The impact of technology systems and professional support in digital mental health interventions: a secondary meta-analysis

BackgroundA rapid review of systematic reviews was conducted to assess the effectiveness of digital mental health interventions for people with a chronic disease. Although it provided an overview of the evidence, it offered limited understanding of ethe types of interventions that were the most effective. The aim of this study was to perform a meta-analysis of primary studies identified in this rapid review of systematic reviews by focusing on the needs of knowledge users. MethodsThis secondary meta-analysis follows a rapid review of systematic reviews, a virtual workshop with knowledge users to identify research questions and a modified Delphi study to guide research methods. We conducted a secondary analysis of the primary studies identified in the rapid review. Two reviewers independently screened the titles and abstracts and applied inclusion criteria: RCT design using a digital mental health intervention in a population of adults with another chronic condition, published after 2010 in French or English, and including an outcome measurement of anxiety or depression. Results708 primary studies were extracted from the systematic reviews and 84 primary studies met the inclusion criteria Digital mental health interventions were significantly more effective than in-person care for both anxiety and depression outcomes. Online messaging was the most effective technology to improve anxiety and depression scores; however, all technology types were effective. Interventions partially supported by healthcare professionals were more effective than self-administered. ConclusionsWhile our meta-analysis identifies digital interventions characteristics that are more effective, all technologies and levels of support can be used considering implementation context and population. Review registrationThe protocol for this review is registered in the National Collaborating Centre for Methods and Tools (NCCMT) COVID-19 Rapid Evidence Service (ID 75).