Effectiveness of Online Interventions for the Universal and Selective Prevention of Mental Health Problems Among Adolescents: a Systematic Review and Meta-Analysis
Open accessAbstract
With the emergence of the coronavirus disease 2019 pandemic as a threat to mental health, the demand for online interventions that can replace face-to-face approaches for the prevention of mental health problems is increasing. Although several previous reviews on online interventions have targeted adolescents with symptoms of or those diagnosed with mental illness, there is still a lack of evidence on the effectiveness of online preventive interventions for general and at-risk adolescents. Therefore, this review aimed to evaluate the effectiveness of online interventions on the prevention of an increase in the scores of stress, anxiety, and depression in general and at-risk adolescents. A search was performed using PubMed, EMBASE, and Cochrane Library CENTRAL. Altogether, 19 studies were included, and 16 studies were used for the meta-analysis. Our results showed that cognitive behavioral therapy and family-based interventions were most commonly used. Twelve and seven studies conducted universal and selective preventive interventions, respectively. The meta-analysis showed that online interventions significantly prevent an increase in depression score but not in stress and anxiety scores. Evidence regarding the prevention of increases in stress and anxiety scores is limited, suggesting the need for further randomized controlled trials on online interventions for stress and anxiety in adolescents.
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Meta-analyses focusing on Internet-delivered prevention reported small significant effects on subclinical symptoms, generally smaller or insignificant for adolescents compared to adults.
“Meta-analyses with a specific focus on Internet-delivered prevention reported small significant effects on subclinical symptoms [45, 61–63], which were generally smaller or even insignificant for adolescents compared to adults [62].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [45]
The Discussion (page unavailable) reports a smaller effect on depression scores in this adolescent prevention review than in two earlier reviews, and a nonsignificant anxiety effect where those reviews found significant effects. But it describes the earlier reviews as involving children and adolescents with symptoms or diagnoses—not adults—so it does not support the claimed adolescent-versus-adult comparison. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMost studies in adolescents so far have focused on subthreshold depression and could not show any significant reductions in anxiety and stress.
“Furthermore, RCTs on Internet-delivered interventions for a broad range of subclinical symptoms are needed as most studies in adolescents so far have focused on subthreshold depression and could not show any significant reductions in anxiety and stress [45].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [45]
The Results (Effects of Online Interventions on Stress, Anxiety, and Depression; page not supplied) report no significant intervention–control differences in the pooled stress and anxiety scores. The Study Characteristics report that depression was assessed more often than anxiety or stress, but do not establish that most studies focused on subthreshold depression. The null findings are pooled results, not a finding that no individual study showed a significant reduction. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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A Digital Behavioral Health Game for Adolescent Mental Health
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- Authors
- Noh, D., & Kim, H.
- Affiliations
- Eulji University (KR)
- Chosun University (KR)
- Corresponding author
- Noh, Dabok
- Venue
- Prevention Science
- Published
- 2022-10-01
- Volume
- 24
- Issue
- 2
- Pages
- 353-364
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC9525943
- OpenAlex
- W4298326594
- Cited by
- 24
- References
- 39
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 9 · 2023: 1
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Prevention Science (publishedVersion, public-domain)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Research Foundation of Korea (NRF-2018R1C1B5041097)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- online intervention, mental health prevention, adolescents, universal prevention, selective prevention, depression prevention, anxiety prevention, stress prevention, cognitive behavioral therapy, family intervention, COVID-19 pandemic, at-risk youth
- MeSH terms
- Internet-Based Intervention, COVID-19, Adolescent, Anxiety, Anxiety Disorders, Humans, Mental Health
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