Annual research review: Digital health interventions for children and young people with mental health problems: a systematic and meta-review

Hollis, Chris; Falconer, Caroline J.; Martin, Jennifer L.; Whittington, Craig; Stockton, Sarah; Glazebrook, Cris; Davies, Eleanor Bethan

Abstract

Digital health interventions (DHIs), 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 DHIs will be preferred by children and young people (CYP) given their ubiquitous digital activity. However, it remains uncertain whether: DHIs for CYP are clinically and cost-effective, CYP prefer DHIs to traditional services, DHIs widen access and how they should be evaluated and adopted by mental health services. This review evaluates the evidence-base for DHIs and considers the key research questions and approaches to evaluation and implementation. We conducted a meta-review of scoping, narrative, systematic or meta-analytical reviews investigating the effectiveness of DHIs for mental health problems in CYP. We also updated a systematic review of randomised controlled trials (RCTs) of DHIs for CYP published in the last 3 years. Twenty-one reviews were included in the meta-review. The findings provide some support for the clinical benefit of DHIs, particularly computerised cognitive behavioural therapy (cCBT), for depression and anxiety in adolescents and young adults. The systematic review identified 30 new RCTs evaluating DHIs for attention deficit/hyperactivity disorder (ADHD), autism, anxiety, depression, psychosis, eating disorders and PTSD. The benefits of DHIs in managing ADHD, autism, psychosis and eating disorders are uncertain, and evidence is lacking regarding the cost-effectiveness of DHIs. Key methodological limitations make it difficult to draw definitive conclusions from existing clinical trials of DHIs. Issues include variable uptake and engagement with DHIs, lack of an agreed typology/taxonomy for DHIs, 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 DHIs for CYP.

Citation

Hollis, C., Falconer, C. J., Martin, J. L., Whittington, C., Stockton, S., Glazebrook, C., & Davies, E. B. (in press). Annual research review: Digital health interventions for children and young people with mental health problems: a systematic and meta-review. Journal of Child Psychology and Psychiatry, https://doi.org/10.1111/jcpp.12663

• Journal Article Type: Article
• Acceptance Date: Sep 29, 2016
• Online Publication Date: Dec 10, 2016
• Deposit Date: Dec 15, 2016
• Publicly Available Date: Dec 15, 2016
• Journal: Journal of Child Psychology and Psychiatry
• Print ISSN: 0021-9630
• Electronic ISSN: 1469-7610
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/jcpp.12663
• Keywords: Digital health; Mental health; eHealth; Methodology; Randomised controlled trials; Prevention
• Public URL: https://nottingham-repository.worktribe.com/output/835805
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12663/abstract
• Additional Information: This is the peer reviewed version of the following article: Hollis, C., Falconer, C. J., Martin, J. L., Whittington, C., Stockton, S., Glazebrook, C. and Davies, E. B. (2016), Annual Research Review: Digital health interventions for children and young people with mental health problems: a systematic and meta-review. J Child Psychol Psychiatr. doi:10.1111/jcpp.12663 which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12663/full This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Dec 15, 2016