Preventive digital mental health interventions for children and young people: a review of the design and reporting of research

Aislinn D Bergin^{1

2}, Elvira Perez Vallejos², E Bethan Davies^{1

2}, David Daley^{1

3

4}, Tamsin Ford⁵, Gordon Harold^{6

7

8}, Sarah Hetrick^{9

10}, Megan Kidner¹¹, Yunfei Long^{12

13}, Sally Merry⁹, Richard Morriss^{1

2

3

14}, Kapil Sayal^{3

4

14}, Edmund Sonuga-Barke^{15

16}, Jo Robinson^{10

17}, John Torous¹⁸, Chris Hollis^{1

2

14}

Affiliations

¹ NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
² NIHR Nottingham Biomedical Research Centre, Mental Health and Technology Theme, University of Nottingham, Nottingham, UK.
³ Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
⁴ Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
⁵ Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁶ Faculty of Education, University of Cambridge, Cambridge, UK.
⁷ MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
⁸ School of Psychology, Trinity College Dublin, Dublin, Ireland.
⁹ Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand.
¹⁰ Orygen, University of Melbourne, Parkville, Australia.
¹¹ The Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK.
¹² Horizon Digital Economy Research Institute, University of Nottingham, Nottingham, UK.
¹³ School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK.
¹⁴ NIHR Applied Research Centre East Midlands, Nottingham, UK.
¹⁵ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹⁶ Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark.
¹⁷ Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.
¹⁸ Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA.

PMID: 33083568
PMCID: PMC7562906
DOI: 10.1038/s41746-020-00339-7

Review

Preventive digital mental health interventions for children and young people: a review of the design and reporting of research

Aislinn D Bergin et al. NPJ Digit Med. 2020.

. 2020 Oct 15:3:133.

doi: 10.1038/s41746-020-00339-7. eCollection 2020.

Authors

Affiliations

¹ NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
² NIHR Nottingham Biomedical Research Centre, Mental Health and Technology Theme, University of Nottingham, Nottingham, UK.
³ Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK.
⁴ Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
⁵ Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁶ Faculty of Education, University of Cambridge, Cambridge, UK.
⁷ MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
⁸ School of Psychology, Trinity College Dublin, Dublin, Ireland.
⁹ Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand.
¹⁰ Orygen, University of Melbourne, Parkville, Australia.
¹¹ The Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK.
¹² Horizon Digital Economy Research Institute, University of Nottingham, Nottingham, UK.
¹³ School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK.
¹⁴ NIHR Applied Research Centre East Midlands, Nottingham, UK.
¹⁵ Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹⁶ Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark.
¹⁷ Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.
¹⁸ Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA.

PMID: 33083568
PMCID: PMC7562906
DOI: 10.1038/s41746-020-00339-7

Abstract

Digital health interventions (DHIs) have frequently been highlighted as one way to respond to increasing levels of mental health problems in children and young people. Whilst many are developed to address existing mental health problems, there is also potential for DHIs to address prevention and early intervention. However, there are currently limitations in the design and reporting of the development, evaluation and implementation of preventive DHIs that can limit their adoption into real-world practice. This scoping review aimed to examine existing evidence-based DHI interventions and review how well the research literature described factors that researchers need to include in their study designs and reports to support real-world implementation. A search was conducted for relevant publications published from 2013 onwards. Twenty-one different interventions were identified from 30 publications, which took a universal (n = 12), selective (n = 3) and indicative (n = 15) approach to preventing poor mental health. Most interventions targeted adolescents, with only two studies including children aged ≤10 years. There was limited reporting of user co-design involvement in intervention development. Barriers and facilitators to implementation varied across the delivery settings, and only a minority reported financial costs involved in delivering the intervention. This review found that while there are continued attempts to design and evaluate DHIs for children and young people, there are several points of concern. More research is needed with younger children and those from poorer and underserved backgrounds. Co-design processes with children and young people should be recognised and reported as a necessary component within DHI research as they are an important factor in the design and development of interventions, and underpin successful adoption and implementation. Reporting the type and level of human support provided as part of the intervention is also important in enabling the sustained use and implementation of DHIs.

Keywords: Medical research; Psychology.

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Conflict of interest statement

Competing interestsJ.R., S.H. and S.M. were contributors to studies included in the review. D.D. reports grants, personal fees, non-financial support and other from Shire/Takeda, personal fees and non-financial support from Eli LIlly, personal fees and non-financial support from Medice, non-financial support from Qb Tech, other from Hachette, other from New Forest Parent Training Programme, outside the submitted work. All other authors have declared that they have no competing or potential conflicts of interest.

Figures

**Fig. 1**
PRISMA flow diagram outlining the search process and the exclusion of ineligible articles.

See this image and copyright information in PMC

References

1. NHS Digital. Mental Health of Children and Young People in England. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/men... (2018).
1. Kessler RC, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry. 2007;6:168–76. - PMC - PubMed
1. Public Health England. Universal approaches to improving children and young people’s mental health and wellbeing. Report of the findings of a Special Interest Group. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploa... (2019).
1. National Public Health Partnership. Preventing Chronic Disease : A strategic framework. 1–55. Available at: https://commed.vcu.edu/Chronic_Disease/2015/NPHPProject.pdf (2001).
1. Gordon R. An operational classification of disease prevention. Public Health Rep. 1983;98:107–109. - PMC - PubMed

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Preventive digital mental health interventions for children and young people: a review of the design and reporting of research

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Preventive digital mental health interventions for children and young people: a review of the design and reporting of research

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Conflict of interest statement

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