Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation
Open accessAbstract
BACKGROUND: Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers. OBJECTIVE: The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program? METHODS: Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score. RESULTS: The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms. CONCLUSIONS: There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool.
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Web- and mobile-based interventions are convenient to implement and not limited by time, venue, or transportation.
“First, web- and mobile-based interventions are convenient to implement and not limited by time, venue, or transportation.”
From Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial. (2023) · cites this paper as [18]
The Principal Findings say web-based interventions can be accessed at any time and from home, removing transportation barriers. The Conclusions also describe them as convenient for users. The paper does not establish these benefits for mobile-based interventions or say the programs are convenient to implement. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe framework used for the extraction tool has been used in 2 recent scoping reviews examining web-based interventions for depression and anxiety.
“This framework has been used in 2 recent scoping reviews examining web-based interventions for depression [15] and anxiety [16].”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [15]
Renton et al identified 32 web-based programs for depression, with only 12 having published evidence of efficacy.
“The review of programs for depression by Renton et al [15] identified 32 programs, with only 12 having published evidence of efficacy.”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [15]
Past reviews found that 50% of programs addressing anxiety had undergone empirical evaluation and 38% of programs addressing depression had been evaluated via an RCT (level II studies).
“This is similar to past reviews, which found that 50% of the programs addressing anxiety had undergone empirical evaluation [16], and 38% of programs addressing depression had been evaluated via an RCT (ie, level II studies) [15].”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [15]
The number of programs in this review is substantially lower than the 32 programs for depression and the 34 programs for anxiety identified by Renton et al and Ashford et al, respectively.
“This is substantially lower than the 32 programs for depression and the 34 programs for anxiety identified by Renton et al [15] and Ashford et al [16], respectively.”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [15]
The use of a scoring system to evaluate and compare programs was based on a framework for evaluating internet-based interventions, as adapted in subsequent research.
“The use of a scoring system to evaluate and compare programs was based on a framework for evaluating internet-based interventions [40], as adapted in subsequent research [15,16].”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [15]
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- Authors
- Renton, T., Tang, H., Ennis, N., Cusimano, M. D., Bhalerao, S., Schweizer, T. A., & Topolovec-Vranic, J.
- Affiliations
- St. Michael's Hospital (CA)
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2014-09-23
- Volume
- 16
- Issue
- 9
- Pages
- e209
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC4211022
- OpenAlex
- W2042424129
- Cited by
- 116
- References
- 53
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 9 · 2023: 14 · 2022: 7 · 2021: 15 · 2020: 11 · 2019: 13 · 2018: 10 · 2017: 12 · 2016: 12 · 2015: 6
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- other-oa
- Locations
- Journal of Medical Internet Research (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, online intervention, internet-delivered treatment, barriers to mental health care, accessibility (transport and spatial geography), usability, cognitive behavioral therapy, evidence-based programs, program evaluation, special populations, adolescents, older adults, military personnel, language access
- MeSH terms
- Depression, Health Services Accessibility, Humans, Language, Program Evaluation, Cognitive Behavioral Therapy, Program Development, Telemedicine, Internet
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