scholarly journals Impact of Internet-Based Interventions on Caregiver Mental Health: Systematic Review and Meta-Analysis (Preprint)

2018 ◽  
Author(s):  
Diana Sherifali ◽  
Muhammad Usman Ali ◽  
Jenny Ploeg ◽  
Maureen Markle-Reid ◽  
Ruta Valaitis ◽  
...  

BACKGROUND The health of informal caregivers of adults with chronic conditions is increasingly vital since caregivers comprise a large proportion of supportive care to family members living in the community. Due to efficiency and reach, internet-based interventions for informal caregivers have the potential to mitigate the negative mental health outcomes associated with caregiving. OBJECTIVE The objective of this systematic review and meta-analysis was to examine the impact of internet-based interventions on caregiver mental health outcomes and the impact of different types of internet-based intervention programs. METHODS MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, and AgeLine databases were searched for randomized controlled trials or controlled clinical trials published from January 1995 to April 2017 that compared internet-based intervention programs with no or minimal internet-based interventions for caregivers of adults with at least 1 chronic condition. The inclusion criteria were studies that included (1) adult informal caregivers (aged 18 years or older) of adults living in the community with a chronic condition; (2) an internet-based intervention program to deliver education, support, or monitoring to informal caregivers; and (3) outcomes of mental health. Title and abstract and full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for mental health outcomes were meta-analyzed. RESULTS The search yielded 7923 unique citations of which 290 studies were screened at full-text. Of those, 13 studies met the inclusion criteria; 11 were randomized controlled trials, 1 study was a controlled clinical trial, and 1 study comprised both study designs. Beneficial effects of any internet-based intervention program resulted in a mean decrease of 0.48 points (95% CI –0.75 to –0.22) for stress and distress and a mean decrease of 0.40 points (95% CI –0.58 to –0.22) for anxiety among caregivers. For studies that examined internet-based information and education plus professional psychosocial support, the meta-analysis results showed small to medium beneficial effect sizes of the intervention for the mental health outcomes of depression (–0.34; 95% CI –0.63 to –0.05) and anxiety (–0.36; 95% CI –0.66 to –0.07). Some suggestion of a beneficial effect on overall health for the use of information and education plus combined peer and professional support was also shown (1.25; 95% CI 0.24 to 2.25). Overall, many studies were of poor quality and were rated at high risk of bias. CONCLUSIONS The review found evidence for the benefit of internet-based intervention programs on mental health for caregivers of adults living with a chronic condition, particularly for the outcomes of caregiver depression, stress and distress, and anxiety. The types of interventions that predominated as efficacious included information and education with or without professional psychological support, and, to a lesser extent, with combined peer and psychological support. Further high-quality research is needed to inform the effectiveness of interactive, dynamic, and multicomponent internet-based interventions. CLINICALTRIAL PROSPERO CRD42017075436; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=75436 (Archived by WebCite at http://www.webcitation.org/709M3tDvn)

2021 ◽  
Author(s):  
Gill A Francis ◽  
Emre Deniz ◽  
Carole Torgerson ◽  
Umar Toseeb

Background and AimsPlay-based interventions are used ubiquitously with children with social, communication, and language needs but the impact of these interventions on the mental health of this atypical group of children is unknown. Despite their pre-existing challenges, the mental health of DLD and ASD children should be given equal consideration to the other more salient features of their disability. To this aim, a systematic literature review with meta-analysis was undertaken to assess the impact of play-based interventions on mental health outcomes from studies of children with DLD and ASD, as well as to identify the characteristics of research in this field. MethodsThe study selection process involved a rigorous systematic search of seven academic databases, double screening of abstracts, and full-text screening to identify studies using RCTs and quasi-experimental designs to assess mental health outcomes from interventions supporting children with social, communication, and language needs. For reliability, data extraction, as well as risk of bias assessments were conducted by two study authors. Qualitative data were synthesized and quantified data was used in the meta-analytic calculation.Main contribution A total of 2 882 papers were identified from the literature search which were double screened at the abstract (n = 1 785) and full-text (n= 366) levels resulting in 10 papers meeting the criteria for inclusion in the review. There were 8 RCTs and 2 quasi-experiments using 7 named play-based interventions with ASD participants only. Meta-analysis results found a significant overall intervention effect (Cohen’s d = 1.57) for studies addressing positive mental health outcomes (n = 5) in contrast to a non-significant overall intervention effect for negative mental health outcomes (Cohen’s d = -0.17).ConclusionsA key observation is the diversity of study characteristics relating to study sample size, duration of interventions, study settings, background of interventionists, and variability of specific mental health outcomes. The heterogeneous nature of studies stand out although only a few studies were eligible for inclusion. ImplicationsThis review provides good evidence of the need for further research into how commonly used play-based interventions designed to support the social, communication, and language needs of students may impact the mental health of children with ASD or DLD.


2021 ◽  
Author(s):  
William Nardi ◽  
Alexandra Roy ◽  
Shira Dunsiger ◽  
Judson Brewer

BACKGROUND Mobile health applications provide a promising avenue to help mitigate the burden on mental health services by complimenting therapist-led treatments for anxiety. However, it remains unclear how specific systems' use of application components (i.e., tools) may be associated with changes in clinical symptomatology (i.e., anxiety, worry). OBJECTIVE This study was a secondary analysis of systems usage data from the Stage I randomized controlled trial testing the impact of the Unwinding Anxiety mobile application among adults with GAD. This secondary analysis was conducted to assess how using specific application tools may be associated with improvements in anxiety, worry, emotional regulation, and interoceptive awareness. METHODS We present analyses of the intervention group (i.e., those who received the Unwinding Anxiety program) during the Stage 1 trial. Total use of specific mobile application tools (i.e., ecological tools, meditation practices, educational modules) as well use specific to each tool (e.g., stress meter, lovingkindness meditation practice) were calculated. We utilized multivariate linear models to investigate the effect of total use of these tools on anxiety, worry, interoceptive awareness, emotional regulation at 2-months post-program initiation controlling for baseline scores, age, and education level. In addition, associations between systems usage metrics and baseline participant characteristics were assessed for differences in usage groupings. RESULTS The sample was primarily female (n=25; 92.6%) and the average age was 42.9 years old (SD=15.6) and educational module completion, the central intervention component, averaged 20.2 + 11.4 modules out of XXX for the total sample. Multivariate models revealed that completing >75% of the program was associated with an average 22.6-point increase in interoceptive awareness (SE=8.32, p=0.013) and an 11.6-point decrease in worry (SE=4.12, p=0.009). In addition, a single log unit change in total number of meditations was associated with a 0.95-point reduction in GAD-7 scores (SE=0.27, p=0.005) while a single log unit use of the stress meter was associated with an average of a 0.5-point increase in emotional regulation scores (FFMQ) (SE=0.21, p=0.027). CONCLUSIONS The work presented offers a clearer understanding of the impact of specific mobile app systems use on mental health outcomes. In addition, this research lays the groundwork for future comprehensive investigations of systems usage in dosing studies for health behavior change. CLINICALTRIAL Developing a Novel Digital Therapeutic for the Treatment of Generalized Anxiety Disorder (NCT03683472).


2017 ◽  
Vol 35 (23-24) ◽  
pp. 5997-6016 ◽  
Author(s):  
Sarah J. Rinehart ◽  
Dorothy L. Espelage ◽  
Kristen L. Bub

Gendered harassment, including sexual harassment and homophobic name-calling, is prevalent in adolescents and is linked to negative outcomes including depression, anxiety, suicidality, substance abuse, and personal distress. However, much of the extant literature is cross-sectional and rarely are perpetrators of these behaviors included in studies of outcomes. Therefore, the current study examined the effects of longitudinal changes in gendered harassment perpetration and victimization on changes in mental health outcomes among a large sample of early adolescents. Given that these behaviors commonly occur in the context of a patriarchal society (males hold power), we also investigated the impact of gender on gendered harassment. Participants included 3,549 students from four Midwestern middle schools (50.4% female, 49% African American, 34% White) at two time points (13 and 17 years old). Results indicated that increases from age 13 to 17 years in sexual harassment perpetration and victimization and homophobic name-calling perpetration and victimization predicted increases in depression symptoms and substance use. Gender did not moderate these pathways. These findings highlight that negative outcomes are associated with changes in gendered harassment among adolescents and emphasize the importance of prevention efforts. Implications for school interventions are discussed.


2017 ◽  
Vol 22 (6) ◽  
pp. 819-825 ◽  
Author(s):  
R.A. Burns ◽  
V. Loh ◽  
J.E. Byles ◽  
H.L. Kendig

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Meneka C Johnson Nicholson ◽  
Peter Martin ◽  
Megan Gilligan ◽  
Carolyn E Cutrona ◽  
Daniel W Russell ◽  
...  

Abstract Background and Objectives Over the years, a large amount of research has been devoted to the investigation of factors that led to mental health outcomes in older adults. For African American older adults, their lived experiences place them at high risk for mental health problems. The purpose of this study was to examine the impact of early life influences (i.e., education, childhood life events, and childhood financial well-being) and present psychosocial resources (i.e., individual, financial, and social) on current mental health outcomes in a sample of African American older adults in their 60s, 80s, and 100s. Research Design and Methods Using data from the Georgia Centenarian Study, 125 participants were interviewed about their mental health, resources, and early life influences. Results A structural equation model was tested and resulted in a good fit. Results indicated that the more social resources African American older adults had available, the lower the number of depressive symptoms they reported. African Americans with higher levels of financial well-being during childhood reported higher self-rated mental health. Older adults had higher levels of financial resources. Level of education showed a positive relationship with financial resources. Indirect effects of distal influences on health outcomes via current resources were not found. Discussion and Implications The findings are of direct practical relevance and can be used to more readily identify older African Americans who may be susceptible to poorer mental health outcomes based upon the impact of their unique distal and proximal psychosocial resources.


2020 ◽  
Vol 246 ◽  
pp. 112587 ◽  
Author(s):  
Melissa E. Smith ◽  
Tanya L. Sharpe ◽  
Joseph Richardson ◽  
Rohini Pahwa ◽  
Dominique Smith ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S557-S557
Author(s):  
Verena R Cimarolli ◽  
Amy Horowitz ◽  
Danielle Jimenez ◽  
Xiaomei Shi ◽  
Francesca Falzarano ◽  
...  

Abstract This study investigated the impact of LDC on mental health utilizing the Sociocultural Stress Process Model as a conceptual framework. A path analytic model tested the impact of caregiving stressors (i.e. distance, frequencies of visits, hours spent helping, burden) and sociocultural values (i.e. familialism) on LDCs’ mental health outcomes (i.e. depression, anxiety), and resources (i.e. coping strategies, social support) which can mediate the association between stressors and mental health outcomes while controlling for socio-demographics. Results show that resources did not mediate the effects of stressors on the mental health outcomes. However, both higher depression and anxiety were associated with living closer to the care recipient (CR), less frequent visits, higher burden, being younger, being female, and less optimal income adequacy. In addition, higher depression was associated with lower use of coping strategies and higher education. Higher anxiety was also associated with lower levels of social support and higher familialism.


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