 2020 7 313 322 10.17294/2330-0698.1733 33163551 PMC7644127
33. Davis C. Rust C. Choi S. A Pilot Randomized Study of Skills Training for African American Cancer Survivors Soc. Work Public Health 2014 29 549 560 10.1080/19371918.2014.892865 25144697
34. Duggleby W. Ghosh S. Struthers-Montford K. Nekolaichuk C. Cumming C. Thomas R. Tonkin K. Swindle J. Feasibility Study of an Online Intervention to Support Male Spouses of Women with Breast Cancer Oncol. Nurs. Forum 2017 44 765 775 10.1188/17.ONF.765-775 29052658
35. Hodge F.S. Line-Itty T. Arbing R.H.A. Cancer-Related Symptom Management Intervention for Southwest American Indians Cancers 2022 14 4771 10.3390/cancers14194771 36230694 PMC9563929
36. Hoogland A.I. Lechner S.C. Gonzalez B.D. Small B.J. Tyson D.M. Asvat Y. Barata A. Gomez M.F. Rodriguez Y. Jim H.S.L. Efficacy of a Spanish-language Self-administered Stress Management Training Intervention for Latinas Undergoing Chemotherapy Psycho-oncology 2018 27 1305 1311 10.1002/pon.4673 29462503 PMC5895519
37. Mitchell G.K. Girgis A. Jiwa M. Sibbritt D. Burridge L.H. Senior H.E. Providing General Practice Needs-Based Care for Carers of People with Advanced Cancer: A Randomised Controlled Trial Br. J. Gen. Pract. 2013 63 e683 e690 10.3399/bjgp13X673694 24152483 PMC3782801
38. Nahm E.-S. Miller K. McQuaige M. Corbitt N. Jaidar N. Rosenblatt P. Zhu S. Son H. Hertsenberg L. Wickersham K. Testing the Impact of a Cancer Survivorship Patient Engagement Toolkit on Selected Health Outcomes Oncol. Nurs. Forum 2019 46 572 584 10.1188/19.ONF.572-584 31424456
39. Nahm E.-S. McQuaige M. Steacy K. Zhu S. Seong H. The Impact of a Digital Cancer Survivorship Patient Engagement Toolkit on Older Cancer Survivors’ Health Outcomes CIN Comput. Inform. Nurs. 2025 43 e01199 10.1097/CIN.0000000000001199 39365650
40. Salsman J.M. McLouth L.E. Tooze J.A. Little-Greene D. Cohn M. Kehoe M.S. Moskowitz J.T. An eHealth, Positive Emotion Skills Intervention for Enhancing Psychological Well-Being in Young Adult Cancer Survivors: Results from a Multi-Site, Pilot Feasibility Trial Int. J. Behav. Med. 2023 30 639 650 10.1007/s12529-023-10162-5 36890329 PMC10485177
41. Santiago-Torres M. Contento I. Koch P. Tsai W.-Y. Brickman A.M. Gaffney A.O. Thomson C.A. Crane T.E. Dominguez N. Sepulveda J. ¡Mi Vida Saludable! A Randomized, Controlled, 2 × 2 Factorial Trial of a Diet and Physical Activity Intervention among Latina Breast Cancer Survivors: Study Design and Methods Contemp. Clin. Trials 2021 110 106524 10.1016/j.cct.2021.106524 34365016 PMC8595705
42. Stoerkel E. Bellanti D. Paat C. Peacock K. Aden J. Setlik R. Walter J. Inman A. Effectiveness of a Self-Care Toolkit for Surgical Breast Cancer Patients in a Military Treatment Facility J. Altern. Complement. Med. 2018 24 916 925 10.1089/acm.2018.0069 30247967 PMC6157373
43. McCusker J. Jones J.M. Li M. Faria R. Yaffe M.J. Lambert S.D. Ciampi A. Belzile E. De Raad M. CanDirect: Effectiveness of a Telephone-Supported Depression Self-Care Intervention for Cancer Survivors J. Clin. Oncol. 2021 39 1150 1161 10.1200/JCO.20.01802 33555912
44. Sánchez-Sosa J.J. Aguilar S.A. A Behavioral Self-Recording Procedure in the Management of Breast Cancer: A Field Test with Disadvantaged Participants Mex. J. Behav. Anal. 2008 34 313 331
45. Soares L. Silva C. Lucas C.V. Toolbox: Technology Anxiety Resource for University Students Psychology 2023 preprints 10.20944/preprints202306.0452.v1
46. Brooks A.C. Chambers J.E. Lauby J. Byrne E. Carpenedo C.M. Benishek L.A. Medvin R. Metzger D.S. Kirby K.C. Implementation of a Brief Treatment Counseling Toolkit in Federally Qualified Healthcare Centers: Patient and Clinician Utilization and Satisfaction J. Subst. Abus. Treat. 2016 60 70 80 10.1016/j.jsat.2015.08.005 26508714
47. Pogrebtsova E. Son Hing L. González-Morales M.G. Effectiveness of an Emotion Regulation Intervention versus an Active Control on Daily Well-Being and Cognitive Reappraisal: An Experience Sampling Randomized Controlled Trial Int. J. Stress Manag. 2022 29 400 412 10.1037/str0000259
48. Spoelstra S. Sikorskii A. Majumder A. Burhenn P. Schueller M. Given B. Oral Anticancer Agents: An Intervention to Promote Medication Adherence and Symptom Management Clin. J. Oncol. Nurs. 2017 21 157 160 10.1188/17.CJON.157-160 28315545
49. Alizioti A. Lyrakos G. Measuring the Effectiveness of Psychoeducation on Adherence, Depression, Anxiety and Stress among Patients with Diagnosis of Schizophrenia. a Control Trial Curr. Psychol. 2021 40 3639 3650 10.1007/s12144-019-00255-4
50. Dolan N. Simmonds-Buckley M. Kellett S. Siddell E. Delgadillo J. Effectiveness of Stress Control Large Group Psychoeducation for Anxiety and Depression: Systematic Review and Meta-analysis Br. J. Clin. Psychol. 2021 60 375 399 10.1111/bjc.12288 33822376
51. Oz H. Oz F. A Psychoeducation Program for Stress Management and Psychosocial Problems in Multiple Sclerosis Niger. J. Clin. Pract. 2020 23 1598 1606 10.4103/njcp.njcp_462_19 33221788
52. Shah L.B.I. Klainin-Yobas P. Torres S. Kannusamy P. Efficacy of Psychoeducation and Relaxation Interventions on Stress-Related Variables in People with Mental Disorders: A Literature Review Arch. Psychiatr. Nurs. 2014 28 94 101 10.1016/j.apnu.2013.11.004 24673782
53. Nakao M. Shirotsuki K. Sugaya N. Cognitive–Behavioral Therapy for Management of Mental Health and Stress-Related Disorders: Recent Advances in Techniques and Technologies Biopsychosoc. Med. 2021 15 16 10.1186/s13030-021-00219-w 34602086 PMC8489050
54. Zhong C. Luo X. Tan M. Chi J. Guo B. Tang J. Guo Z. Deng S. Zhang Y. Wu Y. Digital health interventions to improve mental health in patients with cancer: Umbrella review J. Med. Internet Res. 2025 27 e69621 10.2196/69621 39984165 PMC11890151
55. National Academies of Sciences, Engineering, and Medicine Policy and Global Affairs Committee on Women in Science, Engineering, and Medicine Committee on Improving the Representation of Women and Underrepresented Minorities in Clinical Trials and Research Bibbins-Domingo K. Helman A. Why Diverse Representation in Clinical Research Matters and the Current State of Representation within the Clinical Research Ecosystem Improving Representation in Clinical Trials and Research: Building Research Equity for Women and Underrepresented Groups National Academies Press Washington, DC, USA 2022
56. Center for Drug Evaluation and Research (CDER) Drug Trials Snapshots Summary FDA Silver Spring, MD, USA 2023
57. Fischer S.M. Kline D.M. Min S.-J. Okuyama S. Fink R.M. Apoyo Con Cariño: Strategies to Promote Recruiting, Enrolling, and Retaining Latinos in a Cancer Clinical Trial J. Natl. Compr. Canc. Netw. 2017 15 1392 1399 10.6004/jnccn.2017.7005 29118231
58. Fontanarosa P.B. Bauchner H. Race, Ancestry, and Medical Research JAMA 2018 320 1539 1540 10.1001/jama.2018.14438 30264148
59. Neal K. Not by Proxy: Arguments for Improving the Use of Race in Biomedical Research Am. J. Bioeth. 2017 17 52 54 10.1080/15265161.2017.1353176 28829267