The Effects of Universal Preventive Online Interventions on Depressive Symptoms in Students: Systematic Review and Meta-Analysis
Year: 2023
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: The current study aimed to examine the effects of preventive universal online interventions on depressive symptoms in students.Universal refers to prevention, which is aimed at the entire population, while online interventions refer to interventions which are delivered through the Internet and technological devices.Development of these has been a goal of prevention science in the past few decades as the burden of depression has grown and current treatment options are not enough to address this growing problem.To make informed conclusions about the available research we conducted a systematic review and meta-analysis.Besides exploring the effect, we aimed to investigate differences in effect between subgroups based on gender, study quality, education level, and type of control.Analyses of long-term effects and sensitivity analyses were also included in our study.To our knowledge, no previous systematic review or meta-analysis has concentrated on studying universal online interventions aimed at adolescent and young adult student populations even though these age groups are most vulnerable to depression and its negative consequences.We carried out a systematic search in four electronic databases (CINAHL, Cochrane, PsycINFO, PubMed/MEDLINE) to find randomized controlled trials assessing universal online interventions that were expected to prevent depression in young students.Sixteen studies met the inclusion criteria and were included in the study.Seven studies (44%) were rated as high quality in critical appraisal.The studies included 6529 participants (3506 in the intervention and 3023 in the control arm) and they were aged from 10 to 57 years.The mean age of participants ranged from 13 to 22 years.A small but significant effect on depressive symptoms was found between the intervention and control condition (SMD = -0.13,95% CI [-0.24, -0.02]; p = .03).Heterogeneity was moderate (I 2 = 50%, 95% CI [2.4%, 74%]).Subgroup analyses did not find statistically significant differences between subgroups.Analyses of long-term effects revealed that the effect size reduced from post-intervention to follow-up measures and was no longer significant.In sensitivity analyses, no outliers were detected.The inclusion of low-quality studies resulted in a non-significant effect.Furthermore, analyses indicated a presence of publication bias.In conclusion, online interventions seem to generate a temporal decrease in depressive symptoms in students.However, the effect is not long-lasting, and the observed effect size might be attributed to small-study publication bias.The evidence from our study indicates that online interventions may not effectively reduce the burden of depression.Future research should focus on both developing interventions and comprehensive reporting of participant and intervention characteristics.Better reporting of these characteristics could help future systematic reviews and meta-analyses to draw conclusions about which interventions are beneficial and to whom.
Authors: Häkkinen, Vilma, Airaksinen, Aino
Institution: University of Eastern Finland
Language: English
Subfield: Applied Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7215365116