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Quality social connection as an active ingredient in digital interventions for young people with depression and anxiety: systematic scoping review and meta-analysis

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Title: Quality social connection as an active ingredient in digital interventions for young people with depression and anxiety: systematic scoping review and meta-analysis
Authors: Dewa, L
Lawrance, E
Roberts, L
Brooks-Hall, E
Ashrafian, H
Fontana, G
Aylin, P
Item Type: Journal Article
Abstract: Background Disrupted social connections may negatively impact youth mental health. In contrast, sustained quality social connections (QSC) can improve mental health outcomes. However, few studies have examined how these quality connections impact depression and anxiety outcomes within digital interventions, and conceptualisation is limited. Objective The study aim was to conceptualise, appraise and synthesise evidence on quality social connection within digital interventions (D-QSC) and the impact on depression and anxiety outcomes for young people (14-24). Methods A systematic scoping review and meta-analysis was conducted using the Johanna Briggs Institute methodological frameworks and guided by experts with lived experience. Reporting was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Medline, Embase, PsycInfo and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched against a comprehensive combination of key concepts on 24th June 2020. Search concepts included young people, digital intervention, depression/anxiety, and social connection. Google was also searched. One reviewer independently screened abstracts/titles and full-text and 10% were screened by a second reviewer. A narrative synthesis was used to structure findings on indicators of D-QSC and mechanisms that facilitate the connection. Indicators of D-QSC from included studies were synthesised to produce a conceptual framework. Results 5715 publications were identified and 42 were included. Of these, there were 23,319 participants. Indicators that D-QSC was present varied and included relatedness, having a sense of belonging and connecting to similar people. However, despite the variation, most of the indicators were associated with improved outcomes for depression and anxiety. Negative interactions, loneliness and feeling ignored indicated D-QSC was not present. In ten applicable studies, a meta-analysis showed a significant decrease in depression (-25.6%, 95% CI [-0.352, -0.160], p<0.0005) and anxiety (-15.1%, 95% CI [-0.251, -0.051], p<0.0005) following a D-QSC. Digital mechanisms that helped create a quality connection included anonymity, confidentiality and peer support. In contrast, mechanisms that hindered the connection included disconnection from the real world and inability to see body language. Data synthesis also identified a five-component conceptual framework of D-QSC that included Rapport, Identity and commonality, Valued interpersonal dynamic, Engagement, and Responded to and accepted, referred to as RIVER. Conclusions D-QSC is an important and under-considered component for youth depression and anxiety outcomes. Researchers and developers should consider targeting improved QSC between clinicians and young people within digital interventions for depression. Future research should build on our framework to further examine relationships between individual attributes of QSC, various digital interventions and different populations. Funding This work was funded by a Wellcome Trust Mental Health Priority Area 'Active Ingredients' commission awarded to Dr Lindsay Dewa at Imperial College London.
Issue Date: 17-Dec-2021
Date of Acceptance: 14-Oct-2021
URI: http://hdl.handle.net/10044/1/92716
DOI: 10.2196/26584
ISSN: 1438-8871
Publisher: JMIR Publications
Start Page: 1
End Page: 22
Journal / Book Title: Journal of Medical Internet Research
Volume: 23
Issue: 12
Copyright Statement: ¬©Lindsay H Dewa, Emma Lawrance, Lily Roberts, Ellie Brooks-Hall, Hutan Ashrafian, Gianluca Fontana, Paul Aylin. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 17.12.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
Sponsor/Funder: Wellcome Trust
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
mental health
digital interventions
young people
quality social connection
depression
anxiety
systematic review
meta-analysis
patient and public involvement
mobile phone
MENTAL-HEALTH
COLLEGE-STUDENTS
SUPPORT
ADOLESCENTS
INTERNET
COMMUNICATION
SYMPTOMS
NETWORKING
FACEBOOK
BEHAVIOR
anxiety
depression
digital interventions
mental health
meta-analysis
mobile phone
patient and public involvement
quality social connection
systematic review
young people
Adolescent
Anxiety
Anxiety Disorders
Depression
Humans
Loneliness
Mental Health
Humans
Depression
Anxiety
Loneliness
Mental Health
Anxiety Disorders
Adolescent
Medical Informatics
08 Information and Computing Sciences
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Publication Status: Published
Online Publication Date: 2021-12-17
Appears in Collections:Department of Surgery and Cancer
Department of Infectious Diseases
Faculty of Medicine
Institute of Global Health Innovation
School of Public Health



This item is licensed under a Creative Commons License Creative Commons