Efficacy of digital health interventions in youth with chronic medical conditions: A meta-analysis
Open accessAbstract
Digital health interventions might extend service provisions for youth with chronic medical conditions (CC) and comorbid mental health symptoms. We aimed to comprehensively evaluate the efficacy of Internet- and mobile-based interventions (IMIs) for different psychological and disease-related outcomes in children and adolescents with CC. Studies were identified by systematic searches in CENTRAL, Embase, MEDLINE/PubMed and PsycINFO, complemented by searches in reference lists of eligible studies and other reviews. We included studies, when they were randomized controlled trials (RCTs) comparing the efficacy of an IMI to control conditions in improving psychological and disease-related outcomes in youth (mean age ≤ 18 years) with CC. Study selection, data extraction and risk of bias assessment were conducted independently by two reviewers. Meta-analyses were performed within a random-effects model, and Hedges' g (with 95% confidence intervals) was calculated as effect size measure. Primary outcomes were comorbid mental health symptoms (i.e., depression, anxiety and stress), as well as quality of life and self-efficacy. A total of 19 randomized controlled trials (2410 patients) were included in this meta-analysis. IMIs were associated with improvements in self-efficacy (g = 0.38; 95% CI, 0.15 to 0.61; I2 = 0) and combined disease-related outcomes (g = −0.13; 95% CI, −0.25 to −0.01; I2 = 21). Meta-analyses on other outcomes were non-significant, and some pre-planned analyses were not feasible because of a shortage of studies. The available evidence on IMIs for improving mental and health-related outcomes in youth with CC is limited. Our findings point to a rather small benefit and limited efficacy. Future research is needed, to comprehensively assess the potential of IMIs to extend collaborative care, and to identify factors contributing to improved user-centered interventions with better treatment outcomes.
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Meta-analyses of studies focusing exclusively on internalizing symptoms showed limited methodological quality and indicate limited efficacy.
“These studies showed limited methodological quality and indicate limited efficacy [21, 22].”
From Feasibility and potential efficacy of a guided internet- and mobile-based CBT for adolescents and young adults with chronic medical conditions and comorbid depression or anxiety symptoms (youthCOACHCD): a randomized controlled pilot trial (2022) · cites this paper as [21]
The Discussion (page unavailable) reports predominantly non-significant intervention effects, supporting the limited-efficacy point for youth with chronic medical conditions. But the paper examines psychological and disease-related outcomes, not exclusively internalizing symptoms, and the Discussion describes the included studies as having “high overall quality.” (LLM, conf=0.88)
Experimental — accuracy not yet measuredOnly a few studies focus on the efficacy of internet- and mobile-based interventions targeting adolescents and young adults with a chronic condition and comorbid mental health disorders.
“However, only a few studies focus on the efficacy of IMI targeting AYA with a chronic condition and comorbid mental health disorders.”
From Feasibility and potential efficacy of a guided internet- and mobile-based CBT for adolescents and young adults with chronic medical conditions and comorbid depression or anxiety symptoms (youthCOACHCD): a randomized controlled pilot trial (2022) · cites this paper as [21]
The Introduction (page unavailable) describes the evidence on IMIs for youth with chronic conditions and comorbid mental health problems as fragmented, and the Discussion says some included interventions did not directly target mental health symptoms. This supports the claim that targeted efficacy research is limited. However, the paper’s eligibility criteria cover children and adolescents rather than young adults, and its 19 included trials did not all require comorbid mental health disorders. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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Digital interventions for the treatment of depression: a meta-analytic review
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“These studies showed limited methodological quality and indicate limited efficacy [21, 22].”
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“…et al., 2021; Verkleij et al., 2021), asthma (Bonnert et al., 2021) and coronary artery disease (Bendig et al., 2021) as well as chronic medical conditions in general (Domhardt et al., 2021b) in adults as well as youth (Domhardt et al., 2021b; Geirhos et al., 2021; Nap-van der Vlist et al., 2021).”
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- Authors
- Domhardt, M., Schröder, A., Geirhos, A., Steubl, L., & Baumeister, H.
- Affiliations
- Universität Ulm (DE)
- Corresponding author
- Domhardt, Matthias
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 24
- Pages
- 100373
- ISSN
- 2214-7829 (ISSN-L)
- PMC
- PMC7941178
- OpenAlex
- W3129218224
- Cited by
- 45
- References
- 90
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 8 · 2023: 10 · 2022: 10 · 2021: 5
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Bundesministerium für Bildung und Forschung (FKZ 01GL1740A, FKZ 01GL1740E)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- digital health interventions, online intervention, mobile health, chronic disease, children and adolescents, depression, anxiety, stress, quality of life, self-efficacy, collaborative care
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