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Meta-Analysis
. 2022 Sep 27;24(9):e37776.
doi: 10.2196/37776.

Trends in Effectiveness of Organizational eHealth Interventions in Addressing Employee Mental Health: Systematic Review and Meta-analysis

Elizabeth Stratton  1   2 , Amit Lampit  3 , Isabella Choi  1   2 , Hanna Malmberg Gavelin  3   4 , Melissa Aji  1 , Jennifer Taylor  1 , Rafael A Calvo  5 , Samuel B Harvey  6   7   8 , Nick Glozier  1   2
Affiliations
Meta-Analysis

Trends in Effectiveness of Organizational eHealth Interventions in Addressing Employee Mental Health: Systematic Review and Meta-analysis

Elizabeth Stratton et al. J Med Internet Res. .

Abstract

Background: Mental health conditions are considered the leading cause of disability, sickness absence, and long-term work incapacity. eHealth interventions provide employees with access to psychological assistance. There has been widespread implementation and provision of eHealth interventions in the workplace as an inexpensive and anonymous way of addressing common mental disorders.

Objective: This updated review aimed to synthesize the literature on the efficacy of eHealth interventions for anxiety, depression, and stress outcomes in employee samples in organizational settings and evaluate whether their effectiveness has improved over time.

Methods: Systematic searches of relevant articles published from 2004 to July 2020 of eHealth intervention trials (app- or web-based) focusing on the mental health of employees were conducted. The quality and bias of all studies were assessed. We extracted means and SDs from publications by comparing the differences in effect sizes (Hedge g) in standardized mental health outcomes. We meta-analyzed these data using a random-effects model.

Results: We identified a tripling of the body of evidence, with 75 trials available for meta-analysis from a combined sample of 14,747 articles. eHealth interventions showed small positive effects for anxiety (Hedges g=0.26, 95% CI 0.13-0.39; P<.001), depression (Hedges g=0.26, 95% CI 0.19-0.34; P<.001), and stress (Hedges g=0.25, 95% CI 0.17-0.34; P<.001) in employees' after intervention, with similar effects seen at the medium-term follow-up. However, there was evidence of no increase in the effectiveness of these interventions over the past decade.

Conclusions: This review and meta-analysis confirmed that eHealth interventions have a small positive impact on reducing mental health symptoms in employees. Disappointingly, we found no evidence that, despite the advances in technology and the enormous resources in time, research, and finance devoted to this area for over a decade, better interventions are being produced. Hopefully, these small effect sizes do not represent optimum outcomes in organizational settings.

Trial registration: PROSPERO CRD42020185859; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=185859.

Keywords: eHealth; employee; mental health; mobile phone; systematic review.

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Conflict of interest statement

Conflicts of Interest: NG has a patent PCT/AU2019/051186 pending. NG and ES own the IP of a web-based disclosure decision aid tool for employees.

Figures

Figure 1
Figure 1
Flow Diagram of included studies.
Figure 2
Figure 2
Effects on anxiety symptoms.
Figure 3
Figure 3
Effects on anxiety symptoms at postintervention and follow-up time points.
Figure 4
Figure 4
Effects on stress symptoms at postintervention and follow-up time points.
Figure 5
Figure 5
Mean within-intervention group effect sizes reported in trials each year.
See this image and copyright information in PMC

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