Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis

Background: Digital health interventions might extend service provisions for youth with chronic medical conditions (CC) and comorbid mental health symptoms. We aimed to comprehensively evaluate the efficacy of Internet- and mobile-based interventions (IMIs) for different psychological and disease-re...

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Main Authors: Matthias Domhardt, Annalena Schröder, Agnes Geirhos, Lena Steubl, Harald Baumeister
Format: Article
Language:English
Published: Elsevier 2021-04-01
Series:Internet Interventions
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214782921000130
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author Matthias Domhardt
Annalena Schröder
Agnes Geirhos
Lena Steubl
Harald Baumeister
author_facet Matthias Domhardt
Annalena Schröder
Agnes Geirhos
Lena Steubl
Harald Baumeister
author_sort Matthias Domhardt
collection DOAJ
description Background: Digital health interventions might extend service provisions for youth with chronic medical conditions (CC) and comorbid mental health symptoms. We aimed to comprehensively evaluate the efficacy of Internet- and mobile-based interventions (IMIs) for different psychological and disease-related outcomes in children and adolescents with CC. Method: Studies were identified by systematic searches in CENTRAL, Embase, MEDLINE/PubMed and PsycINFO, complemented by searches in reference lists of eligible studies and other reviews. We included studies, when they were randomized controlled trials (RCTs) comparing the efficacy of an IMI to control conditions in improving psychological and disease-related outcomes in youth (mean age ≤ 18 years) with CC. Study selection, data extraction and risk of bias assessment were conducted independently by two reviewers. Meta-analyses were performed within a random-effects model, and Hedges' g (with 95% confidence intervals) was calculated as effect size measure. Primary outcomes were comorbid mental health symptoms (i.e., depression, anxiety and stress), as well as quality of life and self-efficacy. Results: A total of 19 randomized controlled trials (2410 patients) were included in this meta-analysis. IMIs were associated with improvements in self-efficacy (g = 0.38; 95% CI, 0.15 to 0.61; I2 = 0) and combined disease-related outcomes (g = −0.13; 95% CI, −0.25 to −0.01; I2 = 21). Meta-analyses on other outcomes were non-significant, and some pre-planned analyses were not feasible because of a shortage of studies. Conclusion: The available evidence on IMIs for improving mental and health-related outcomes in youth with CC is limited. Our findings point to a rather small benefit and limited efficacy. Future research is needed, to comprehensively assess the potential of IMIs to extend collaborative care, and to identify factors contributing to improved user-centered interventions with better treatment outcomes.
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spelling doaj.art-d5e6fd7c5ec047e296685fb69a468de42022-12-21T23:18:30ZengElsevierInternet Interventions2214-78292021-04-0124100373Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysisMatthias Domhardt0Annalena Schröder1Agnes Geirhos2Lena Steubl3Harald Baumeister4Corresponding author: Department of Clinical Psychology and Psychotherapy, Ulm University, Lise-Meitner-Str. 16, 89081 Ulm, Germany.; Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, GermanyDepartment of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, GermanyDepartment of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, GermanyDepartment of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, GermanyDepartment of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, GermanyBackground: Digital health interventions might extend service provisions for youth with chronic medical conditions (CC) and comorbid mental health symptoms. We aimed to comprehensively evaluate the efficacy of Internet- and mobile-based interventions (IMIs) for different psychological and disease-related outcomes in children and adolescents with CC. Method: Studies were identified by systematic searches in CENTRAL, Embase, MEDLINE/PubMed and PsycINFO, complemented by searches in reference lists of eligible studies and other reviews. We included studies, when they were randomized controlled trials (RCTs) comparing the efficacy of an IMI to control conditions in improving psychological and disease-related outcomes in youth (mean age ≤ 18 years) with CC. Study selection, data extraction and risk of bias assessment were conducted independently by two reviewers. Meta-analyses were performed within a random-effects model, and Hedges' g (with 95% confidence intervals) was calculated as effect size measure. Primary outcomes were comorbid mental health symptoms (i.e., depression, anxiety and stress), as well as quality of life and self-efficacy. Results: A total of 19 randomized controlled trials (2410 patients) were included in this meta-analysis. IMIs were associated with improvements in self-efficacy (g = 0.38; 95% CI, 0.15 to 0.61; I2 = 0) and combined disease-related outcomes (g = −0.13; 95% CI, −0.25 to −0.01; I2 = 21). Meta-analyses on other outcomes were non-significant, and some pre-planned analyses were not feasible because of a shortage of studies. Conclusion: The available evidence on IMIs for improving mental and health-related outcomes in youth with CC is limited. Our findings point to a rather small benefit and limited efficacy. Future research is needed, to comprehensively assess the potential of IMIs to extend collaborative care, and to identify factors contributing to improved user-centered interventions with better treatment outcomes.http://www.sciencedirect.com/science/article/pii/S2214782921000130Adolescent mental healthPediatricsPsychotherapyInternet- and mobile-based interventioneHealthmHealth
spellingShingle Matthias Domhardt
Annalena Schröder
Agnes Geirhos
Lena Steubl
Harald Baumeister
Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis
Internet Interventions
Adolescent mental health
Pediatrics
Psychotherapy
Internet- and mobile-based intervention
eHealth
mHealth
title Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis
title_full Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis
title_fullStr Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis
title_full_unstemmed Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis
title_short Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis
title_sort efficacy of digital health interventions in youth with chronic medical conditions a meta analysis
topic Adolescent mental health
Pediatrics
Psychotherapy
Internet- and mobile-based intervention
eHealth
mHealth
url http://www.sciencedirect.com/science/article/pii/S2214782921000130
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