Abstract
BackgroundThere is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcomes. However, the modes of delivery used to engage CYP in digital MH interventions may differ, with implications for the extent to which findings pertain to the level of engagement with the DHI. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible.ObjectiveThis review aimed to (1) identify modes of delivery used in CYP digital MH interventions, (2) explore influencing factors to usage and implementation, and (3) investigate ways in which the interventions have been evaluated and whether CYP engage in DHIs.MethodsA literature search was performed in the Cochrane Library, Excerpta Medica dataBASE (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and PsycINFO databases using 3 key concepts “child and adolescent mental health,” “digital intervention,” and “engagement.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least two reviewers. The selected articles were assessed for quality using the mixed methods appraisal tool, and data were extracted to address the review aims. Data aggregation and synthesis were conducted and presented as descriptive numerical summaries and a narrative synthesis, respectively.ResultsThis study identified 6 modes of delivery from 83 articles and 71 interventions for engaging CYP: (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. Overall, 2 themes emerged highlighting intervention-specific and person-specific barriers and facilitators to CYP’s engagement. These themes encompassed factors such as suitability, usability, and acceptability of the DHIs and motivation, capability, and opportunity for the CYP using DHIs. The literature highlighted that CYP prefer DHIs with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders. The findings of this review suggest a high average retention rate of 79% in studies involving various DHIs.ConclusionsThe development of DHIs is increasing and may be of interest to CYP, particularly in the area of MH treatment. With continuous technological advancements, it is important to know which modalities may increase engagement and help CYP who are facing MH problems. This review identified the existing modalities and highlighted the influencing factors from the perspective of CYP. This knowledge provides information that can be used to design and evaluate new interventions and offers important theoretical insights into how and why CYP engage in DHIs.
Highlights
Prevalence of Mental Health Problems in Children and Young People Mental health (MH) problems in childhood and adolescence are of great importance because of their prevalence, early onset, and impact on different areas of the child’s life [1]
The literature highlighted that children and young people (CYP) prefer digital health intervention mental health (MH) (DHI) with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders
Recent meta-analyses highlighted the potential effectiveness of children and young people’s mental health (CYPMH) DHIs [17,18,45], this review aimed to present information that might be of use in the development of real-world interventions that are more likely to increase engagement from CYP
Summary
Prevalence of Mental Health Problems in Children and Young People Mental health (MH) problems in childhood and adolescence are of great importance because of their prevalence, early onset, and impact on different areas of the child’s life [1]. The number of children and young people (CYP) who experience MH problems ranges from 10% to 20% worldwide [2]. An international study conducted in 27 countries estimated the worldwide pooled prevalence of MH problems to be 13.4% among CYP [3]. Estimates further suggest that approximately 1 in every 3 adolescents will meet the criteria for anxiety and depressive disorders [2], while 1 in 4 young people aged 16 to 24 years has experienced at least one MH problem in the past year [3]. There is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible
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