Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis

Matthias Domhardt; Annalena Schröder; Agnes Geirhos; Lena Steubl; Harald Baumeister

Internet Interventions (Apr 2021)

Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis

Matthias Domhardt,
Annalena Schröder,
Agnes Geirhos,
Lena Steubl,
Harald Baumeister

Affiliations

Matthias Domhardt: Corresponding author: Department of Clinical Psychology and Psychotherapy, Ulm University, Lise-Meitner-Str. 16, 89081 Ulm, Germany.; Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
Annalena Schröder: Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
Agnes Geirhos: Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
Lena Steubl: Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
Harald Baumeister: Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany

Journal volume & issue: Vol. 24
p. 100373

Abstract

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Background: Digital health interventions might extend service provisions for youth with chronic medical conditions (CC) and comorbid mental health symptoms. We aimed to comprehensively evaluate the efficacy of Internet- and mobile-based interventions (IMIs) for different psychological and disease-related outcomes in children and adolescents with CC. Method: Studies were identified by systematic searches in CENTRAL, Embase, MEDLINE/PubMed and PsycINFO, complemented by searches in reference lists of eligible studies and other reviews. We included studies, when they were randomized controlled trials (RCTs) comparing the efficacy of an IMI to control conditions in improving psychological and disease-related outcomes in youth (mean age ≤ 18 years) with CC. Study selection, data extraction and risk of bias assessment were conducted independently by two reviewers. Meta-analyses were performed within a random-effects model, and Hedges' g (with 95% confidence intervals) was calculated as effect size measure. Primary outcomes were comorbid mental health symptoms (i.e., depression, anxiety and stress), as well as quality of life and self-efficacy. Results: A total of 19 randomized controlled trials (2410 patients) were included in this meta-analysis. IMIs were associated with improvements in self-efficacy (g = 0.38; 95% CI, 0.15 to 0.61; I2 = 0) and combined disease-related outcomes (g = −0.13; 95% CI, −0.25 to −0.01; I2 = 21). Meta-analyses on other outcomes were non-significant, and some pre-planned analyses were not feasible because of a shortage of studies. Conclusion: The available evidence on IMIs for improving mental and health-related outcomes in youth with CC is limited. Our findings point to a rather small benefit and limited efficacy. Future research is needed, to comprehensively assess the potential of IMIs to extend collaborative care, and to identify factors contributing to improved user-centered interventions with better treatment outcomes.

Published in Internet Interventions

ISSN: 2214-7829 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Technology: Technology (General): Industrial engineering. Management engineering: Information technology; Philosophy. Psychology. Religion: Psychology
Website: http://www.journals.elsevier.com/internet-interventions/

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