Cargando…

The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis

BACKGROUND: Recent years have highlighted an increasing need to promote mental well-being in the general population. This has led to a rapidly growing market for fully automated digital mental well-being tools. Although many individuals have started using these tools in their daily lives, evidence o...

Descripción completa

Detalles Bibliográficos
Autores principales: Groot, Julia, MacLellan, Alexander, Butler, Madelaine, Todor, Elisa, Zulfiqar, Mahnoor, Thackrah, Timothy, Clarke, Christopher, Brosnan, Mark, Ainsworth, Ben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623223/
https://www.ncbi.nlm.nih.gov/pubmed/37856172
http://dx.doi.org/10.2196/44658
_version_ 1785130701034618880
author Groot, Julia
MacLellan, Alexander
Butler, Madelaine
Todor, Elisa
Zulfiqar, Mahnoor
Thackrah, Timothy
Clarke, Christopher
Brosnan, Mark
Ainsworth, Ben
author_facet Groot, Julia
MacLellan, Alexander
Butler, Madelaine
Todor, Elisa
Zulfiqar, Mahnoor
Thackrah, Timothy
Clarke, Christopher
Brosnan, Mark
Ainsworth, Ben
author_sort Groot, Julia
collection PubMed
description BACKGROUND: Recent years have highlighted an increasing need to promote mental well-being in the general population. This has led to a rapidly growing market for fully automated digital mental well-being tools. Although many individuals have started using these tools in their daily lives, evidence on the overall effectiveness of digital mental well-being tools is currently lacking. OBJECTIVE: This study aims to review the evidence on the effectiveness of fully automated digital interventions in promoting mental well-being in the general population. METHODS: Following the preregistration of the systematic review protocol on PROSPERO, searches were carried out in MEDLINE, Web of Science, Cochrane, PsycINFO, PsycEXTRA, Scopus, and ACM Digital (initial searches in February 2022; updated in October 2022). Studies were included if they contained a general population sample and a fully automated digital intervention that exclusively used psychological mental well-being promotion activities. Two reviewers, blinded to each other’s decisions, conducted data selection, extraction, and quality assessment of the included studies. Narrative synthesis and a random-effects model of per-protocol data were adopted. RESULTS: We included 19 studies that involved 7243 participants. These studies included 24 fully automated digital mental well-being interventions, of which 15 (63%) were included in the meta-analysis. Compared with no intervention, there was a significant small effect of fully automated digital mental well-being interventions on mental well-being in the general population (standardized mean difference 0.19, 95% CI 0.04-0.33; P=.02). Specifically, mindfulness-, acceptance-, commitment-, and compassion-based interventions significantly promoted mental well-being in the general population (P=.006); insufficient evidence was available for positive psychology and cognitive behavioral therapy–based interventions; and contraindications were found for integrative approaches. Overall, there was substantial heterogeneity, which could be partially explained by the intervention duration, comparator, and study outcomes. The risk of bias was high, and confidence in the quality of the evidence was very low (Grading of Recommendations, Assessment, Development, and Evaluations), primarily because of the high rates of study dropout (average 37%; range 0%-85%) and suboptimal intervention adherence (average 40%). CONCLUSIONS: This study provides a novel contribution to knowledge regarding the effectiveness, strengths, and weaknesses of fully automated digital mental well-being interventions in the general population. Future research and practice should consider these findings when developing fully automated digital mental well-being tools. In addition, research should aim to investigate positive psychology and cognitive behavioral therapy–based tools as well as develop further strategies to improve adherence and reduce dropout in fully automated digital mental well-being interventions. Finally, it should aim to understand when and for whom these interventions are particularly beneficial. TRIAL REGISTRATION: PROSPERO CRD42022310702; https://tinyurl.com/yc7tcwy7
format Online
Article
Text
id pubmed-10623223
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher JMIR Publications
record_format MEDLINE/PubMed
spelling pubmed-106232232023-11-04 The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis Groot, Julia MacLellan, Alexander Butler, Madelaine Todor, Elisa Zulfiqar, Mahnoor Thackrah, Timothy Clarke, Christopher Brosnan, Mark Ainsworth, Ben JMIR Ment Health Review BACKGROUND: Recent years have highlighted an increasing need to promote mental well-being in the general population. This has led to a rapidly growing market for fully automated digital mental well-being tools. Although many individuals have started using these tools in their daily lives, evidence on the overall effectiveness of digital mental well-being tools is currently lacking. OBJECTIVE: This study aims to review the evidence on the effectiveness of fully automated digital interventions in promoting mental well-being in the general population. METHODS: Following the preregistration of the systematic review protocol on PROSPERO, searches were carried out in MEDLINE, Web of Science, Cochrane, PsycINFO, PsycEXTRA, Scopus, and ACM Digital (initial searches in February 2022; updated in October 2022). Studies were included if they contained a general population sample and a fully automated digital intervention that exclusively used psychological mental well-being promotion activities. Two reviewers, blinded to each other’s decisions, conducted data selection, extraction, and quality assessment of the included studies. Narrative synthesis and a random-effects model of per-protocol data were adopted. RESULTS: We included 19 studies that involved 7243 participants. These studies included 24 fully automated digital mental well-being interventions, of which 15 (63%) were included in the meta-analysis. Compared with no intervention, there was a significant small effect of fully automated digital mental well-being interventions on mental well-being in the general population (standardized mean difference 0.19, 95% CI 0.04-0.33; P=.02). Specifically, mindfulness-, acceptance-, commitment-, and compassion-based interventions significantly promoted mental well-being in the general population (P=.006); insufficient evidence was available for positive psychology and cognitive behavioral therapy–based interventions; and contraindications were found for integrative approaches. Overall, there was substantial heterogeneity, which could be partially explained by the intervention duration, comparator, and study outcomes. The risk of bias was high, and confidence in the quality of the evidence was very low (Grading of Recommendations, Assessment, Development, and Evaluations), primarily because of the high rates of study dropout (average 37%; range 0%-85%) and suboptimal intervention adherence (average 40%). CONCLUSIONS: This study provides a novel contribution to knowledge regarding the effectiveness, strengths, and weaknesses of fully automated digital mental well-being interventions in the general population. Future research and practice should consider these findings when developing fully automated digital mental well-being tools. In addition, research should aim to investigate positive psychology and cognitive behavioral therapy–based tools as well as develop further strategies to improve adherence and reduce dropout in fully automated digital mental well-being interventions. Finally, it should aim to understand when and for whom these interventions are particularly beneficial. TRIAL REGISTRATION: PROSPERO CRD42022310702; https://tinyurl.com/yc7tcwy7 JMIR Publications 2023-10-19 /pmc/articles/PMC10623223/ /pubmed/37856172 http://dx.doi.org/10.2196/44658 Text en ©Julia Groot, Alexander MacLellan, Madelaine Butler, Elisa Todor, Mahnoor Zulfiqar, Timothy Thackrah, Christopher Clarke, Mark Brosnan, Ben Ainsworth. Originally published in JMIR Mental Health (https://mental.jmir.org), 19.10.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Review
Groot, Julia
MacLellan, Alexander
Butler, Madelaine
Todor, Elisa
Zulfiqar, Mahnoor
Thackrah, Timothy
Clarke, Christopher
Brosnan, Mark
Ainsworth, Ben
The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis
title The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis
title_full The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis
title_fullStr The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis
title_full_unstemmed The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis
title_short The Effectiveness of Fully Automated Digital Interventions in Promoting Mental Well-Being in the General Population: Systematic Review and Meta-Analysis
title_sort effectiveness of fully automated digital interventions in promoting mental well-being in the general population: systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623223/
https://www.ncbi.nlm.nih.gov/pubmed/37856172
http://dx.doi.org/10.2196/44658
work_keys_str_mv AT grootjulia theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT maclellanalexander theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT butlermadelaine theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT todorelisa theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT zulfiqarmahnoor theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT thackrahtimothy theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT clarkechristopher theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT brosnanmark theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT ainsworthben theeffectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT grootjulia effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT maclellanalexander effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT butlermadelaine effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT todorelisa effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT zulfiqarmahnoor effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT thackrahtimothy effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT clarkechristopher effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT brosnanmark effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis
AT ainsworthben effectivenessoffullyautomateddigitalinterventionsinpromotingmentalwellbeinginthegeneralpopulationsystematicreviewandmetaanalysis