Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 13, 2024
Open Peer Review Period: Nov 8, 2024 - Jan 3, 2025
Date Accepted: Feb 20, 2025
(closed for review but you can still tweet)
Exploring Engagement and Effectiveness of Digital Mental Health Interventions in Young People of Different Ethnicities: A Systematic Review
ABSTRACT
Background:
The prevalence of mental health difficulties among young people has risen in recent years, with 75% of mental disorders emerging before age 24. Identification and treatment of mental health issues earlier in life improves later-life outcomes. The COVID-19 pandemic spurred the growth of digital mental health interventions (DMHIs), which offer accessible support. Ethnic minority youth, however, face barriers to DHMIs, such as socioeconomic disadvantage and cultural stigma.
Objective:
This review summarises and evaluates the engagement and effectiveness of DMHIs among ethnic minority youth.
Methods:
Searches were conducted in MEDLINE, EMBASE, and PsycINFO for studies published from January 2019 to May 2024, and updated in September 2024. Inclusion criteria included participants aged under 25 utilising DMHIs, from various ethnicities. Three reviewers independently screened and selected studies. Data were extracted on the experiences of young people of different ethnicities using DMHI including engagement, usage, user acceptability, uptake, and retention; and effectiveness of these interventions within these populations. Studies were quality assessed using the Mixed Methods Appraisal Tool.
Results:
The final search yielded 67 studies, of which seven met inclusion criteria. All studies were from high-income countries. Participants were predominantly aged 12-25, with varied ethnic representation. Culturally adapted, low-cost interventions showed higher engagement and effectiveness. Limited studies and small sample sizes impeded robust comparisons. Language barriers reduce effectiveness, emphasizing the need for linguistic adaptations, while co-production, mentorship and personalised support offer a potential avenue for improving cultural relatability.
Conclusions:
DMHIs show potential for ethnic minority youth, especially when co-produced and culturally relatable, playing a role as mental health promotional tools. Future research should focus on developing a consensus definition of DMHIs, exploring DMHIs in children under 12, and conducting detailed qualitative research on usage factors and treatment efficacy of DMHIs for ethnic minority youth.
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