Cliffe Bethany, Tingley Jessica, Greenhalgh Isobel, Stallard Paul
Department for Health, University of Bath, Bath, United Kingdom.
Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Bristol, United Kingdom.
J Med Internet Res. 2021 Apr 30;23(4):e25140. doi: 10.2196/25140.
Self-harm is a growing issue with increasing prevalence rates; however, individuals who self-harm do not often receive treatment. Mobile health (mHealth) interventions are a possible solution to some of the barriers that individuals face when seeking support, and they have also been found to be effective in improving mental health. Thus far, reviews of mHealth interventions for self-harm have been limited by study type. Therefore, we determined that a broader scoping review will provide a more exhaustive understanding of mHealth interventions for self-harm.
This scoping review aims to identify mHealth interventions for self-harm within the literature, understand the types and features of interventions that have been developed and evaluated, highlight research findings around mHealth interventions for self-harm, and determine what outcomes are typically used to assess the efficacy of interventions.
A search was conducted using Embase, PubMed, PsycINFO, PsycEXTRA, Web of Science, and the Cochrane Library. Studies were included if they described an mHealth intervention designed to have a direct (ie, if the intervention was designed for self-harm or for people who self-harm) or indirect (ie, if self-harm was measured as an outcome) treatment effect and if the paper was available in English. There were no exclusion criteria based on the study design.
A total of 36 papers were included in the review, and most of them were randomized controlled trials published within the last 4 years. The interventions were mostly smartphone apps and calling or texting services, with 62% (21/34) having underlying therapeutic models to inform the intervention content. They were generally shown to be promising and appealing, but only 5 were widely available for use. Outcomes focused on a reduction of self-harm and suicidality, mood, and the users' experiences of the intervention. Samples were typically nondiverse, and there was limited variety in the study designs and in the measurements of self-harm recovery.
Promising and appealing mHealth interventions have been developed but are not widely available. Research could benefit from greater diversity as well as a broader and more nuanced understanding of recovery from self-harm.
自我伤害是一个日益严重的问题,其患病率不断上升;然而,进行自我伤害的个体往往得不到治疗。移动健康(mHealth)干预措施可能是解决个体在寻求支持时所面临的一些障碍的办法,而且人们还发现这些措施在改善心理健康方面是有效的。到目前为止,对用于自我伤害的mHealth干预措施的综述受到研究类型的限制。因此,我们决定进行一项更广泛的范围综述,以便更全面地了解用于自我伤害的mHealth干预措施。
本范围综述旨在在文献中识别用于自我伤害的mHealth干预措施,了解已开发和评估的干预措施的类型和特点,突出关于用于自我伤害的mHealth干预措施的研究结果,并确定通常用于评估干预措施效果的结果指标。
使用Embase、PubMed、PsycINFO、PsycEXTRA、科学引文索引和考克兰图书馆进行检索。如果研究描述了旨在产生直接(即,如果干预措施是为自我伤害或进行自我伤害的人设计的)或间接(即,如果将自我伤害作为一个结果指标来衡量)治疗效果的mHealth干预措施,并且论文为英文,则纳入该研究。没有基于研究设计的排除标准。
本综述共纳入36篇论文,其中大部分是过去4年内发表的随机对照试验。干预措施大多是智能手机应用程序以及呼叫或短信服务,62%(21/34)的干预措施有潜在的治疗模型来指导干预内容。这些干预措施总体上显示出有前景且具有吸引力,但只有5种可供广泛使用。结果指标侧重于减少自我伤害和自杀倾向、情绪以及用户对干预措施的体验。样本通常缺乏多样性,研究设计和自我伤害恢复的测量方法也较为有限。
已开发出有前景且具有吸引力的mHealth干预措施,但尚未广泛应用。研究可以从更大的多样性以及对自我伤害恢复的更广泛、更细致入微的理解中受益。