| 其他摘要 | Anxiety disorder is highly prevalent in adolescents and greatly affects adolescents’ mental health. It has become a social problem that should not be underestimated. Digital Intervention is a newly emerged psychological intervention. Evidence-based research indicated that it could reduce adolescent anxiety, however, related research on the effectiveness and the influencing factors is not sufficient. In China, the research of digital intervention is still at early stage. Based on this, we conducted this study.
We conducted a meta-analysis as study one to systematically search Pubmed, APA PsycInfo, Science Direct, Web of Science, Scopus, The Cochrane Library, China Knowledge Network Full Text Database (CNKI), WanFang Data and CQVIP database from database inception to October 2022. Randomized controlled trials were included to compare the post intervention mean and standard deviation of the intervention and control groups, and the pooled effect size (Hedges g) was calculated to analyze the effect of the intervention group compared with the control group on anxiety in adolescents. The meta-analysis was conducted using Review Manager version 5.3 software and the quality of the included literature was assessed using the Cochrane Risk of Bias tool (version 2.0). The meta-analysis also performed subgroup analyses to explore influential factors associated with effect. Study one included 29 randomized controlled trials. Results showed that the immediate effect of the digital intervention was significant in reducing adolescent anxiety symptoms, the follow-up effect was not significant, indicating that the effect could not be maintained over time. Therapist assistance, parental involvement, dropout rate of the intervention, intervention type, the intervention therapy basis and number of times the intervention was delivered were the influencing factors for the effectiveness of the digital intervention, while whether the psychological problems targeted by the intervention and the place where the intervention was delivered were influencing factors was not confirmed.
In study two we conducted a Delphi analysis. We designed an expert questionnaire based on existing literature to inquire experts about issues not covered or not explored thoroughly in study one, such as intervention therapies, intervention techniques, and intervention design factors, and the implementation factors for the interventions. We also consult experts on the issues that need to be considered when conducting digital interventions for adolescent anxiety in China. After two rounds of inquiry, the factors and indicators were consolidated based on the experts' feedback. Results showed that the authority coefficient of the experts and the Kendall's coordination coefficient in both rounds meet the requirements. After two rounds of expert inquiry, the overall effectiveness of the intervention was agreed by the experts. The importance of therapies, techniques, and design factors on the efficacy of the digital intervention were agreed by the experts; however, the importance of some implementation factors on the efficacy of the digital intervention were not agreed by the experts. The Delphi method study showed that the top three therapies for digital interventions for adolescent anxiety were cognitive behavioral therapy, problem-solving therapy, and interpersonal therapy, etc.; the top five techniques for interventions were cognitive restructuring, interpersonal communication skills and training, emotion identification and management, homework, and communicating the goals of the intervention, etc.; and the top three design factors were accessibility design, interactivity design, and fun design.
This study investigated the effectiveness and the influencing factors for effectiveness of digital interventions for adolescent anxiety. At the same time, the factors should be considered for conducting digital interventions for adolescent anxiety in China are also discussed in this study. |
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