Abstract
BACKGROUND: Global cancer is rising, and many survivors struggle to stay active despite clear health benefits. Mobile health tools can help with tracking and guidance, but users' real needs and barriers are unclear. This qualitative metasynthesis summarizes what survivors want, what helps, and what gets in the way. METHODS: We systematically searched CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, Web of Science, and CINAHL from inception to April 2025. Qualitative studies (or qualitative components of mixed-methods studies) exploring survivors' experiences with mHealth-supported PA were eligible. Two reviewers independently screened studies, extracted data, and appraised methodological quality using the JBI qualitative checklist (2016). Findings were integrated via meta-synthesis, and confidence in synthesized findings was graded with the ConQual approach. Reporting followed ENTREQ. RESULTS: Twelve qualitative studies (n = 243 participants; 8 countries) were included. Fifty findings were aggregated into 11 categories and synthesized into 3 higher-order findings: (1) survivors have multidimensional needs regarding content tailoring, professional input, social features, and usable design; (2) mHealth can strengthen motivation, self-efficacy, and convenience for engaging in PA; and (3) participation is shaped by patient-related, technology-related, and economic factors. CONCLUSION: Addressing survivors' motivations, lived experiences, and practical barriers-through personalization, professional guidance, privacy-preserving social support, and robust technical design-may enhance adoption and sustained use of mHealth for PA in cancer survivorship. SYSTEMATIC REVIEW REGISTRATION: CRD420251140902.