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Quality Social Connection as an 'Active Ingredient' in Digital Interventions for Young People With Depression and Anxiety: A Systematic Scoping Review and Meta-Analysis

51 Pages Posted: 2 Dec 2020

See all articles by Lindsay Helen Dewa

Lindsay Helen Dewa

Imperial College London - Imperial NIHR Patient Safety Translational Research Centre

Emma L. Lawrance

Imperial College London - Institute of Global Health Innovation

Lily F. Roberts

Imperial College London - Institute of Global Health Innovation

Ellie Brooks-Hall

Person With Lived Experience

Hutan Ashrafian

Imperial College London - Institute of Global Health Innovation; Imperial College London - Department of Surgery and Cancer

Gianluca Fontana

Imperial College London - Institute of Global Health Innovation

Paul Aylin

Imperial College London - Imperial NIHR Patient Safety Translational Research Centre

More...

Abstract

Background: A quality social connection (QSC) can influence outcomes in mental health support. Digital interventions may modify this influence, although conceptualisation and evidence on psychiatric outcomes is limited. We aimed to conceptualise and appraise evidence on digital QSC (D-QSC) for young people. 

Methods: Systematic scoping review and meta-analysis, with embedded stakeholder involvement, searching healthcare databases, websites and the grey literature. We included studies that explored QSC within a digital intervention as part of the prevention or treatment of depression and/or anxiety in 14-24-year olds. 

Findings: 5714 publications were identified and 42 were included. Of these, there were 23,319 participants. D-QSC translated into a five-component conceptual framework: Rapport, Identity and commonality, Valued interpersonal dynamic, Engagement and Responded to and accepted (RIVER). There was 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). Heterogeneity was high. Literature and stakeholder evidence showcased D-QSC’s importance in the prevention and treatment of depression, though evidence was weaker for anxiety. Stakeholder insights highlighted that demographic, dynamic and environmental factors, including blended care, may influence D-QSC experiences and outcomes. 

Interpretation: D-QSC is an important and under-considered component for depression and anxiety outcomes. Whilst more research is required, the RIVER conceptual framework can inform standardised measures for D-QSC. These measures can be used in the development and evaluation of digital interventions for mental health, particularly during the COVID-19 pandemic, where necessary support will be increasingly provided in online spaces. 

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.

Declaration of Interests: No competing interest to declare.

Ethics Approval Statement: The authors noted that ethical approval was not required.

Suggested Citation

Dewa, Lindsay Helen and Lawrance, Emma L. and Roberts, Lily F. and Brooks-Hall, Ellie and Ashrafian, Hutan and Fontana, Gianluca and Aylin, Paul, Quality Social Connection as an 'Active Ingredient' in Digital Interventions for Young People With Depression and Anxiety: A Systematic Scoping Review and Meta-Analysis. TLDIGITALHEALTH-D-20-00975, Available at SSRN: https://ssrn.com/abstract=3730021 or http://dx.doi.org/10.2139/ssrn.3730021

Lindsay Helen Dewa (Contact Author)

Imperial College London - Imperial NIHR Patient Safety Translational Research Centre ( email )

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

Emma L. Lawrance

Imperial College London - Institute of Global Health Innovation ( email )

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

Lily F. Roberts

Imperial College London - Institute of Global Health Innovation ( email )

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

Ellie Brooks-Hall

Person With Lived Experience ( email )

Hutan Ashrafian

Imperial College London - Institute of Global Health Innovation

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

Imperial College London - Department of Surgery and Cancer

Praed Street
London, NW1 1SQ
United Kingdom

Gianluca Fontana

Imperial College London - Institute of Global Health Innovation

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

Paul Aylin

Imperial College London - Imperial NIHR Patient Safety Translational Research Centre ( email )

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

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