Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 18, 2020
Date Accepted: Oct 14, 2021
Date Submitted to PubMed: Dec 20, 2021
Quality social connection as an 'active ingredient' in digital interventions for young people with depression and anxiety: a systematic scoping review and meta-analysis
ABSTRACT
Background:
Disrupted social connections may negatively impact youth mental health. In contrast, sustained quality social connections can improve outcomes. However, few studies have examined how these quality connections impact depression and anxiety outcomes within digital interventions, and conceptualisation is limited.
Objective:
The study aim was to conceptualise, appraise and synthesise evidence on quality social connection within digital interventions on depression and anxiety outcomes for young people (14-24).
Methods:
A systematic scoping review and meta-analysis, with embedded stakeholder involvement, was conducted and guided by the PRISMA-ScR and Johanna Briggs Institute methodological frameworks. Medline, Embase, PsycInfo and CINAHL databases were searched against a comprehensive combination of key concepts on 24th June 2020. Search concepts included young people, digital intervention, depression/anxiety and social connection. Grey literature was also searched. One reviewer independently screened abstracts/titles and full-text and 10% were screened by a second reviewer. A narrative synthesis was used to structure findings on indicators of quality social connection within digital interventions and mechanisms that facilitate the connection. Indicators of quality social connection from included studies and stakeholder involvement were integrated into a conceptual framework for quality social connection with digital interventions.
Results:
5714 publications were identified and 42 were included. Of these, there were 23,319 participants. D-QSC translated into a five-component conceptual framework: Rapport, Identity and commonality, Valued interpersonal dynamic, Engagement and Responded to and accepted (RIVER). There was a significant decrease in depression (-25.6%, 95% CI [-0.352, -0.160], p<0.0005) and anxiety (-15.1%, 95% CI [-0.251, -0.051], p<0.0005). Heterogeneity was high. Literature and stakeholder evidence showcased the importance of quality social connection within digital interventions for depression, though evidence was weaker for anxiety. Stakeholders reported demographic, dynamic and environmental factors, including blended care, may influence quality social connection experiences and outcomes.
Conclusions:
Quality social connection within digital interventions is an important and under-considered component for youth depression and anxiety outcomes. Researchers and developers should consider targeting improved social connections with clinicians and young people within digital interventions for depression, in particular. Future research should build on our framework to further examine relationships between individual attributes of quality social connection, various digital interventions and different populations. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.