Effectiveness of just-in-time adaptive interventions for improving mental health and psychological well-being: a systematic review and meta-analysis
Open accessAbstract
Question: The rising prevalence of mental health conditions and a global treatment gap demand new solutions that address symptoms and foster psychological well-being. Just-in-time adaptive interventions (JITAIs) and ecological momentary interventions (EMIs) are emerging mobile health approaches, providing real-time, personalised support. However, the effectiveness of current JITAIs/EMIs and the longevity of effects remain uncertain. Study selection and analysis: Studies investigating the effectiveness of JITAIs/EMIs for depression, anxiety and indicators of psychological well-being, published between 2018 and May 2025, were eligible. Following the standards for reporting (Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PRISMA) and quality assessment (Risk of Bias; RoB), a total of K=23 studies and N=2563 individuals (71.7% female) were included. Findings: JITAIs/EMIs showed a small between-group effect (g=0.15, 95% CI 0.05 to 0.26, p=0.003). Nine studies reported follow-up effects (mean follow-up time M=3.06 months, SD=2.21) with significant results at 1 and 3–6 months. Interventions shorter than 6 weeks yielded greater longevity of effects (g=0.71, 95% CI 0.18 to 1.24, p=0.008). Funnel plots and sensitivity analyses confirmed robustness of findings. Risk of bias was moderate to high for intervention adherence and missing outcome data. Conclusions: Currently existing JITAIs and EMIs slightly improve mental health, particularly mental illness, with long-term effects up to 6 months. A clear definition of JITAIs and decision rules, research on long-term effects and careful selection of control conditions are needed.
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Flagged first, then by citations
- Authors
- von Lützow, U., Neuendorf, N. L., & Scherr, S.
- Affiliations
- Center for Interdisciplinary Health Research & Department of Media, Knowledge, and Communication, University of Augsburg, Augsburg, Germany
- University of Augsburg (DE)
- Venue
- BMJ Mental Health
- Publisher
- BMJ
- Published
- 2025-09
- Volume
- 28
- Issue
- 1
- Pages
- e301641
- ISSN
- 2755-9734 (ISSN-L)
- PMC
- PMC12481328
- OpenAlex
- W4414675723
- Cited by
- 29
- References
- 14
- Citations by year
- 2026: 27 · 2025: 2
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- BMJ Mental Health (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- just-in-time adaptive interventions, ecological momentary intervention, mobile health, depression, anxiety, psychological well-being, mental health, long-term effects, intervention duration, treatment gap
- MeSH terms
- Psychological Well-Being, Anxiety, Mental Disorders, Depression, Humans, Mental Health, Telemedicine
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