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Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta‐review
Author(s) -
Hollis Chris,
Falconer Caroline J.,
Martin Jennifer L.,
Whittington Craig,
Stockton Sarah,
Glazebrook Cris,
Davies E. Bethan
Publication year - 2017
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.12663
Subject(s) - psychological intervention , mental health , anxiety , systematic review , psychology , randomized controlled trial , autism , eating disorders , psychiatry , digital health , autism spectrum disorder , social anxiety , clinical psychology , medline , medicine , health care , political science , law , surgery , economics , economic growth
Background Digital health interventions ( DHI s), including computer‐assisted therapy, smartphone apps and wearable technologies, are heralded as having enormous potential to improve uptake and accessibility, efficiency, clinical effectiveness and personalisation of mental health interventions. It is generally assumed that DHI s will be preferred by children and young people ( CYP ) given their ubiquitous digital activity. However, it remains uncertain whether: DHI s for CYP are clinically and cost‐effective, CYP prefer DHI s to traditional services, DHI s widen access and how they should be evaluated and adopted by mental health services. This review evaluates the evidence‐base for DHI s and considers the key research questions and approaches to evaluation and implementation. Methods We conducted a meta‐review of scoping, narrative, systematic or meta‐analytical reviews investigating the effectiveness of DHI s for mental health problems in CYP . We also updated a systematic review of randomised controlled trials ( RCT s) of DHI s for CYP published in the last 3 years. Results Twenty‐one reviews were included in the meta‐review. The findings provide some support for the clinical benefit of DHI s, particularly computerised cognitive behavioural therapy ( cCBT ), for depression and anxiety in adolescents and young adults. The systematic review identified 30 new RCT s evaluating DHI s for attention deficit/hyperactivity disorder ( ADHD ), autism, anxiety, depression, psychosis, eating disorders and PTSD . The benefits of DHI s in managing ADHD , autism, psychosis and eating disorders are uncertain, and evidence is lacking regarding the cost‐effectiveness of DHI s. Conclusions Key methodological limitations make it difficult to draw definitive conclusions from existing clinical trials of DHI s. Issues include variable uptake and engagement with DHI s, lack of an agreed typology/taxonomy for DHI s, small sample sizes, lack of blinded outcome assessment, combining different comparators, short‐term follow‐up and poor specification of the level of human support. Research and practice recommendations are presented that address the key research questions and methodological issues for the evaluation and clinical implementation of DHI s for CYP .