Animal-Assisted Interventions Improve Mental, But Not Cognitive or Physiological Health Outcomes of Higher Education Students: a Systematic Review and Meta-analysis

Abstract

Due to the high burden of mental health issues among students at higher education institutions world-wide, animal-assisted interventions (AAIs) are being used to relieve student stress. The objective of this study was to systematically review of the effects of AAIs on the mental, physiological, and cognitive outcomes of higher education students. Randomized controlled trials using any unfamiliar animal as the sole intervention tool were included in this review. Study quality was assessed using the Cochrane Risk-of-Bias tool. Where possible, effect sizes (Hedges' g) were pooled for individual outcomes using random-effects meta-analyses. Albatross plots were used to supplement the data synthesis. Of 2.494 identified studies, 35 were included. Almost all studies used dogs as the intervention animal. The quality of most included studies was rated as moderate. Studies showed an overall reduction of acute anxiety and stress. For other mental outcomes, studies showed smaller, but nonetheless beneficial effects. Studies showed no clear effect on physiological or cognitive outcomes. Strong methodological heterogeneity between studies limited the ability to draw clear conclusions.

Supplementary information: The online version contains supplementary material available at 10.1007/s11469-022-00945-4.

Keywords: Animal-assisted intervention; Higher education; Mental health; One Health; Systematic review.

Fig. 1

PRISMA flow chart. ¹Quantitative outcomes assessed by less than three studies as well as qualitative outcomes were not eligible for inclusion in the meta-analyses. ²Methodological heterogeneity = heterogeneous for type of intervention condition (active/passive), animal used or type of control condition (active animal/active human/active other or no-treatment)

Fig. 2

Forest plot acute anxiety (n = 4). TE: Hedges’ g. seTE: standard error of Hedges’ g. N(i): number of participants in intervention condition. N(c): number of participants in control condition

Fig. 3

Albatross plot acute anxiety (n = 11)

Fig. 4

Albatross plot acute self-perceived stress (n = 7)

Fig. 5

Forest plot negative affect (n = 4). TE: Hedges’ g. seTE: standard error of Hedges’ g. N(i): number of participants in intervention condition. N(c): number of participants in control condition

Fig. 6

Albatross plot negative affect (n = 4)

Fig. 7

Albatross plot heart rate (n = 8)