Suzana Raquel Lopes Marques, Andrezza Gonzalez Escarce, Stela Maris Aguiar Lemos
Health literacy and self-rated health in adults primary care patients
CoDAS
efficacy effectiveness digital interventions depression wellestablished however precise effect size estimates mediators transmitting effects digital interventions available integrative insights specific mechanisms change internet mobilebased interventions imisas related key features like delivery type accompanying support theoretical foundationare largely pending conduct systematic review individual participant data metaanalysis ipdma evaluating mediators associated therapeutic change various imis depression adults use three electronic databases ie embase medlinepubmed psycinfo well already established database ipd identify relevant published unpublished studies include 1 randomized controlled trials examine 2 mediators 3 guided unguided 4 imis 5 various theoretical orientations 6 adults 7 clinically relevant symptoms depression 8 compared active passive control condition 9 depression symptom severity primary outcome study selection data extraction well quality risk bias rob assessment done independently two reviewers corresponding authors eligible primary studies invited share ipd metaanalytic study 1stage ipdma mediation analyses eg potential mediators like selfefficacy emotion regulation problem solving performed using multilevel structural equation modeling approach within randomeffects framework indirect effects estimated multiple imputation missing data overall model fit evaluated statistical heterogeneity assessed furthermore investigate indirect effects moderated different variables participant eg age sexgender symptom severity study eg quality studies evaluating temporal ordering changes mediators outcomes interventionlevel eg theoretical foundation delivery type guidance systematic review ipdma generate comprehensive information differential strength mediators associated therapeutic processes digital interventions depression findings might contribute empiricallyinformed advancement psychotherapeutic interventions leading effective interventions improved treatment outcomes digital mental health besides novel approach mediation analyses ipdma might also add methodological progression evidencesynthesis psychotherapy process research httpsosfiomd7pq