Effect of Engagement With Digital Interventions on Mental Health Outcomes: A Systematic Review and Meta-Analysis.
Effect of Engagement With Digital Interventions on Mental Health Outcomes: A Systematic Review and Meta-Analysis.
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DOI：
10.3389/fdgth.2021.764079
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发表时间：
2021
影响因子：
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通讯作者：
Torok M
中科院分区：
文献类型：
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作者：
Gan DZQ;McGillivray L;Han J;Christensen H;Torok M
数字心理健康干预（DMHIs）是解决心理健康服务提供差距的一种有希望的方法。然而，在这些干预措施的背景下，用户参与和成果之间的关系尚未建立。这项研究讨论了目前关于DMHI参与和心理健康结果之间关系的证据状况。检索了MEDLINE、PsycINFO和EmBASE数据库从开始到2021年8月1日的数据。如果随机对照试验（RCT）检查DMHI参与与干预后结局之间的关系，则纳入其原始或次要分析。35项研究有资格纳入叙述性综述，25项研究有足够的数据进行荟萃分析。随机效应荟萃分析表明，更高的参与度与干预后心理健康的改善显著相关，无论是否使用相关性[r = 0.24，95%CI]探讨了这种关系（0.17，0.32），Z = 6.29，p < 0.001]或组间设计[Hedges' g = 0.40，95%CI（0.097，0.705），p = 0.010]。无论干预类型（无指导/有指导）、诊断状态或目标心理健康状况如何，这种关联也是一致的。这是第一篇提供经验证据的综述，表明DMHI与治疗收益相关。影响和未来的方向进行了讨论。系统综述注册：PROSPERO，标识符：CRD 42020184706。
Digital mental health interventions (DMHIs) present a promising way to address gaps in mental health service provision. However, the relationship between user engagement and outcomes in the context of these interventions has not been established. This study addressed the current state of evidence on the relationship between engagement with DMHIs and mental health outcomes. MEDLINE, PsycINFO, and EmBASE databases were searched from inception to August 1, 2021. Original or secondary analyses of randomized controlled trials (RCTs) were included if they examined the relationship between DMHI engagement and post-intervention outcome(s). Thirty-five studies were eligible for inclusion in the narrative review and 25 studies had sufficient data for meta-analysis. Random-effects meta-analyses indicated that greater engagement was significantly associated with post-intervention mental health improvements, regardless of whether this relationship was explored using correlational [r = 0.24, 95% CI (0.17, 0.32), Z = 6.29, p < 0.001] or between-groups designs [Hedges' g = 0.40, 95% CI (0.097, 0.705), p = 0.010]. This association was also consistent regardless of intervention type (unguided/guided), diagnostic status, or mental health condition targeted. This is the first review providing empirical evidence that engagement with DMHIs is associated with therapeutic gains. Implications and future directions are discussed. Systematic Review Registration: PROSPERO, identifier: CRD 42020184706.