School of Psychology, Deakin University, Geelong, Australia.
Center for Social and Early Emotional Development, Deakin University, Burwood, Australia.
Health Psychol Rev. 2024 Dec;18(4):839-852. doi: 10.1080/17437199.2024.2379784. Epub 2024 Jul 23.
The management of stress has evolved in recent years due to widespread availability of mobile-device applications (apps) and their capacity to deliver psychological interventions. We evaluated the efficacy of mental health apps on stress and sought to identify characteristics associated with effect size estimates. Sixty-nine randomised controlled trials (RCTs) were included. Random effects meta-analyses were performed and putative moderators were examined at univariate and multivariate (combinations and interactions) levels. From 78 comparisons, we observed a small but significant pooled effect of apps over control conditions on perceived stress levels ( = 0.27; 95% CI = 0.20, 0.34; = 68%). This effect weakened after taking into account small-study bias according to the trim-and-fill procedure ( = 0.10; 95% CI = 0.02, 0.19; = 78%). Delivery of apps with stress monitoring features produced smaller efficacy estimates, although this association interacted with other trial features (small sample size and inactive control group) in multivariate analyses, suggesting that this effect may have been explained by features characteristic of low-quality trials. Mental health apps appear to have small, acute effects on reducing perceived stress. Future research should shift focus towards identifying change mechanisms, longitudinal outcomes, features that facilitate sustained app usage, and tangible pathways to integrating apps into real-world clinical settings.
近年来，由于移动设备应用程序（apps）的广泛普及及其提供心理干预的能力，压力管理方法也得到了发展。我们评估了心理健康应用程序对压力的疗效，并试图确定与效应量估计相关的特征。共纳入 69 项随机对照试验（RCT）。进行了随机效应荟萃分析，并在单变量和多变量（组合和交互）水平上检查了潜在的调节因素。在 78 项比较中，我们观察到应用程序相对于对照条件对感知压力水平的影响具有小但显著的总体效应（ = 0.27；95% CI = 0.20, 0.34； = 68%）。根据修剪和填充程序考虑到小样本偏倚后，这种效应减弱（ = 0.10；95% CI = 0.02, 0.19； = 78%）。具有压力监测功能的应用程序的疗效估计较小，但这种关联在多变量分析中与其他试验特征（样本量小和无活性对照组）相互作用，表明这种效应可能是由低质量试验的特征解释的。心理健康应用程序似乎具有减轻感知压力的短期、急性作用。未来的研究应将重点转移到识别变化机制、纵向结果、促进应用程序持续使用的特征以及将应用程序整合到实际临床环境中的切实途径上。
