Lattie Emily G, Adkins Elizabeth C, Winquist Nathan, Stiles-Shields Colleen, Wafford Q Eileen, Graham Andrea K
Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States.
Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.
J Med Internet Res. 2019 Jul 22;21(7):e12869. doi: 10.2196/12869.
College students are increasingly reporting common mental health problems, such as depression and anxiety, and they frequently encounter barriers to seeking traditional mental health treatments. Digital mental health interventions, such as those delivered via the Web and apps, offer the potential to improve access to mental health treatment.
This study aimed to review the literature on digital mental health interventions focused on depression, anxiety, and enhancement of psychological well-being among samples of college students to identify the effectiveness, usability, acceptability, uptake, and adoption of such programs.
We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (registration number CRD42018092800), and the search strategy was conducted by a medical research librarian in the following databases: MEDLINE (Ovid), EMBASE (Elsevier), PsycINFO (EbscoHost), the Cochrane Library (Wiley), and Web of Science (Thomson Reuters) from the date of inception to April 2019. Data were synthesized using a systematic narrative synthesis framework, and formal quality assessments were conducted to address the risk of bias.
A total of 89 studies met the inclusion criteria. The majority of interventions (71/89, 80%) were delivered via a website, and the most common intervention was internet-based cognitive behavioral therapy (28, 31%). Many programs (33, 37%) featured human support in the form of coaching. The majority of programs were either effective (42, 47%) or partially effective (30, 34%) in producing beneficial changes in the main psychological outcome variables. Approximately half of the studies (45, 51%) did not present any usability or acceptability outcomes, and few studies (4, 4%) examined a broad implementation of digital mental health interventions on college campuses. Quality assessments revealed a moderate-to-severe risk of bias in many of the studies.
Results suggest that digital mental health interventions can be effective for improving depression, anxiety, and psychological well-being among college students, but more rigorous studies are needed to ascertain the effective elements of these interventions. Continued research on improving the user experience of, and thus user engagement with, these programs appears vital for the sustainable implementation of digital mental health interventions on college campuses.
越来越多的大学生报告存在常见的心理健康问题，如抑郁和焦虑，并且他们在寻求传统心理健康治疗时经常遇到障碍。数字心理健康干预措施，如通过网络和应用程序提供的干预措施，有可能改善心理健康治疗的可及性。
本研究旨在回顾关于针对大学生样本中抑郁、焦虑以及提升心理健康的数字心理健康干预措施的文献，以确定此类项目的有效性、可用性、可接受性、采用率和使用率。
我们按照系统评价与Meta分析的首选报告项目指南（注册号CRD42018092800）进行了一项系统评价，检索策略由医学研究馆员在以下数据库中进行：MEDLINE（Ovid）、EMBASE（爱思唯尔）、PsycINFO（EbscoHost）、Cochrane图书馆（威利）以及科学引文索引（汤森路透），检索时间从各数据库建库至2019年4月。数据使用系统叙述性综合框架进行综合，并进行正式的质量评估以解决偏倚风险。
共有89项研究符合纳入标准。大多数干预措施（71/89，80%）通过网站提供，最常见的干预措施是基于互联网的认知行为疗法（28项，31%）。许多项目（33项，37%）以辅导的形式提供人工支持。大多数项目在产生主要心理结局变量的有益变化方面有效（42项，47%）或部分有效（30项，34%）。大约一半的研究（45项，51%）未呈现任何可用性或可接受性结果，很少有研究（4项，4%）考察了数字心理健康干预措施在大学校园的广泛实施情况。质量评估显示许多研究存在中度至重度偏倚风险。
结果表明，数字心理健康干预措施对改善大学生的抑郁、焦虑和心理健康可能有效，但需要更严格的研究来确定这些干预措施的有效要素。持续研究改善这些项目的用户体验，从而提高用户参与度，对于数字心理健康干预措施在大学校园的可持续实施似乎至关重要。
