scholarly journals Digital health interventions for the management of mental health in people with chronic diseases: a rapid review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044437
Author(s):  
Maxime Sasseville ◽  
Annie LeBlanc ◽  
Mylène Boucher ◽  
Michèle Dugas ◽  
Gisele Mbemba ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Disease ◽  
Mental Health Problems ◽  
Digital Health ◽  
Health Interventions ◽  
Children And Youth ◽  
Rapid Review ◽  
Web Based ◽  
Manage Mental ◽  
Manage Mental Health

ObjectiveDetermine the effectiveness of digital mental health interventions for individuals with a concomitant chronic disease.DesignWe conducted a rapid review of systematic reviews. Two reviewers independently conducted study selection and risk of bias evaluation. A standardised extraction form was used. Data are reported narratively.InterventionsWe included systematic reviews of digital health interventions aiming to prevent, detect or manage mental health problems in individuals with a pre-existing chronic disease, including chronic mental health illnesses, published in 2010 or after.Main outcome measureReports on mental health outcomes (eg, anxiety symptoms and depression symptoms).ResultsWe included 35 reviews, totalling 702 primary studies with a total sample of 50 692 participants. We structured the results in four population clusters: (1) chronic diseases, (2) cancer, (3) mental health and (4) children and youth. For populations presenting a chronic disease or cancer, health provider directed digital interventions (eg, web-based consultation, internet cognitive–behavioural therapy) are effective and safe. Further analyses are required in order to provide stronger recommendations regarding relevance for specific population (such as children and youth). Web-based interventions and email were the modes of administration that had the most reports of improvement. Virtual reality, smartphone applications and patient portal had limited reports of improvement.ConclusionsDigital technologies could be used to prevent and manage mental health problems in people living with chronic conditions, with consideration for the age group and type of technology used.

scholarly journals Preventive digital mental health interventions for children and young people: a review of the design and reporting of research

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Aislinn D. Bergin ◽  
Elvira Perez Vallejos ◽  
E. Bethan Davies ◽  
David Daley ◽  
Tamsin Ford ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Real World ◽  
Mental Health Problems ◽  
Digital Health ◽  
Health Problems ◽  
Poor Mental Health ◽  
Research Literature ◽  
Health Interventions ◽  
Children And Young People

Abstract Digital health interventions (DHIs) have frequently been highlighted as one way to respond to increasing levels of mental health problems in children and young people. Whilst many are developed to address existing mental health problems, there is also potential for DHIs to address prevention and early intervention. However, there are currently limitations in the design and reporting of the development, evaluation and implementation of preventive DHIs that can limit their adoption into real-world practice. This scoping review aimed to examine existing evidence-based DHI interventions and review how well the research literature described factors that researchers need to include in their study designs and reports to support real-world implementation. A search was conducted for relevant publications published from 2013 onwards. Twenty-one different interventions were identified from 30 publications, which took a universal (n = 12), selective (n = 3) and indicative (n = 15) approach to preventing poor mental health. Most interventions targeted adolescents, with only two studies including children aged ≤10 years. There was limited reporting of user co-design involvement in intervention development. Barriers and facilitators to implementation varied across the delivery settings, and only a minority reported financial costs involved in delivering the intervention. This review found that while there are continued attempts to design and evaluate DHIs for children and young people, there are several points of concern. More research is needed with younger children and those from poorer and underserved backgrounds. Co-design processes with children and young people should be recognised and reported as a necessary component within DHI research as they are an important factor in the design and development of interventions, and underpin successful adoption and implementation. Reporting the type and level of human support provided as part of the intervention is also important in enabling the sustained use and implementation of DHIs.

scholarly journals The need for accessible mental health interventions for young adults in the COVID-19 pandemic: A student psychologists’ perspective and rapid systematic review

2021 ◽  
Author(s):  
Dilan Hulaj ◽  
Sophie Antesberger ◽  
Tabea Blum ◽  
Raffaela Böswald ◽  
Hannah M. Brandl ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young Adults ◽  
General Population ◽  
Mental Health Problems ◽  
Severe Disease ◽  
Health Interventions ◽  
Medium Effect ◽  
Web Based ◽  
Mental Health Interventions

Importance: Although young adults are on average less affected by the physical consequences of COVID-19 infections, showing less severe disease progression and lower mortality risk, they suffer strongly from the mental health impact of the pandemic.Objective: We, a group of psychology students experiencing these impacts, aim to provide an overview of the existing literature on prevention and intervention efforts to effectively reduce the development of, or suffering from, mental health problems in young adults (18-35) during the COVID-19 pandemic.Evidence Review: A rapid systematic review was conducted to identify studies focusing on the implementation of mental health interventions for young adults of the general population during the COVID-19 pandemic. Literature was searched with Pubmed and Web of Science on June 17, 2021. The quality of each study was assessed by two reviewers with the Standard Quality Assessment Criteria for Evaluating Primary Research Papers.Findings: Of N = 76 records initially screened, eight studies met the inclusion criteria. Six applied web-based interventions, of which four were randomized controlled trials. Interventions were based on Cognitive Behavioral Therapy approaches (n = 5), mindfulness practices, logo-autobiography, and synergistic thinking methods. The interventions varied in length from single sessions to multiple sessions over a period of up to 10 weeks. All interventions were effective in reducing depression and anxiety symptoms, as well as stress with small to medium effect sizes and a symptom reduction up to 78.9%. With only three studies being of high quality, the overall quality was low.Conclusions and Relevance: Research on mental health interventions for young adults in the general population during the pandemic is sparse. However, all interventions resulted in symptoms reductions and thus have been shown to be effective ways of counteracting the potential development of mental disorders during times of uncertainty, with high levels of stress, such as during a pandemic. Therefore, we propose a concept for an innovative and cost-effective web-based platform to structure and raise awareness for existing measures.

Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review (Preprint)

2021 ◽  
Author(s):  
Tristan J Philippe ◽  
Naureen Sikder ◽  
Anna Jackson ◽  
Maya E Koblanski ◽  
Eric Liow ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mobile Communications ◽  
Digital Health ◽  
Health Interventions ◽  
Stress Disorders ◽  
Health Conditions ◽  
Rapid Review ◽  
Mental Health Conditions

BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, video conferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a rapid review of the literature to assess the state of digital health interventions for the treatment of several mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010-2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Sixty percent (60%) of research involved the treatment of substance use disorders, 25% focused on mood, anxiety and traumatic stress disorders and 5% or less on other mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective, but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and online forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients, who are marginalized, and may lack access to digital health interventions.

scholarly journals Recorded Mental Health Recovery Narratives as a Resource for People Affected by Mental Health Problems: Development of the Narrative Experiences Online (NEON) Intervention

10.2196/24417 ◽  
2021 ◽  
Vol 5 (5) ◽  
pp. e24417
Author(s):  
Mike Slade ◽  
Stefan Rennick-Egglestone ◽  
Joy Llewellyn-Beardsley ◽  
Caroline Yeo ◽  
James Roe ◽  
...  
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Digital Health ◽  
Health Interventions ◽  
Advisory Panel ◽  
Service Users ◽  
Impact Model ◽  
Harm Minimization ◽  
Web Based ◽  
Recovery Narratives

Background The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing recovery from health problems are a focus of research, including those presented in recorded (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). Objective This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs. Methods Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users (n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made. Results KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses. Conclusions RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.

scholarly journals Recorded Mental Health Recovery Narratives as a Resource for People Affected by Mental Health Problems: Development of the Narrative Experiences Online (NEON) Intervention (Preprint)

2020 ◽  
Author(s):  
Mike Slade ◽  
Stefan Rennick-Egglestone ◽  
Joy Llewellyn-Beardsley ◽  
Caroline Yeo ◽  
James Roe ◽  
...  
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Digital Health ◽  
Health Interventions ◽  
Advisory Panel ◽  
Service Users ◽  
Impact Model ◽  
Harm Minimization ◽  
Web Based ◽  
Recovery Narratives

BACKGROUND The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing <i>recovery</i> from health problems are a focus of research, including those presented in <i>recorded</i> (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). OBJECTIVE This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs. METHODS Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users (n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made. RESULTS KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses. CONCLUSIONS RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.

Impact of guidance on intervention adherence in computerised interventions for mental health problems: a meta-analysis

2021 ◽  
pp. 1-12
Author(s):  
Peter Musiat ◽  
Catherine Johnson ◽  
Melissa Atkinson ◽  
Simon Wilksch ◽  
Tracey Wade
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Health Interventions ◽  
Web Based ◽  
Symptoms Of Depression ◽  
Mental Health Interventions ◽  
Intervention Content ◽  
Intervention Adherence ◽  
The Impact

Abstract Web-based interventions are increasingly used for the prevention, treatment and aftercare of mental disorders. A crucial factor to the efficacy of such online programmes is adherence to the intervention content and procedure. It has been frequently suggested that adherence in web-based interventions is low and little is known about which factors influence adherence. To increase intervention uptake and completion, studies increasingly include interventions with some form of guidance. Guided interventions have been shown to have higher efficacy, however, evidence for the impact on adherence is limited and mixed. This meta-analysis explored the impact of human guidance on intervention completion in web-based mental health interventions. A total of 22 studies were included with interventions primarily targeting symptoms of depression and anxiety disorders. Results showed that guidance significantly increases the average amount of intervention completion [g = 0.29, 95% confidence interval (CI) 0.18–0.40] and the proportion of intervention completers [log odds ratio (OR) = 0.50, 95% CI 0.34–0.66] with small effects. On average, full completion rates were 12% higher in guided intervention groups. This meta-analysis demonstrated that guidance in web-based mental health interventions does increase adherence, but more research is required to better understand the specific mechanisms between guidance, adherence and outcomes.

Development of a framework for the implementation of synchronous digital mental health: a realist synthesis of systematic reviews (Preprint)

2021 ◽  
Author(s):  
David Villarreal-Zegarra ◽  
Christoper A. Alarcon-Ruiz ◽  
GJ Melendez-Torres ◽  
Roberto Torres-Puente ◽  
Alba Navarro-Flores ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Reviews ◽  
Mental Health Problems ◽  
Digital Health ◽  
Health Problems ◽  
Realist Synthesis ◽  
Health Interventions ◽  
Theory Approach ◽  
Access To Treatment ◽  
Mental Health Interventions

BACKGROUND The use of technologies has served to reduce gaps in access to treatment and digital health interventions show promise in the care of mental health problems. However, to understand what and how these interventions work, it's imperative to document the aspects related to their challenging implementation. OBJECTIVE To determine what evidence is available for synchronous digital mental health implementation and develop a framework, informed by a realist review, to explain what makes digital mental health interventions work for people with mental health problems. METHODS The SPIDER framework was used to develop the following review question: What makes digital mental health interventions with a synchronous component work on people with mental health problems, including depression, anxiety, or stress, based on implementation, economic, quantitative, qualitative, and mixed methods studies? MEDLINE, EBM Reviews, PsycINFO, EMBASE, SCOPUS, CINAHL Complete, and Web of Science databases from 1st January 2015 to September 2020 were searched with no language restriction. AMSTAR-2 was used to assess the risk of bias, and CERQual was used to assess the confidence in cumulative evidence. Realist synthesis analysis allowed for developing a framework on the implementation of synchronous digital mental health using a grounded theory approach with an emergent approach. RESULTS 21 systematic reviews were included in the study. Ninety percent of the studies presented a critically low confidence level assessed with the AMSTAR-2. The realist synthesis allowed the development of three hypotheses to identify the context and mechanisms in which these interventions achieve these outcomes: Hypothesis 1: These interventions reach populations otherwise unable to have access because they do not require the physical presence of the therapist nor the patient, thereby tackling geographic barriers posed by in-person therapy. Hypothesis 2: These interventions reach populations otherwise unable to have access because they can be successfully delivered by non-specialists, which makes them more cost-effective to implement in health services. Hypothesis 3: These interventions are acceptable and show good results in satisfaction, because they require less need of disclosure and provide more privacy, comfortability, and participation, enabling the establishment of rapport with the therapist. CONCLUSIONS We developed a framework with three hypotheses that explain what makes digital mental health interventions with a synchronous component work on people with mental health problems. Each hypothesis represented essential outcomes in the implementation process. CLINICALTRIAL PROSPERO (CRD420203811). INTERNATIONAL REGISTERED REPORT RR2-10.12688/f1000research.27150.2

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