eHealth and mHealth Psychosocial Interventions for Youths With Chronic Illnesses: Systematic Review (Preprint)

Abstract

BACKGROUND An estimated 12.8% of children and adolescents experience chronic health conditions which lead to poor quality of life, adjustment and coping issues, and concurrent mental health problems. Digital health deployment of psychosocial interventions to support youth with chronic illness has become increasingly popular with the advent of the technological advances in the Digital Age. OBJECTIVE To (1) systematically review published efficacy studies of eHealth (internet-based) and mHealth (mobile health) psychosocial interventions for youths with chronic illnesses; and, (2) review intervention theory and treatment components. METHODS PubMed, Embase, Web of Science, PsychInfo, and Cochrane Database of Systematic reviews were searched for studies published from 2008-2018 of eHealth and mHealth psychosocial interventions designed for children and adolescents with chronic illnesses in which efficacy outcomes were reported. We excluded studies of interventions for caregivers, healthy youth, disease and medication management, and telehealth interventions that function solely as a platform to connect patients to providers via phone, text, or videoconference. RESULTS We screened 1,853 articles, and 108 relevant full-text articles. Fifteen efficacy studies with psychosocial and health outcomes met inclusion criteria, which represented 11 unique interventions. Of the included studies, 11 were randomized controlled trials and four were prospective cohort studies with no comparison group. Most interventions were based in cognitive-behavioral theory and designed as eHealth interventions; only 1 was designed as an mHealth intervention. All but one intervention provided access to support staff via text, phone, email, or discussion forums. The significant heterogeneity in intervention content, intervention structure, medical diagnoses, and outcomes precluded meta-analysis. For example, measurement timepoints ranged from immediately post-completion of the mHealth program to 18-months later, and we identified 38 unique outcomes of interest. Most included studies (73%) reported significant changes in measured health and/or psychosocial post-treatment outcomes, with small to large effect sizes. CONCLUSIONS Although the available literature on the efficacy of eHealth and mHealth psychosocial interventions for youth with chronic illnesses is limited, preliminary research suggests some evidence of positive treatment responses. Future studies should continue to evaluate whether digital health platforms may be a viable alternative model of delivery to traditional face-to-face approaches.

Using science as a differentiator in a crowded digital mental health market

“…Science is an integral, yet underutilized asset in the digital mental health industry. Systematic reviews examining digital mental health apps reveal that a mere 2-3.4% substantiate their product and app claims with scientific evidence (24)(25)(26). This issue is of paramount significance, not only due to the ongoing mental health crisis and the need for efficacious interventions (27,28), but also for companies striving to differentiate themselves in a crowded market.…”