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Cited by 252Child and Adolescent Psychosocial and Emotional DevelopmentSchool Health and Nursing EducationStudent Stress and Coping

A systematic review and meta-analysis of school-based stress, anxiety, and depression prevention programs for adolescents

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Feiss, Robyn, Dolinger, Sarah Beth, Merritt, Monaye, Reiche, Elaine, Martin, Karley, Yanes, Julio A., Thomas, Chippewa M., Pangelinan, Melissa·2019·Journal of Youth and Adolescence
DOI 10.1007/s10964-019-01085-0PMC PMC7548227
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Abstract

Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11-18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.

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  • Feiss et al. (2019) found that universal and targeted interventions were both effective at significantly reducing anxiety, however universal interventions were more effective in a higher dose of the intervention whereas targeted interventions were not affected by dose.

    “Feiss et al. (2019) examined the outcomes of both universal and targeted interventions for depression, anxiety and stress. It was found that uni­ versal and targeted interventions were both effective at significantly reducing anxiety, however universal interventions were more effective in a higher dose of the intervention whereas targeted interventions were not affected by dose.”

    From Acceptance and commitment therapy interventions in secondary schools and their impact on students' mental health and well-being: A systematic review (2022) · cites this paper as Feiss et al., 2019

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  • Feiss et al. (2019) found that targeted interventions were more effective for both depression and stress than universal interventions, however only significant results for depression were found.

    “Targeted interventions were more effective for both depression and stress than universal interventions, however only significant results for depression were found.”

    From Acceptance and commitment therapy interventions in secondary schools and their impact on students' mental health and well-being: A systematic review (2022) · cites this paper as Feiss et al., 2019

    The Results sections report greater reductions with targeted than universal programs for both depression and stress. The claim’s significance qualifier is misleading: the stress meta-regression found a significant effect of program type (p < 0.001), although stress interventions overall did not significantly outperform controls (p = 0.73). Depression interventions overall did significantly outperform controls (p < 0.01). (LLM, conf=0.85)

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  • In Feiss et al. (2019), none of the benefits were maintained at follow up for either intervention type.

    “In this study, none of the benefits were maintained at follow up for either intervention type.”

    From Acceptance and commitment therapy interventions in secondary schools and their impact on students' mental health and well-being: A systematic review (2022) · cites this paper as Feiss et al., 2019

  • Previous research demonstrates higher levels of effectiveness for targeted compared to universal school-based interventions.

    “This finding aligns with previous research that demon­ strates higher levels of effectiveness for targeted compared to universal school-based interventions (Corrieri et al., 2014; Feiss et al., 2019; Werner-Seidler et al., 2017).”

    From Acceptance and commitment therapy interventions in secondary schools and their impact on students' mental health and well-being: A systematic review (2022) · cites this paper as Feiss et al., 2019

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Research works printed but not linked: 5

  1. Eccles JS, & Gootman JA (2002). Community programs to promote youth development. Washington D.C.: National Academy Press.
  2. Moher D, Liberati A, Tetzlaff J, & Altman DG, The PRISMA Group. (2009). Systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6(7), e1000097 10.1371/journal.pmed1000097. 19621072 PMC2707599 · DOI
  3. Noel LT, Rost K, & Gromer J (2013). Depression prevention among rural preadolescent girls: a randomized controlled trial. School Social Work Journal, 38(1), 1– 18.
  4. Reeves B, Deeks J, Higgins J, & Wells G (2011). Chapter 13: Including non-randomised studies In Higgins J & Green S (Eds), Cochrane handbook for systematic reviews of interventions (Version 5). The Cochrane Collaboration.
  5. Schünemann HJ, Oxman AD, Higgins JPT, Vist GE, Glasziou P, Akl E, & Guyatt GH (2017). Chapter 11: Completing ‘summary of findings’ tables and grading the confidence in or quality of the evidence In Higgins J, Churchill R, Chandler J, & Crumpston M (Eds), Cochrane handbook for systematic reviews of interventions (Version 5). The Cochrane Collaboration.

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Authors
Feiss, R., Dolinger, S. B., Merritt, M., Reiche, E., Martin, K., Yanes, J. A., Thomas, C. M., & Pangelinan, M.
Affiliations
Auburn University (US)
Corresponding author
Feiss, Robyn
ORCID
Venue
Journal of Youth and Adolescence
Publisher
Springer Science and Business Media LLC
Published
2019-07-26
Volume
48
Issue
9
Pages
1668-1685
ISSN
  • 0047-2891 (ISSN-L)
  • 1573-6601
DOI
10.1007/s10964-019-01085-0
PMC
PMC7548227
OpenAlex
W2966427219
Cited by
252
References
87
Citations by year
2026: 39 · 2025: 37 · 2024: 48 · 2023: 58 · 2022: 40 · 2021: 21 · 2020: 9
FWCI
2.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Youth and Adolescence (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (F31DA044013)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
Keywords
school-based prevention, adolescent mental health, stress, anxiety, depression, internalizing problems, targeted interventions, universal interventions, intervention effectiveness, long-term intervention effects
MeSH terms
Adolescent, Anxiety, Child, Depression, Female, Humans, Male, Primary Prevention, School Health Services, Stress, Psychological, Students, Program Evaluation

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