Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 21, 2021
Date Accepted: Dec 3, 2021
Date Submitted to PubMed: Dec 8, 2021
Effectiveness of live health professional-led group eHealth interventions for adult mental health: A systematic review of randomized controlled trials
ABSTRACT
Background:
Systematic reviews suggest eHealth interventions can be effective at addressing mental health and substance use problems. A problem is that positive outcomes are often tied to the intensity of therapist guidance, which has cost implications that can make the population scale-up of more effective interventions prohibitive. A way to offset cost while maintaining the intensity of therapist guidance is to offer eHealth programs to groups of individuals rather than more standard one-on-one or asynchronous formats.
Objective:
To examine experimental evidence for live, health professional-led group interventions delivered entirely using one of three eHealth platforms (video, phone or live online chat) on improvements in adult mental health or substance use in community-based settings. Given current need related to the COVID-19 pandemic, we also systematically searched for RCTs that examined bereavement outcomes. Within articles selected for our primary aim, we also examined the impact of eHealth interventions that encouraged physical activity on mental health outcomes relative to those that did not.
Methods:
This review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched MEDLINE, the Cochrane Library, CINAHL, and PsycINFO in June 2020. Eligible studies included randomized controlled trials of eHealth interventions targeting mental health, substance use, or bereavement as primary outcomes in adults. We extracted data for end of intervention and calculated effect sizes for each study. To explore effect moderators, we performed subgroup analyses by outcome, eHealth delivery platform, and intervention intensity. Results were summarized using the SWiM (Synthesis Without Meta-Analysis) guidelines. Risk of bias was assessed using the Cochrane Collaboration tool.
Results:
Of the 4,099 identified studies, 22 were included. These studies reported on mental health outcomes among 2,387 participants across seven countries. No studies examining substance use or bereavement were found.
Conclusions:
Group eHealth interventions led by health professionals can foster small to moderate improvements in depression and anxiety compared to passive control. Clinical Trial: Not applicable
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