Session Information
05 SES 05.5 A, General Poster Session
General Poster Session
Contribution
Adolescence is characterized as a stage of human development in which individuals attain and develop the skills and competencies necessary for becoming productive and functioning adults (Barker, 2007). This critical point in human development is characterised by changes (such as physical and socio-emotional), as well as social and cognitive development (Slater & Bremner, 2017). Due to the mentioned changes and development undergone, adolescents can be at risk for mental health concerns (e.g., anxiety). WHO (2021) reports that one in seven adolescents aged between 10 and 19 experiences a mental health concern which is often left untreated. Thus, prevention programs offer opportunities for supporting the mental health of adolescents. By increasing their mental health literacy (Jorm, 2012) we can equip them with the knowledge of recognizing and properly responding to mental health issues in themselves and others. By developing effective prevention programs for adolescents we can mitigate at least some of the mental health issues that spill over from adolescence to adulthood, as for example many anxiety and depression-related disorders have their onset in adolescence (Gibb et al., 2010; Kim-Cohen et al., 2003). As adolescents are the most active users of digital devices (UNICEF, 2017) it is reasonable to focus on programs that can be accessed on digital devices (e.g., computers, smartphones) as this builds on their willingness to use such devices (Gibson & Trnka, 2020) and enable the development of interventions that are aligned with their habits.
The need for digital prevention programs that can be implemented independently of time, geographical or personnel restrictions has been further exacerbated by the COVID-19 pandemic (Kaess et al., 2021). For example, Ravens-Sieberer et al. (2022) found more mental health problems and higher anxiety in children and adolescents during the pandemic. Moreover, authors (e.g., Babbage et al., 2018; Kaess et al., 2021) agree that there is a clear need and value for such programs/interventions, but caution has to be put in place as digital resources for mental health are not always formally evaluated or evidence-based in their development (Domhardt et al., 2021; Torous et al., 2019).
In order to support the development of a digital mental health tool for adolescents, the present paper builds on a previously conducted systematic review (Wright et al., in press) and aims to provide recommendations for creating a digital tool for the mentioned age group. The tool is being developed as a part of the ongoing Erasmus project me_HeLi-D (Mental Health Literacy and Diversity. Enhancing Mental Health and Resilience through digital Resources for Youth). In line with the goals of the project, the following contribution focuses on existing mental health programs with a digital/online component that focuses on the mental health of adolescents (aged between 11 to 18 years) and the following domains of mental health: mindfulness, resilience, and help-seeking. We are particularly interested in the content, design, and activities of existing evidence-based programs in order to inform the development of our own digital program with recommendations that are based on findings and good practices from existing programs.
In the present paper, we aim to answer three research questions: 1) Which evidence-based mental health programs/interventions with a digital component have been shown to be effective in supporting the mental health of adolescents aged 11 to 18 years? 2) What were the contents of effective mental health programs/interventions? 3) How were effective mental health programs/interventions designed?
Method
A systematic literature search was conducted in the databases PsychInfo, PubMed, and The Cochrane Library. The search aimed to identify preventive interventions with a digital component that promote mental health in general, as well as well-being, mental health literacy, resilience, help-seeking behavior, and mindfulness. The following inclusion criteria were implemented: participants (children/adolescents aged between 11 and 18 years), intervention (preventive interventions with >= 50% digital delivery), study type (quantitative or mixed-methods studies), study design (controlled studies-CT with pre-post comparison), and publication (peer-reviewed; published between 2000 and 2021). A detailed description of the methodology (search terms and results according to PRISMA recommendations, risk of bias assessment) is available in another publication (Wright et al., in press). The systematic literature search identified 27 studies matching the inclusion criteria. In order to further evaluate the interventions according to our research questions, we conducted a backward search by also identifying papers that are connected to the interventions (i.e., protocol papers, papers focused on different results of the same interventions), as well as accessing the interventions (applicable, if the intervention was accessible online). This approach enabled a comprehensive overview of how the interventions were created and presented to students. The following data was extracted from the interventions: design of the intervention (e.g., number of sessions, length of sessions, number of modules), content of intervention (e.g., which topics were included in the programs), and activities (e.g., quizzes, reflective writing, games, mood ratings, mindfulness exercises).
Expected Outcomes
From the 27 studies matching the criteria for inclusion we focused on 20 studies that showed significant effects of digital interventions. Specifically, 15 studies reported significant effects favouring the intervention group (between-group effects), 3 reported significant within-group effects but no between-group effects and 2 studies that incorporated an alternative intervention showed both conditions (digital intervention and alternative intervention) led to significant improvements in outcome measures with no between-group effects. In general, results showed that digital interventions differ according to content, design, and activities. For example, with regard to the design, interventions can range from a single-session digital intervention (Osborn et al., 2020) to a self-paced intervention with various modules in which students are free to choose activities (O’Dea et al., 2019). In terms of content, digital mental health interventions focused on various topics, such as mindfulness, problem-solving, goal-setting and skills development. Based on these results, recommendations for developing our own digital mental health intervention for students aged 12 to 15 years (target group in me_HeLi-D) are formulated (e.g. Digital mental health programs should include elements of gamification in order to engage, motivate and capture the attention of students in supporting their learning). In the presentation, these recommendations will be presented as key take-aways that researchers and developers are encouraged to keep in mind when developing digital interventions that will be formally evaluated. In the me_HeLi-D project, the recommendations will be further assessed with input from students in an iterative content and design development process (Thabrew et al., 2018) in order to tailor the digital intervention to the needs and preferences of the relevant stakeholders (i.e. adolescents).
References
Barker, G. (2007). Adolescents, social support and help-seeking behaviour. World Health Organization. https://apps.who.int/iris/handle/10665/254500 Domhardt, M. et al. (2021). Mobile-based interventions for common mental disorders in youth: A systematic evaluation of pediatric health apps. Child and Adolescent Psychiatry and Mental Health, 15(1), 49. Gibb, S. J. et al. (2010). Burden of psychiatric disorder in young adulthood and life outcomes at age 30. British Journal of Psychiatry, 197(2), 122–127. https://doi.org/10.1192/bjp.bp.109.076570 Gibson, K., & Trnka, S. (2020). Young people’s priorities for support on social media: “It takes trust to talk about these issues.” Computers in Human Behavior, 102, 238–247. Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231–243. Kaess, M. et al. (2021). Editorial Perspective: A plea for the sustained implementation of digital interventions for young people with mental health problems in the light of the COVID‐19 pandemic. Journal of Child Psychology and Psychiatry, 62(7), 916–918. Kim-Cohen, J. et al. (2003). Prior Juvenile Diagnoses in Adults With Mental Disorder: Developmental Follow-Back of a Prospective-Longitudinal Cohort. Archives of General Psychiatry, 60(7), 709. O’Dea, B. et al (2019). Evaluating a Web-Based Mental Health Service for Secondary School Students in Australia: Protocol for a Cluster Randomized Controlled Trial. JMIR Research Protocols, 8(5), e12892. Osborn, T. L. et al. (2020). Single-Session Digital Intervention for Adolescent Depression, Anxiety, and Well-Being: Outcomes of a Randomized Controlled Trial With Kenyan Adolescents. Ravens-Sieberer, U. et al. (2022). Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. European Child & Adolescent Psychiatry, 31(6), 879–889. Slater, A., & Bremner, J. G. (Eds.). (2017). An introduction to developmental psychology (Third edition). John Wiley & Sons Inc. Thabrew, H. et al. (2018). Co-design of eHealth Interventions With Children and Young People. Frontiers in Psychiatry, 9, 481. Torous, J. et al. (2019). Towards a consensus around standards for smartphone apps and digital mental health. World Psychiatry, 18(1), 97–98. UNICEF (Ed.). (2017). Children in a digital world. UNICEF. WHO. (2021). Adolescent mental health. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health Wright, M. et al. (in press). Interventions With Digital Tools for Mental Health Promotion Among 11-18 Year Olds: A Systematic Review and Meta-Analysis. Journal of Youth and Adolescence.
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