Background: Accumulating evidence suggests the COVID-19 pandemic has negative effects on public mental health. Digital interventions that have been developed and evaluated in recent years may be used to mitigate the negative consequences of the pandemic. However, evidence-based recommendations on the use of existing telemedicine and internet-based (eHealth) and app-based mobile health (mHealth) interventions are lacking.
Objective: The aim of this study was to investigate the theoretical and empirical base, user perspective, safety, effectiveness, and cost-effectiveness of digital interventions related to public mental health provision (ie, mental health promotion, prevention, and treatment of mental disorders) that may help to reduce the consequences of the COVID-19 pandemic.
Methods: A rapid meta-review was conducted. The MEDLINE, PsycINFO, and CENTRAL databases were searched on May 11, 2020. Study inclusion criteria were broad and considered systematic reviews and meta-analyses that investigated digital tools for health promotion, prevention, or treatment of mental health conditions and determinants likely affected by the COVID-19 pandemic.
Results: Overall, 815 peer-reviewed systematic reviews and meta-analyses were identified, of which 83 met the inclusion criteria. Our findings suggest that there is good evidence on the usability, safety, acceptance/satisfaction, and effectiveness of eHealth interventions. Evidence on mHealth apps is promising, especially if social components (eg, blended care) and strategies to promote adherence are incorporated. Although most digital interventions focus on the prevention or treatment of mental disorders, there is some evidence on mental health promotion. However, evidence on process quality, cost-effectiveness, and long-term effects is very limited.
Conclusions: There is evidence that digital interventions are particularly suited to mitigating psychosocial consequences at the population level. In times of physical distancing, quarantine, and restrictions on social contacts, decision makers should develop digital strategies for continued mental health care and invest time and efforts in the development and implementation of mental health promotion and prevention programs.

/pdf/evidence-synthesis-of-digital-interventions-to-mitigate-the-4e3gw2c5t7.pdf

Evidence Synthesis of Digital Interventions to Mitigate the Negative Impact of the COVID-19 Pandemic on Public Mental Health: Rapid Meta-review.

BACKGROUND
Digital interventions typically involve using smartphones or PCs to access online or downloadable self-help and may offer a more accessible and convenient option than face-to-face interventions for some people with mild to moderate eating disorders. They have been shown to substantially reduce eating disorder symptoms, but treatment dropout rates are higher than for face-to-face interventions. We need to understand user experiences and preferences for digital interventions to support the design and development of user-centered digital interventions that are engaging and meet users' needs.


OBJECTIVE
This study aims to understand user experiences and user preferences for digital interventions that aim to reduce mild to moderate eating disorder symptoms in adults.


METHODS
We conducted a metasynthesis of qualitative studies. We searched 6 databases for published and unpublished literature from 2013 to 2024. We searched for studies conducted in naturalistic or outpatient settings, using primarily unguided digital self-help interventions designed to reduce eating disorder symptoms in adults with mild to moderate eating disorders. We conducted a thematic synthesis using line-by-line coding of the results and findings from each study to generate themes.


RESULTS
A total of 8 studies were included after screening 3695 search results. Overall, 7 metathemes were identified. The identified metathemes included the appeal of digital interventions, role of digital interventions in treatment, value of support in treatment, communication at the right level, importance of engagement, shaping knowledge to improve eating disorder behaviors, and design of the digital intervention. Users had positive experiences with digital interventions and perceived them as helpful for self-reflection and mindfulness. Users found digital interventions to be convenient and flexible and that they fit with their lifestyle. Overall, users noticed reduced eating disorder thoughts and behaviors. However, digital interventions were not generally perceived as a sufficient treatment that could replace traditional face-to-face treatment. Users have individual needs, so an ideal intervention would offer personalized content and functions.


CONCLUSIONS
Users found digital interventions for eating disorders practical and effective but stressed the need for interventions to address the full range of symptoms, severity, and individual needs. Future digital interventions should be cocreated with users and offer more personalization. Further research is needed to determine the appropriate balance of professional and peer support and whether these interventions should serve as the first step in the stepped care model.


TRIAL REGISTRATION
PROSPERO CRD42023426932; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=426932.

User Experiences and Preferences of Self-Guided Digital Interventions for the Treatment of Mild to Moderate Eating Disorders: A Systematic Review and Meta-Synthesis (Preprint)

Teenage pregnancy is an important issue; adolescence is associated with various challenges and changes, as a result, pregnant adolescents have fewer cognitive, emotional, and social resources to meet the challenges of pregnancy. Stress and distress are often associated with these challenges and many adolescents lack the coping strategies to manage them. Research suggests that stress during pregnancy can have a significant impact on the wellbeing of both mother and child. E-health interventions are being used more frequently to support adolescents with their challenges however, only a small number of these are aimed at pregnant adolescents. Psychosocial interventions for pregnant adolescents have been developed and evaluated, and most of them aim to provide social support, access to professionals and pregnancy related resources. Psychosocial interventions targeting adolescents in general often focus on improving or maintaining their emotional and social wellbeing. E-health interventions are a relatively new yet highly successful mode of support for teenagers as they are easily accessible, less time consuming, inexpensive and therefore more widely available than face to face interventions. ‘Positively Pregnant’ is an E-health intervention using a resilience-focussed model to improve the wellbeing of pregnant women. The purpose of this study was to introduce the ‘Positively Pregnant app’ to pregnant adolescents and professionals working alongside them, to gain their feedback on how we might tailor the app to the needs of pregnant adolescents. Three professionals working alongside pregnant adolescents were recruited through email and social media. One parenting teen and one pregnant teen were

Teen pregnancy: Tailoring a pregnancy app to the needs of pregnant adolescents

<sec> <title>BACKGROUND</title> Digital interventions typically involve using smartphones or personal computers to access online or downloadable self-help, and may offer a more accessible and convenient option than face-to-face for some people with mild to moderate eating disorders. They have been shown to reduce eating disorder symptoms significantly, but treatment dropout rates can be high. We need to understand user experiences and preferences for digital interventions to support the design and development of user-centred digital interventions which are engaging and meet users’ needs. Objective: To understand user experiences and user preferences for digital interventions that aim to reduce mild to moderate eating disorder symptoms in adults. </sec> <sec> <title>OBJECTIVE</title> To understand user experiences and user preferences for digital interventions that aim to reduce mild to moderate eating disorder symptoms in adults. </sec> <sec> <title>METHODS</title> We conducted a meta-synthesis of qualitative studies. We searched six databases for published and unpublished literature from 2013 to 2023. We searched for studies conducted in naturalistic or outpatient settings, using primarily unguided digital self-help interventions designed to reduce eating disorder symptoms in adults with mild to moderate eating disorders. We conducted a thematic synthesis using line-by-line coding of the results and findings from each study to generate themes. </sec> <sec> <title>RESULTS</title> Eight studies were included after screening 2,435 search results. Eight meta-themes were identified. Meta-themes include (1) Appeal of digital interventions, (2) Role of digital interventions in treatment, (3) Value of support in treatment, (4) Communication at the right level, (5) Importance of engagement, (6) Flexibility of digital interventions, (7) Shaping knowledge to improve eating disorder behaviours, and (8) Design of the digital intervention. Users had positive experiences with digital interventions and perceived them as helpful for self-reflection and mindfulness. Users found digital interventions to be convenient and flexible to fit with their lifestyle. Overall, users noticed reduced eating disorder thoughts and behaviours. However, digital interventions were not generally perceived as a sufficient treatment that could replace traditional face-to-face treatment. Users have individual needs, so an ideal intervention would offer personalised content and functions. Users preferred an intervention that offered diary functions to log their food, moods and binges as these supported engagement. </sec> <sec> <title>CONCLUSIONS</title> Users found digital interventions for eating disorders to be a practical and effective method of intervention. However, users emphasised the importance of an intervention that recognises the range of eating disorder symptoms and severity and meets their language, lifestyle and engagement needs. An ideal intervention would allow users to tailor content, functions, appearance, and format of content. Increased personalisation may increase adherence to digital interventions for people with mild to moderate eating disorders. Future studies should investigate more diverse samples and include populations that are often overlooked in mental health research (for example, older adults and men). Future studies may also investigate the use of artificial intelligence and machine learning to further improve digital interventions. </sec> <sec> <title>CLINICALTRIAL</title> PROSPERO (CRD42023426932) </sec> 

A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions

Aims To review the effectiveness of e-mediated therapies and computer applications for children and young people (CYP) with mental health (MH) problems. To conduct focus groups eliciting service users views on computer-based applications. This work is part of a DH-commissioned website which will provide e-learning to people assisting CYP with MH problems, overseen by the MindEd Consortium at RCPCH. Methods Medical, psychological/sociological, educational and grey literature databases were searched for randomised controlled trials of interventions for MH problems in CYP, either through remote therapist contact (e-mediated therapy) or computer-based applications. Studies were included if the mean age of participants was Results The review included studies of e-mediated and computer-based therapies for anxiety and depression (N=26), phobia (N=2), OCD (N=2), PTSD (N=1), eating disorders (N=6), ADHD (N=10), conduct disorder (N=2), substance misuse (N=11), autism (N=1), Tourette syndrome (N=1) and psychosis (N=1). Based on the GRADE system, the evidence was predominantly low quality with limited data, inadequate study design and unreliable outcome measures being major contributors to downgrading. The strongest evidence was for cCBT programs for depression in adolescents, and there was some promise for cCBT programs for anxiety in adolescents. The focus groups identified several key issues, including: the need for products to be engaging and up-to-date; the desire to set own goals; being active in therapy; continued contact with therapists; and the importance of endorsement by professionals. Conclusions Computer-based applications such as cCBT show promise and e-mediated strategies are potentially useful. In the provision and development of new products, input is needed from specialists in software design as well as psychology, with consideration given to the software’s technological suitability, therapeutic benefit and acceptability, as well as individual autonomy and integration with MH services. There should be continued robust evaluation of the evidence for effectiveness and cost effectiveness.

https://adc.bmj.com/content/archdischild/99/Suppl_1/A58.1.full.pdf

G130 E-therapies for mental health problems in children and young people: A systematic review and focus group investigation

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G130 E-therapies for mental health problems in children and young people: A systematic review and focus group investigation