E Bethan Davies|Richard Morriss|Cris Glazebrook
Computer-Delivered and Web-Based Interventions to Improve Depression, Anxiety, and Psychological Well-Being of University Students: A Systematic Review and Meta-Analysis
Institute of Mental Health|University of Nottingham|Institute of Mental Health|University of Nottingham|Institute of Mental Health|University of Nottingham
depression anxiety common mental health difficulties experienced university students impair academic social functioning students limited seeking help professionals university students highly connected digital technologies webbased computerdelivered interventions could used improve students mental health effectiveness intervention types requires investigation identify whether viable prevention strategies university studentsthe intent study systematically review analyze trials webbased computerdelivered interventions improve depression anxiety psychological distress stress university studentsseveral databases searched using keywords relating higher education students mental health ehealth interventions eligibility criteria studies included review 1 study aimed improve symptoms relating depression anxiety psychological distress stress 2 study involved computerdelivered webbased interventions accessed via computer laptop tablet 3 study randomized controlled trial 4 study trialed higher education students trials reviewed outcome data analyzed random effects metaanalyses outcome type trial arm comparison cochrane collaboration risk bias tool used assess study qualitya total 17 trials identified seven three interventions separate samples 14 reported sufficient information metaanalysis majority n13 websitedelivered nine interventions based cognitive behavioral therapy cbt total 1795 participants randomized 1480 analyzed risk bias considered moderate many publications sufficiently report methods seven explicitly conducted completers analyses comparison inactive control sensitivity metaanalyses supported intervention improving anxiety pooled standardized mean difference smd 056 95 ci 077 035 p001 depression pooled smd 043 95 ci 063 022 p001 stress pooled smd 073 95 ci 127 019 p008 comparison active controls sensitivity analyses support either condition anxiety pooled smd 018 95 ci 098 062 p66 depression pooled smd 028 95 ci 075 020 p25 contrast comparison intervention neither condition supported sensitivity analyses anxiety pooled smd 010 95 ci 039 018 p48 depression pooled smd 033 95 ci 043 109 p40the findings suggest webbased computerdelivered interventions effective improving students depression anxiety stress outcomes compared inactive controls caution needed compared trial arms methodological issues noticeable interventions need trialed heterogeneous student samples would benefit user evaluation future trials address methodological considerations improve reporting trial quality address postintervention skewed data