Burgeoning technologies and the COVID-19 pandemic resulted in a boom of telehealth for immunocompromised patients, such as those with cancer. Telehealth modalities overcome barriers and promote accessibility to care. Currently, efficacious psychosocial interventions exist to address negative aftereffects of a cancer diagnosis and treatment. Many of these interventions often incorporate asynchronous telehealth (e.g., web-based, smartphone mobile app) features. However, asynchronous platforms are limited by suboptimal engagement. Subjective indicators of perceived engagement in the forms of acceptability, feasibility, and adherence are often captured, yet prior research has found discrepancies between perceived and actual engagement. The FITT (frequency, intensity, time/duration, type of engagement) model, originally developed for use to quantify engagement within exercise trials, provides a framework to assess objective engagement of psychosocial interventions for breast cancer. Using 14 keywords and searching six databases through 11/2023, 56 studies that used asynchronous telehealth interventions in breast cancer were identified. All FITT domains were reported at least once across studies with intensity metrics most commonly reported. Nine metrics were described across FITT domains. Human-centered design principles to guide telehealth development and privacy considerations are discussed. Findings offer suggestions for how to represent and optimize objective engagement in asynchronous telehealth cancer care.

新兴技术和 COVID-19 大流行导致了针对免疫功能低下患者（例如癌症患者）的远程医疗热潮。远程医疗模式克服了障碍并促进了护理的可及性。目前，存在有效的心理社会干预措施来解决癌症诊断和治疗的负面后遗症。其中许多干预措施通常包含异步远程医疗（例如基于网络的智能手机移动应用程序）功能。然而，异步平台受到次优参与的限制。感知参与度的主观指标通常以可接受性、可行性和依从性的形式被捕获，但之前的研究发现感知参与度和实际参与度之间存在差异。FITT（频率、强度、时间/持续时间、参与类型）模型最初是为了量化运动试验中的参与度而开发的，它提供了一个框架来评估乳腺癌心理社会干预的客观参与度。截至 2023 年 11 月，使用 14 个关键词并搜索 6 个数据库，确定了 56 项在乳腺癌中使用异步远程医疗干预措施的研究。在强度指标最常报告的研究中，所有 FITT 域至少报告一次。跨 FITT 领域描述了九个指标。讨论了指导远程医疗发展的以人为本的设计原则和隐私考虑。研究结果为如何代表和优化异步远程医疗癌症护理中的客观参与提供了建议。