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Meta-Analysis
. 2019 Sep;48(9):1668-1685.
doi: 10.1007/s10964-019-01085-0. Epub 2019 Jul 26.

A Systematic Review and Meta-Analysis of School-Based Stress, Anxiety, and Depression Prevention Programs for Adolescents

Robyn Feiss  1 , Sarah Beth Dolinger  2 , Monaye Merritt  2 , Elaine Reiche  2 , Karley Martin  2 , Julio A Yanes  3   4 , Chippewa M Thomas  5   6 , Melissa Pangelinan  2
Affiliations
Meta-Analysis

A Systematic Review and Meta-Analysis of School-Based Stress, Anxiety, and Depression Prevention Programs for Adolescents

Robyn Feiss et al. J Youth Adolesc. 2019 Sep.

Abstract

Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11-18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.

Keywords: Anxiety; Depression; Health policy; Meta-analysis; Stress.

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Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The PRISMA flowchart of the article selection process
Fig. 2
Fig. 2
Risk of bias summary graph
Fig. 3
Fig. 3
Risk of bias summary chart including judgements regarding risk of bias for all five domains of the RoB2 and the overall risk for each included study
Fig. 4
Fig. 4
Forrest plot of effect sizes for comparisons between intervention and control groups on changes in stress symptoms immediately post-intervention
Fig. 5
Fig. 5
Forrest plot of effect sizes for comparisons between intervention and control groups on changes in anxiety symptoms immediately post-intervention
Fig. 6
Fig. 6
Forrest plot of effect sizes for comparisons between intervention and control groups on changes in depressive symptoms using the BDI, BDI-II, BYI-II, CDI, CDI-S, MFQ, or SMFQ immediately post-intervention
Fig. 7
Fig. 7
Forrest plot of effect sizes for comparisons between intervention and control groups on changes in depressive symptoms using the BASC-2, BSI, CDRS, CES-D, CGAS, K-SADS, RADS, RADS-2, or YSR immediately post-intervention
See this image and copyright information in PMC

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