MacDougall Sarah, Jerrott Susan, Clark Sharon, Campbell Leslie Anne, Murphy Andrea, Wozney Lori
Maritime SPOR SUPPORT Unit, Halifax, NS, Canada.
Nova Scotia Health, Halifax, NS, Canada.
JMIR Ment Health. 2021 Jan 8;8(1):e16508. doi: 10.2196/16508.
The vast majority of adolescent mental health and substance use disorders go undiagnosed and undertreated. SMS text messaging is increasingly used as a method to deliver adolescent health services that promote psychological well-being and aim to protect adolescents from adverse experiences and risk factors critical for their current and future mental health. To date, there has been no comprehensive synthesis of the existing literature on the extent, range, and implementation contexts of these SMS text message interventions.
The objective of this scoping review was to map and categorize gaps in the current body of peer-reviewed research around the use of SMS text messaging-based interventions for mental health and addiction services among adolescents.
A scoping review was conducted according to Levac's adaptation of Arksey and O'Malley's methodological framework for scoping reviews in six iterative stages. A search strategy was cocreated and adapted for five unique databases. Studies were screened using Covidence software. The PICO (patient, intervention, comparator, outcome) framework and input from multiple stakeholder groups were used to structure and pilot a data extraction codebook. Data were extracted on study methodology and measures, intervention design, and implementation characteristics, as well as policy, practice, and research implications.
We screened 1142 abstracts. Of these, 31 articles published between 2013 and 2020 were eligible for inclusion. Intervention engagement was the most common type of outcome measured (18/31), followed by changes in cognitions (16/31; eg, disease knowledge, self-awareness) and acceptability (16/31). Interventions were typically delivered in less than 12 weeks, and adolescents received 1-3 messages per week. Bidirectional messaging was involved in 65% (20/31) of the studies. Limited descriptions of implementation features (eg, cost, policy implications, technology performance) were reported.
The use of SMS text messaging interventions is a rapidly expanding area of research. However, lack of large-scale controlled trials and theoretically driven intervention designs limits generalizability. Significant gaps in the literature were observed in relation to implementation considerations, cost, clinical workflow, bidirectionality of texting, and level of personalization and tailoring of the interventions. Given the growth of mobile phone-based interventions for this population, a rigorous program of large-scale, well-designed trials is urgently required.
绝大多数青少年心理健康和物质使用障碍未得到诊断和治疗。短信越来越多地被用作提供青少年健康服务的一种方式，这些服务旨在促进心理健康，并保护青少年免受对其当前和未来心理健康至关重要的不良经历和风险因素的影响。迄今为止，尚未对这些短信干预措施的范围、种类和实施背景的现有文献进行全面综述。
本范围综述的目的是梳理和分类当前同行评审研究中围绕使用基于短信的干预措施来提供青少年心理健康和成瘾服务方面存在的差距。
根据Levac对Arksey和O'Malley的范围综述方法框架的改编，分六个迭代阶段进行了范围综述。共同创建并针对五个独特数据库调整了检索策略。使用Covidence软件筛选研究。采用PICO（患者、干预措施、对照、结局）框架并结合多个利益相关者群体的意见来构建和试用数据提取编码手册。提取了有关研究方法和测量指标、干预设计、实施特征以及政策、实践和研究意义的数据。
我们筛选了1142篇摘要。其中，2013年至2020年间发表的31篇文章符合纳入标准。干预参与度是最常测量的结局类型（18/31），其次是认知方面的变化（16/31；例如疾病知识、自我意识）和可接受性（16/31）。干预通常在不到12周内完成，青少年每周收到1 - 3条信息。65%（20/31）的研究涉及双向信息传递。关于实施特征（如成本、政策影响、技术性能）的描述有限。
短信干预措施的使用是一个迅速扩展的研究领域。然而，缺乏大规模对照试验和理论驱动的干预设计限制了研究结果的可推广性。在实施考虑因素、成本、临床工作流程、短信的双向性以及干预措施的个性化和定制程度方面，文献中存在显著差距。鉴于针对该人群的基于手机的干预措施不断增加，迫切需要开展严格的大规模、精心设计的试验项目。
