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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

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


Authors

CHRIS HOLLIS chris.hollis@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry and Digital Mental Health

Caroline J. Falconer

Jennifer L. Martin

Craig Whittington

Sarah Stockton



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.