Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, UK; Research Department of Clinical, Educational and Health Psychology, University College London, UK.
Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, UK; Foundations What Works Centre for Children & Families, London, UK.
J Affect Disord. 2024 Apr 1;350:955-973. doi: 10.1016/j.jad.2023.12.080. Epub 2024 Jan 9.
Co-design is recommended in mental health fields and has been associated with improved intervention efficacy. Despite its growing popularity, syntheses of evidence on the effectiveness of co-designed interventions are scarce, and little is known about their impact on anxiety and depression.
The purpose of this systematic review and meta-analysis was to consolidate evidence on the effectiveness of in-person, co-designed mental health interventions for reducing anxiety and depression symptoms. An exhaustive search was conducted across six electronic databases (PubMed, PsycINFO, Embase, CINAHL, CENTRAL, and ProQuest) and grey literature. Criteria for inclusion comprised studies utilizing randomized or quasi-randomized methods, implementing non-digital/in-person, co-designed interventions for mental health enhancement, and assessing anxiety and/or depression. Intervention impacts were evaluated using random-effects meta-analyses.
The review identified 20 studies, with only three using the term 'co-design'. Other terminologies included 'co-developed' (n = 2), 'co-produced' (n = 2), and 'CBPR' (n = 11). Seventeen studies exhibited moderate risk of bias, while three demonstrated high risk. Meta-analyses demonstrated a moderate non-significant effect size of 0.5 (95 % CI: -0.8, 1.08; p = 0.08) on depression outcomes, and a small non-significant effect size of 0.12 (95 % CI: -0.1, 0.33; p = 0.23) on anxiety outcomes.
The majority of studies lacked sufficient statistical power to detect between-group differences. Following GRADE criteria, confidence in estimates was low.
Notwithstanding widespread enthusiasm for co-design, the current evidence base is inadequate to confirm the impact of in-person, co-designed mental health interventions on anxiety and depression. More full-scale evaluation trials of higher quality are urgently needed, along with uniform terminology and measurement.
共同设计在心理健康领域受到推荐，并与干预效果的提高有关。尽管它越来越受欢迎，但关于共同设计干预措施有效性的综合证据仍然很少，并且对于它们对焦虑和抑郁的影响知之甚少。
本系统评价和荟萃分析的目的是整合关于面对面、共同设计的心理健康干预措施降低焦虑和抑郁症状的有效性证据。我们在六个电子数据库（PubMed、PsycINFO、Embase、CINAHL、CENTRAL 和 ProQuest）和灰色文献中进行了全面搜索。纳入标准包括使用随机或准随机方法的研究、实施非数字/面对面、共同设计的心理健康增强干预措施以及评估焦虑和/或抑郁的研究。使用随机效应荟萃分析评估干预影响。
该综述确定了 20 项研究，其中只有 3 项使用了“共同设计”一词。其他术语包括“共同开发”（n=2）、“共同制作”（n=2）和“CBPR”（n=11）。17 项研究存在中度偏倚风险，3 项研究存在高度偏倚风险。荟萃分析显示，抑郁结果的中等非显著效应大小为 0.5（95%CI：-0.8，1.08；p=0.08），焦虑结果的小非显著效应大小为 0.12（95%CI：-0.1，0.33；p=0.23）。
大多数研究缺乏足够的统计能力来检测组间差异。根据 GRADE 标准，估计的置信度较低。
尽管对共同设计普遍充满热情，但目前的证据基础不足以确认面对面、共同设计的心理健康干预措施对焦虑和抑郁的影响。迫切需要更多高质量的全面评估试验，以及统一的术语和测量方法。
