Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 24, 2024
Date Accepted: Jun 26, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Internet-Based and Mobile-App-Based Mental Health Interventions among Adults: A Best Evidence Synthesis of Rigorous Randomized Controlled Trials
ABSTRACT
Compared to in-person mental health interventions, programs delivered through mobile applications or the internet might be more cost-effective, scalable, demand less training, and are more acceptable and accessible among populations. In the aftermath of the pandemic, the use of online mental health interventions has increased significantly. However, there is limited understanding of the conditions and populations for which these interventions are most effective. To address this gap, we conducted a meta-analysis to synthesize findings from existing randomized controlled trials and expand our knowledge on this topic. Research plans were pre-registered before analyzing the data. We conducted a meticulous search strategy including database queries, handsearching, forward and backward citation tracking and retrieved 8944 studies. After double blinded screening, 64 studies and 247 effect sizes (total sample sizes = 17,388) were eligible to be included in this systematic review and meta-analysis. Results showed that these online interventions were effective (ES = -0.80, p < .001) while holding all moderators fixed at their mean. Specifically, online interventions were effective at reducing anxiety, depression, stress, and psychological distress. However, studies on average showed no impacts on suicidal ideation. Moderator analysis showed that online interventions targeting anxiety outcomes are more effective than interventions targeting psychological distress; internet-based interventions are more effective than mobile-app-based interventions, although both modalities showed effectiveness. These findings provide valuable insights for policymakers and practitioners in developing cost-effective technology-based mental health interventions. While technology can be a double-edged tool, this review highlighted its benefits for improving adult well-being, particularly in the treatment of mental health symptoms.
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