# Mapping Characteristics, Applications, and Implementation Challenges of Virtual Communities in Cancer Care: NASSS Framework-Informed Scoping Review

## TL;DR

This review explores how virtual communities can help cancer patients with emotional support but face challenges like low retention and poor integration into healthcare systems.

## Contribution

Applies the NASSS framework to analyze virtual communities in cancer care, highlighting barriers and facilitators for sustainable implementation.

## Key findings

- Virtual communities provide psychosocial benefits like reduced loneliness and improved emotional well-being.
- Key challenges include low user retention and limited participation from underrepresented groups.
- Few studies report long-term effectiveness due to lack of longitudinal follow-up and engagement metrics.

## Abstract

Patients with cancer frequently experience psychological and social challenges, including depression, anxiety, and isolation, which are often intensified by treatment side effects and unmet psychosocial needs. Conventional support systems are often inaccessible, under-resourced, or poorly tailored to diverse patient populations. In this context, virtual communities have emerged as promising alternatives that enable peer interaction, emotional support, and information exchange. However, their implementation and sustainability are influenced by complex sociotechnical and organizational factors that remain underexplored.

This scoping review applies the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework to examine how virtual communities have been implemented in cancer care. It aims to identify key barriers and facilitators, evaluate the alignment between platform features and user needs, and synthesize evidence to inform sustainable integration into care systems.

A systematic search was conducted across 6 databases (PubMed, Scopus, Embase, Web of Science, PsycINFO, and CINAHL), covering studies published between 2019 and 2024. Eligible studies were empirical and reported on the development, implementation, or evaluation of virtual communities for patients with cancer. Data were extracted using a structured Non-adoption, Abandonment, Scale-up, Spread, and Sustainability–based matrix and synthesized thematically across diverse research designs.

The search yielded 322 records, of which 175 full-text studies were assessed for eligibility, and 25 studies were included in the review. These studies covered a range of virtual community formats used by patients with cancer. All included studies reported psychosocial benefits, including reduced loneliness, improved emotional well-being, and greater opportunities for experience sharing. However, key challenges remained, such as low user retention, limited participation from underrepresented groups, and difficulties integrating these platforms into existing health care systems. Few studies reported longitudinal follow-up or detailed engagement metrics, limiting insights into long-term effectiveness.

Virtual communities show strong potential to address the psychosocial needs of patients with cancer, especially in underserved populations. However, to ensure long-term effectiveness, attention must be paid to inclusivity, user retention, ethical considerations, and system-level integration. Future research should incorporate standardized metrics, longitudinal designs, and equity-oriented approaches to optimize the development and implementation of virtual communities in cancer care.