A Meta-Analysis of the Impact of Universal and Indicated Preventive Technology-Delivered Interventions for Higher Education Students

Abstract

The uses of technology-delivered mental health treatment options, such as interventions delivered via computer, smart phone, or other communication or information devices, as opposed to primarily face-to-face interventions, are proliferating. However, the literature is unclear about their effectiveness as preventive interventions for higher education students, a population for whom technology-delivered interventions (TDIs) might be particularly fitting and beneficial. This meta-analytic review examines technological mental health prevention programs targeting higher education students either without any presenting problems (universal prevention) or with mild to moderate subclinical problems (indicated prevention). A systematic literature search identified 22 universal and 26 indicated controlled interventions, both published and unpublished, involving 4763 college, graduate, or professional students. As hypothesized, the overall mean effect sizes (ESs) for both universal (0.19) and indicated interventions (0.37) were statistically significant and differed significantly from each other favoring indicated interventions. Skill-training interventions, both universal (0.21) and indicated (0.31), were significant, whereas non-skill-training interventions were only significant among indicated (0.25) programs. For indicated interventions, better outcomes were obtained in those cases in which participants had access to support during the course of the intervention, either in person or through technology (e.g., email, online contact). The positive findings for both universal and indicated prevention are qualified by limitations of the current literature. To improve experimental rigor, future research should provide detailed information on the level of achieved implementation, describe participant characteristics and intervention content, explore the impact of potential moderators and mechanisms of success, collect post-intervention and follow-up data regardless of intervention completion, and use analysis strategies that allow for inclusion of cases with partially missing data.

Internet interventions for mental health in university students: A systematic review and meta‐analysis

“…Davies, Morriss, and Glazebrook () included 14 studies, primarily evaluating Internet‐based cognitive behavioural therapy (CBT; 93%), and found moderate to large effects on depression, anxiety, and stress (standardized mean difference [SMD] = 0.43–0.73) compared with inactive control groups but no superiority of these interventions compared with active controls. Conley, Durlak, Shapiro, Kirsch, and Zahniser () conducted a systematic search in 2014 targeting preventive interventions, but included somewhat outdated technology (e.g., VCR and audiotape player), and reported effects from SMD = 0.20–0.34 on depression, anxiety, and stress outcomes in non‐clinical student samples compared with control groups. A systematic review on Internet‐based eating disorder prevention was published in 2008 (Yager & O'Dea, ), with no meta‐analysis performed.…”

Efficacité des interventions en prévention et en promotion de la santé mentale dans les établissements d’enseignement postsecondaire

“…Pour sa part, la méta-analyse de Conley et coll. 23 35 . Les analyses portaient sur l'impact de stratégies relatives à différents aspects de l'environnement universitaire : le développement de politiques priorisant la santé mentale, la création d'espaces scolaires plus conviviaux, la diffusion de messages en promotion de la santé, des modifications apportées aux programmes académiques, etc.…”

Supported Internet-Delivered Cognitive Behavioral Therapy Programs for Depression, Anxiety, and Stress in University Students: Open, Non-Randomised Trial of Acceptability, Effectiveness, and Satisfaction (Preprint)

“…A recent meta-analysis of 48 studies supported the efficacy of Internet delivered mental health interventions in college student samples [10]. Most online mental health interventions are based on cognitivebehavioral therapy (CBT), which is an empirically-supported treatment for many mental health disorders [11].…”

“…Most online mental health interventions are based on cognitivebehavioral therapy (CBT), which is an empirically-supported treatment for many mental health disorders [11]. Although interventions can be self-guided, those that are clinician-supported are generally more effective than those that are self-guided [10] [12].…”

“…Although internet-delivered CBT (iCBT) has been shown to be effective for college students [10], some gaps remain in our understanding of how best to implement these interventions on campuses. For example, most studies have used convenience samples such as students in psychology classes.…”