Effectiveness of Live Health Professional–Led Group eHealth Interventions for Adult Mental Health: Systematic Review of Randomized Controlled Trials

Abstract

Background The COVID-19 pandemic has had adverse impacts on mental health and substance use worldwide. Systematic reviews suggest eHealth interventions can be effective at addressing these problems. However, strong positive eHealth outcomes are often tied to the intensity of web-based therapist guidance, which has time and cost implications that can make the population scale-up of more effective interventions difficult. A way to offset cost while maintaining the intensity of therapist guidance is to offer eHealth programs to groups rather than more standard one-on-one formats. Objective This systematic review aims to assess experimental evidence for the effectiveness of live health professional–led group eHealth interventions on mental health, substance use, or bereavement among community-dwelling adults. Within the articles selected for our primary aim, we also seek to examine the impact of interventions that encourage physical activity compared with those that do not. Methods Overall, 4 databases (MEDLINE, CINAHL, PsycINFO, and the Cochrane Library) were searched in July 2020. Eligible studies were randomized controlled trials (RCTs) of eHealth interventions led by health professionals and delivered entirely to adult groups by videoconference, teleconference, or webchat. Eligible studies reported mental health, substance use, or bereavement as primary outcomes. The results were examined by outcome, eHealth platform, and intervention length. Postintervention data were used to calculate effect size by study. The findings were summarized using the Synthesis Without Meta-Analysis guidelines. Risk of bias was assessed using the Cochrane Collaboration Tool. Results Of the 4099 identified studies, 21 (0.51%) RCTs representing 20 interventions met the inclusion criteria. These studies examined mental health outcomes among 2438 participants (sample size range: 47-361 participants per study) across 7 countries. When effect sizes were pooled, live health professional–led group eHealth interventions had a medium effect on reducing anxiety compared with inactive (Cohen d=0.57) or active control (Cohen d=0.48), a medium to small effect on reducing depression compared with inactive (Cohen d=0.61) or active control (Cohen d=0.21), and mixed effects on mental distress and coping. Interventions led by videoconference, and those that provided 8-12 hours of live health professional–led group contact had more robust effects on adult mental health. Risk of bias was high in 91% (19/21) of the studies. Heterogeneity across interventions was significant, resulting in low to very low quality of evidence. No eligible RCT was found that examined substance use, bereavement, or physical activity. Conclusions Live eHealth group interventions led by health professionals can foster moderate improvements in anxiety and moderate to small improvements in depression among community-based adults, particularly those delivered by videoconference and those providing 8-12 hours of synchronous engagement. Trial Registration PROSPERO CRD42020187551; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=187551 International Registered Report Identifier (IRRID) RR2-10.1186/s13643-020-01479-3

COVID-19 and mental health disorders in children and adolescents (Review)

“…Internet-based remote interventions are playing an increasingly important role in the context of strict isolation measures as the epidemic progresses ( Heckendorf, Lehr, and Boß 2022 ; Dixon, Holoshitz, and Nossel 2016 ). Increasing evidence suggests that child and adolescent mental health network interventions have better feasibility, acceptability, and effectiveness ( Korpilahti-Leino et al 2022 ; Currie et al 2022 ). Numerous organizations have created online tools and specific interventions to help young children cope with stress and mental health issues during the pandemic ( Meherali et al 2021 ).…”

Telemedicine Interventions as an Attempt to Improve the Mental Health of Populations during the COVID-19 Pandemic—A Narrative Review

“…A possible solution is to offer therapist-led eHealth interventions in groups. If effective, group eHealth interventions could increase public access to mental health professionals during and after a pandemic [ 44 ].…”

“…However, the results should be considered with caution due to the high heterogeneity (I 2 = 93% and 95%). High heterogeneity also characterised the systematic review by Currie et al, who evaluated the effectiveness of group eHealth interventions delivered by health professionals on mental health [ 44 ]. A medium effect was noted for anxiety reduction compared to inactive interventions or active controls, as well as a medium and small effect for depression reduction compared to inactive and active controls.…”

O uso de tecnologias digitais na intervenção com protocolo transdiagnóstico desenvolvido com base na terapia cognitivo-comportamental e na terapia comportamental dialética

“…Moreover, it was a facilitating factor for the observation of the participants´ behavior during the meetings, as well as during individual contact outside the sessions, whenever necessary. According to a systematic review (Currie et al, 2022), the group approach, with the constant presence and guidance of professionals, made the intervention less expensive for the participants while still being effective in dealing with various mental health issues. It was observed that the combination and cohesion of the clinical staff favored feelings of acceptance and commitment by the participants, enhancing their adherence and engagement with the work proposal.…”

“…A systematic review published in 2019 (Gentry et al 2019) indicated the viability of therapeutic group approaches by videoconference with similar results to in-person treatment, in addition to high participant satisfaction. Another review concluded that online group interventions conducted by healthcare professionals, can have a moderate impact on participants' anxiety (Currie et al, 2022).…”