Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Oct 22, 2022
Date Accepted: Jan 11, 2023
Date Submitted to PubMed: Jan 12, 2023
The usability, feasibility, acceptability, and efficacy of digital mental health services in COVID-19: a scoping review, systematic review, and meta-analysis
ABSTRACT
Background:
Following the rapid spread of the novel coronavirus SARS-CoV-2, short-term and long-term mental health impacts on the public, in particular for vulnerable individuals, have been reported worldwide. Although digital mental health expands accessibility while removing many barriers to in-person therapy, its usability, feasibility, acceptability, and efficacy remain examined during the pandemic and its aftermath.
Objective:
To understand what mental health services are offered, whether they are practical or acceptable, and to what extent digital mental health services are effective in response to COVID-19.
Methods:
The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and scoping review extension. We implemented searches in PubMed (MEDLINE), Web of Science (CORE Collection), EMBASE, PsycINFO, and CINAHL between December 2019 and October 2021 for studies that involve the use of digital mental health services. Two review authors screened, assessed, and extracted studies independently. The protocol was registered on the PROSPERO (CRD42022307695).
Results:
This review identified 7506 articles through database searching. Sixty-five studies from 18 countries with 67,884 participants were eligible for the scoping review, and sixteen studies were included in the meta-analysis. Twenty-two studies (33.8%) measured usability, twenty-seven (41.5%) evaluated feasibility, thirty (46.2%) considered acceptability and fifty-four (83.1%) assessed efficacy. Web-based program (32.3%), videoconferencing platform (24.6%), smartphone application (21.5%), and text messaging (7.7%) were the main techniques. Psychotherapy (67.7%) followed by psychoeducation (9.2%) and psychological support (7.7%) were commonly used. The results of meta-analysis showed digital mental health interventions were associated with a small reduction in depressive symptoms (SMD=-0.49, 95%CI=-0.73 to -0.25), and a moderate reduction in anxiety symptoms (SMD=-0.62, 95%CI=-0.93 to -0.3) significantly. The moderator of the measurements of depressive and anxiety was identified.
Conclusions:
Findings suggested that digital mental health intervention may be practical and helpful for general population, at-risk individuals, and patients with pre-existing mental disorders. An expanded research agenda is needed to apply different strategies for addressing diverse psychological needs and develop integrated mental health services in the post-COVID-19 era. Clinical Trial: Not applicable
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