Meta-analytic review of online guided self-help interventions for depressive symptoms among college students

OBJECTIVE: This meta-analysis examines the effect of online guided self-help interventions for depressive symptoms among college students. METHODS: We searched studies through PubMed, Embase, Web of Science, PsycINFO, and Cochrane Central. Effect estimates were reported as standardized mean differences (SMD) and data were pooled using random-effects models. Subgroup analyses were conducted to investigate the differential effects of these interventions by sample type, level of contact, use of incentive, length of intervention, and program content. RESULTS: 24 comparisons (n = 3074) deriving from 19 trials were included in the meta-analysis. Intervention participants (n = 1620) indicated significant reductions in depressive symptoms at post-intervention compared to non-active control conditions (n = 1454). The weighted effect size was 0.46 (95% CI: 0.28–0.64), which dropped to 0.36 (95% CI: 0.26–0.45) after an outlier was removed. Subgroup analyses showed that the effects were significant among interventions using both selective and universal samples; among interventions of shorter (≤4 weeks), moderate (4–8 weeks), and greater length (≥8 weeks); among interventions with high, moderate, and low levels of contact; among interventions with and without incentive; and among interventions employing cognitive-behavioral therapy (CBT) and third-wave CBT. CONCLUSION: This meta-analysis reinforces evidence to support the effectiveness of online guided self-help interventions in reducing depressive symptoms among college students. However, because of the generally variable and limited quality of current evidence, further research applying rigorous methods is needed to confirm and extend the findings of this meta-analysis.