Use of cultural appropriateness strategies and behavioral frameworks in behavioral interventions for black and hispanic cancer survivors: a systematic review

Background: Black and Hispanic cancer survivors experience significant inequities in supportive cancer care. Incorporating cultural appropriateness strategies and behavioral frameworks into supportive care interventions can improve cancer outcomes of Black and Hispanic survivors. This review evaluated behavioral oncology trials for Black and Hispanic cancer survivors to assess their use of cultural appropriateness strategies and behavioral frameworks. Methods: A systematic search was conducted across seven databases with a cutoff date of November 15, 2023: 1) PubMed, 2) Cochrane Central Register of Controlled Trials, 3) Embase, 4) Cumulative Index of Nursing and Allied Health Literature, 5) APA PsycInfo, 6) Scopus, and 7) Web of Science. Studies with Black or Hispanic cancer survivors, with or without a comparator, were included. Results: Thirty-seven trials met the inclusion criteria. Most focused on Black survivors (n = 19, 51.4%) and breast cancer survivors (n = 32, 86.5%). Most were psychosocial interventions addressing quality of life or distress (n = 20, 54.1%). Culturally appropriate strategies were reported in 86.5% (n = 32) of trials, with the most common being sociocultural (n = 30, 81.1%;), constituent-involving (n = 27, 73.0%;), and linguistic (n = 20, 54.1%;). Behavioral frameworks were reported in 56.8% (n = 21) of trials, with Social Cognitive Theory (n = 10, 52.6%) and Stress and Coping Theory (n = 3, 15.8%) being the most frequent. Less than half combined cultural adaptation strategies and a behavioral framework (n = 18, 48.6%). Conclusion: While most trials incorporated cultural appropriateness strategies, fewer utilized behavioral frameworks, and even fewer used both. Future research should integrate these approaches to improve cancer outcomes and address disparities. © The Author(s) 2025.