Introduction
Current study
Methods
Search Strategy
PubMed and Cochrane | PsycINFO |
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(“Mental health” OR Wellbeing OR Well-being OR “Well being” OR e-health OR “life skills”) AND (Online OR Digital OR Mobile OR Phone OR App OR Textmessag* OR Web OR Computerized OR Computer-based) AND (“Help-seeking behavio*” OR Relaxation OR Stress OR Mindfulness OR Resilienc* OR “Positive psychology”) AND (Youth OR Adolescents OR students) AND (Training OR prevention OR Intervention OR Program NOT therapy) | (Mental-health OR Wellbeing OR Well-being OR e-health OR life-skills) AND (Online OR Digital OR Mobile OR Phone OR App OR Textmessag* OR Web OR Computerized OR Computer-based) AND (Help-seeking-behavio* OR Relaxation OR Stress OR Mindfulness OR Resilienc* OR Positive-psychology) AND (Youth OR Adolescents OR students) AND (Training OR prevention OR Intervention OR Program NOT therapy) |
Eligibility Criteria
Inclusion criteria | Exclusion criteria | |
---|---|---|
Participants | Children/adolescents aged between 11 to 18 years | Clinical sample |
Intervention | Preventive interventions with ≥50% digital delivery | Clinical trials; therapy |
Study type | Quantitative or mixed-methods studies | Qualitative studies |
Study design | Controlled studies (CT) with pre-post comparison | No control group |
Publication | Peer-reviewed; between 2000 and 2021 | Prior to 2000 |
Language | English | Not English |
Study Selection Process
Data Extraction
Quality Assessment
Analyses
Narrative synthesis
Meta-analytic procedure
Results
Study Characteristics
# | Study (Country, Design) | Study sample (Mean age) | Conditions | Na | Theoretical background | Key intervention components | Setting Mode and method of delivery | Duration and frequency of intervention | Post-tests | Attrition rate(s)b | Main findings |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | Bohleber et al. (2016) (CHE, CT) | Employed apprentices (EA, 16.9) Unemployed adolescents (UA, 18.4) Total (17.7) | 1. Companion App (EA) 2. Companion App (UA) 3. Control (EA) 4. Control (UA) | 1.134 | Positive peer culture | Peer mentoring app • Mentor = peer with same profession • Messaging and discussion groups • Counseling service & blog • Psychoeducation (Links to MH web content) | Leisure Online Mobile App | 10 months Self-directed, NS | post-test Longi-tudinal data only analyzed for EA. | 34.1% (EA: 54.6%) | No significant effects. Potential explanations may be the low frequency of app usage and the lack of need. However, concept of the app was well received. |
2 | Burckhardt et al. (2015) (AUS, RCT) | High school students (14.2) | 1. Bite Back program 2. Control, alternate websites | 336 | Positive Psychology (PP) | Website with interactive activities and workbook • Gratitude entries • Mindfulness practices • Private and public postings • Psychoeducation on PP domains | School Partly online Website + Workbook | 4–6 weeks 6 h total | post-test | 40.9% | No significant effects (ITT). Delivery as a structured school program might explain the non-significant results (compare study #16). Both groups demonstrated improvements in depressive symptoms, stress and life satisfaction. |
3 | Calear et al. (2016) (AUS, Pilot RCT) | Secondary school students (15.0) | 1. E-couch (worry & anxiety) program 2. Wait-list control | 225 | Cognitive behavior therapy (CBT) Mindfulness Progressive Muscle Relaxation (PMR) | Program with toolkits • CBT kit • Relaxation kit • Physical activity kit • Psychoeducation in each of the toolkits | School Online Web-based program | 6 weeks 30–40 min/week | post-test 3 months | 32.4% 43.1% | No significant effects (ITT). However, effect sizes of anxiety sensitivity (post-test, d = 0.19) and mental well-being (post-test, d = 0.17; FU: d = 0.30) were consistent with effects reported in other prevention trials. |
4 | Craig Rushing et al. (2021) (USA, RCT + crossover) | Adolescents identifying as AI/AN (range: 15–24) | 1. BRAVE program 2. Control, STEM program | 1.030 | Principles of inclusion, equity belonging and diversity | Text messages with MH-related content • Resources, videos • Reflective questions • Q&A response • Psychoeducation | Leisure Online Mobile-based program | 8 weeks 3 text messages/ week | 3 months 5 months 8 months | 8.4% 45.5% 50.1% | No significant effects. Both interventions improved measured health outcomes. |
5 | De la Barrera et al. (2021) (ESP, RCT) | High school students (12.6) | 1. EmoTIC 2. Wait-list control | 286 | Ability model of emotional intelligence | Space adventure game and classroom sessions • Rebuild a spaceship • Group discussions • Reflections • Skill testing • Psychoeducation | School + leisure Partly online Game-based program + F2F sessions | 4 weeks 1 classroom session/week, 3 home activities/ week | post-test | 58.4% | Significant effects. BETWEEN: IG showed improved self-esteem (η2 = 0.12), affect balance (η2 = 0.06), emotional symptoms (η2 = 0.15), behavioral problems (η2 = 0.05) and hyperactivity (η2 = 0.06). |
6 | Douma et al. (2021) (NLD, RCT) | Adolescents with physical chronical illness (15.1) | 1. Op Koers Online 2. Wait-list control | 59 | CBT | Group therapy sessions • Information seeking • Relaxation techniques • Social-competences • Positive thinking • Psychoeducation | Leisure Online Web-based program | 8 weeks 90-min Life Chat/ week + booster session at 4 months | 6 months 12 months | 22% 13.6% | Significant effects (ITT). BETWEEN: Beneficial effects on disease-related coping skills (6-month FU: relaxation, β = 0.68; social competence, β = 0.57; info seeking, β = 0.52; 12-month FU: info seeking, β = 0.61) and health-related QoL (6-month FU: total HRQoL, β = 0.52; social-, β = 0.56; school-, β = 0.55; psychosocial-functioning, β = 0.60; 12-month FU: ns.). |
7 | Edridge et al. (2020) (GBR, c-RCT) | Primary and secondary school students (10.9) | 1. ReZone 2. Control, school as usual | 409 | CBT Mindfulness Attention bias modification training (ABMT) | App for stress relief and refocus • Stress-related functions • Breathing exercise • Art therapy • Games | School + leisure Partly online Mobile App + F2F Tutorial | 3 months 1-hour tutorial Self-directed, NS | post-test | 16% | No significant effects (ITT). Potential reasons may have been implementation barriers of new digital interventions in schools and the lack of usage consistency. |
8 | Egan et al. (2021) (USA, RCT) | Adolescents identifying as SGMYs with cyberbullying experience (15.8) | 1. Singularities 2. Wait-list control | 240 | Social cognitive theory Stress and coping theory Social and emotional learning framework | Role-playing game • Team setting to encourage help-seeking behavior • Use of productive coping skills • Psychoeducative web resources | Leisure Online Game-based program | 4 months Self-directed, NS | 1 month, 2 months | 32.1% 35.8% | Significant effects (ITT). BETWEEN: IG reported lesser cyberbullying victimization, binge drinking, and marijuana use than CG. Interpret with caution: not powered for measuring efficacy (feasibility study). |
9 | Fridrici and Lohaus (2009) (DEU, CT) | Secondary school students (14.8) | 1. Face-to-face, F2F 2. Online-school, OS 3. Online-home, OH 4. Control | 904 | Stress prevention | Stress prevention program with modules on: • Problem solving • Cognitive reconstruction • Support seeking • Relaxation • Time management | School + leisure Partly online Web-based + F2F program | 8 weeks 90 min/week Online IGs: 2 F2F training sessions (baseline, 4 weeks) | post-test | NS | Significant effects. BETWEEN: Increase in knowledge gain in all 3 IGs (OS, η2 = 0.130; OH, η2 = 0.022; F2F, η2 = 0.060). Increase in positive thinking for OS (η2 = 0.021) and F2F (η2 = 0.041). Reduction of psychological stress in the F2F and OS condition (multivariate analysis was not significant). |
10 | Haug et al. (2021) (CHE, c-RCT) | Secondary and upper secondary school students (15.4) | 1. SmartCoach 2. Control | 1473 | Social cognitive theory | Life-skills training program to prevent substance use • Text messages with quizzes, video and web links • Self-management • Social & substance resistance skills • Psychoeducation | Leisure Online Mobile-based program | 22 weeks 2–4 texts/week, NS | 6 months | 16.3% | Significant effects (ITT). BETWEEN: IG reports lower amounts of alcohol consumed per month (d = −0.08), fewer cigarettes smoked per month (d = −0.13) and reduced perceived stress (d = −0.15). |
11 | Huppert and Johnson (2010) (GBR, CT) | Male students from fee-paying boy’s schools (14.5) | 1. Mindfulness 2. Control, school as usual | 155 | Mindfulness-based stress reduction (MBSR) | Mindfulness training • Guided classroom sessions (teacher) • Guided home practice (CD) | School + leisure Partly digital CD- & video-based + F2F program | 4 weeks F2F: 40 min/ week CD: 8 min/ day | post-test | 13.6% | No significant effects. However, a significant positive association between the amount of individual practice and improvement in well-being and mindfulness was shown within the IG. |
12 | Kauer et al. (2012) (AUS, RCT) | Young people with mental health concerns (17.9) | 1. Mobiletype + ESA 2. Control, Mobiletype | 114 | Emotional self-awareness (ESA) Stepped-care approach | Self-monitoring app to enhance ESA: • Mood • Current activity • Stress • Alcohol use • Cannabis use • Diet • Sleep • Exercise | Leisure Online Mobile-based program | 2–4 weeks 4 monitoring prompts (1–3 min)/day | post-test 6 weeks | 23.7% 24.5% | Significant effects (ITT). BETWEEN: Self-monitoring was shown to effectively decrease depressive symptoms in IG (ĸ² = 0.54), through the mediating effect of ESA (emotional self-awareness). Rumination decreased in both groups over time. |
13 | Kenny et al. (2020) (IRL, c-RCT) | Second-level school students (16.1) | 1. CopeSmart 2. Control | 560 | Emotional self-awareness Positive coping strategies | App promoting self-management • Mood rating and mood history • Positive coping tips • Psychoeducation | School + leisure Online Mobile App | 4 weeks Every day, self-directed, NS | post-test 8–10 weeks | 9% 31% | No significant effects (ITT). A potential reason may have been the low levels of distress at baseline, which made improvements harder to detect. |
14 | Kutok et al. (2021) (USA, Pilot RCT) | Adolescents with past experience of cybervictimization (15.3) | 1. IMPACT 2. Control, web-based resource packet | 80 | CBT Motivational interviewing (MI) | App and video session to prevent/reduce the effect of cyberbullying • CBT and MI-PowerPoint session • Daily mood rating with text messages response • On-demand mood messages | Leisure Online Video-conferencing tool + Mobile App | 8 weeks Brief video intervention; 1 query + message/day | post-test 16 weeks | 2.5% 8.3% | Significant effects (ITT). BETWEEN: IG had better overall well-being (post-test, β = 1.17; FU, β = 3.24), higher bystander self-efficacy (post-test, β = 2.65), decreased stress (post-test, β = -0.66; FU, β = -0.89), and higher perceived social support (FU, β = 3.50) than CG. |
15 | Malboeuf-Hurtubise et al. (2021) (CAN, Randomized cluster pilot study) | Elementary school students (11.3) | 1. Mandala drawing 2. Emotion-based directed drawing | 22 | CBT Social-emotional learning Mindfulness | Art-based intervention • Mandala drawing (mindfulness-based) • Emotion-based drawing related to fear, worry and irritation | School Partly online Video-conferencing tool + analog drawing activity | 5 weeks 45 min/week | post-test | 0% | No significant effects. Both drawing interventions may be beneficial with regards to inattention and hyperactivity. |
16 | Manicavasagar et al. (2014) (AUS, RCT) | Young people (15.4) | 1. Bite Back 2. Control, 2 youth-oriented control websites | 235 | Positive Psychology | Website with interactive activities • Methods for skill development in PP domains • Links to MH resources • Comments and discussions • Psychoeducation on PP domains | Leisure Online Website | 6 weeks 1 h/week | post-test | 34.5% | Significant effects. WITHIN: IG reported lower depressive symptoms and stress, and higher well-being scores. The most reduction was observed in depressive symptoms and stress scores for participants with high adherence. Interpret with caution: small groups - IG split into low/high adher. |
17 | O’Dea et al. (2020) (AUS, RCT) | Young people (14.82) | 1. WeClick 2. Wait-list control | 193 | CBT Social learning Theory | Relationship-focused app • Interactive story-telling • Activities to overcome relationship difficulties and negative thinking • Problem solving • Help-seeking | Leisure Online Mobile App | Single-session 1 h | 4-weeks 12 weeks | 16.1% 40.4% | Significant effects (ITT). BETWEEN: Greater increase in well-being (d = 0.37) and help-seeking intentions (d = 0.36) for IG. Mental health outcomes can be improved with less than one hour of exposure with sustained effects at 12-week FU. |
18 | O’Dea et al. (2021) (AUS, c-RCT) | Secondary school students (14.3) | 1. Smooth Sailing 2. Control, school as usual | 1841 | Theory of help-seeking for MH problems in youth Principles of stepped care | Service model to improve help-seeking intentions • Mood check-ins • Session with school counselor (if severe symptoms) • Psychoeducation: modules on general MH, anxiety, depression, and help-seeking | School Online Web-based stepped-care service model | 12 weeks 5×10 min psycho-education 4 mood check-ins | 6 weeks 12 weeks | 24.8% 30.1% | Significant effects (ITT). BETWEEN: IG reported small improvements in help-seeking intentions (ES = 0.10) and a greater reduction in students who needed support for their mental health, but were not seeking help. |
19 | Osborn et al. (2020) (KEN, RCT) | Secondary school students (15.5) | 1. Shamiri-Digital Wellness 2. Control, Study-skills | 103 | Growth mindset theory | Self-help intervention to reduce anxiety and depressive symptoms and promote well-being • Three modules: growth mindset, gratitude, and value/virtue affirmation • Psychoeducation within each module (learn, read, write) | School Digital program | Single-session ~ 1 h | 2 weeks | 0% | Significant effects (ITT). BETWEEN: IG experienced larger declines in depressive symptoms than CG (d = 0.50), even more substantial effects in the high-symptom subsample (d = 0.83). The anxiety reduction was steeper than that for depressive symptoms (d = 0.29), but the study-skills condition was also associated with a steep reduction in anxiety, preventing the difference from being significant. |
20 | Perkins et al. (2021) (GBR, RCT) | Students (16.6) | 1. SSI 2. Control, school as usual | 80 | Growth mindset theory | Mindset intervention • Videos on coping • Multiple-Choice questions • Writing a letter of advice • Psychoeducation | School Online Web-based program | Single-session 30 min | post-test 4 weeks 8 weeks | 2.5% 11.3% 47.5% | No significance testing (ITT; feasibility study). Favoring the IG: At 4-week FU: small ES for self-compassion, g = 0.41; self-esteem, g = 0.33; depressive symptoms & anxiety, d = −0.45; At 8-week FU: moderate ES for anxiety, g = −0.57 and small ES for self-esteem, g = 0.39, depressive symptoms & anxiety, g = −0.35. |
21 | Puolakanaho et al. (2019) (FIN, RCT) | Ninth grade students (15.3) | 1. Youth COMPASS - iACT face group 2. Youth COMPASS - iACT group 3. Control | 243 | Acceptance and Commitment therapy | Program aiming to enhance psychological flexibility • Modules on acceptance, defusion, mindfulness, self-compassion, and adaptation skills • Motivational feedback and questions • Coaching sessions | School + leisure Online Web- and mobile-based program | 5 weeks ≥ 6 exercises of 5–10 min/ week 1. iACT face: 45-min Coaching + weekly Whatsapping with coach 2. iACT: Weekly text messaging with coach | post-test | 1.6% | No significant effects (ITT). Significant effects (PP). Reduction in symptoms of overall stress (d = 0.22) and an increase in academic buoyancy (d = 0.27) favoring the IGs. Gains were larger among those with higher stress levels. |
22 | Santor et al. (2007) (CAN, CT) | Junior and senior high school students (14.7) | 1. Logon 2. No Logon | 1775 | Proactive health and wellness model Reactive health-needs model | Health magazine to promote MH literacy, early detection of difficulties & help-seeking • Information • Posting questions • Answers from MH professionals | Leisure Online Website | 12 months self-directed | post-test | 13.6% | Significant effects. BETWEEN: Small reduction in school worry. Positive correlation between frequency of web site use and actual help seeking behavior. |
23 | Schleider et al. (2020) (USA, RCT) | Female tenth grade students from rural, low-income high school (15.2) | 1. Growing Minds 2. Control, Heart | 222 | Growth mindset theory | Program targeting growth mindsets: • Personality, self-regulation, and intelligence mindsets • Quizzes + feedback • Coping strategies • Writing exercise • Psychoeducation | School Online Web-based program | Single-session 45 min | post-test 4 months | 0.5% 5% | Significant effects (ITT). BETWEEN: IG showed greater improvements in depressive symptom severity (d = 0.23) and larger reduction in their odds of reporting elevated depressive symptoms (d = 0.29). |
24 | Sousa et al. (2020) (PRT, CT) | Students (12.4) | 1. F2F + TeenPower 2. F2F | 353 | Health Information Technology Acceptance Model (HITAM) | Mental health app • Resources (videos, infographics, tips) • Social support (discussions forums, chats, messages) • Self-monitoring (e.g. sleeping habits, physical activity) • Interactive training modules • Motivational tools | School + leisure Partly online F2F program + Web-based software and mobile app | 6 months self-directed | post-test | 42.4% | Significant effects. BETWEEN: Nutrition (η2 = 0.03), positive life perspective (η2 = 0.04) and global lifestyle (η2 = 0.02) increased in IG compared to CG. Older adolescents tended to show a significant increase in rates of stress management. |
25 | Van Vliet and Andrews (2009) (AUS, CT) | High school students (13.0) | 1. Stress management 2. Control, de-facto | 653 | Stress management Coping strategies | Stress management program • Cartoon narrative • Coping strategies • Teaching of skills, e.g. breathing exercises, PMR • Psychoeducation on stress and coping | School Partly online Web-based program & activity book | Duration, NS 6 lessons 30 min/lesson | post-test 3 months | NS | Significant effects. WITHIN: Increase in knowledge (ES = 0.36), support-seeking coping (ES = 0.015), well-being (ES = 0.1). Decrease in avoidant coping (ES = 0.22), total difficulties (ES = 0.16), psychological distress (ES = 0.16). |
26 | Yuan (2021) (CHN, CT) | Middle school students (13.3) | 1. Mindfulness training group 2. Control | 180 | Mindfulness training (MT) | Mindfulness training • Mindfulness trainings recordings • Daily checks if practice was completed | Homeschooling Online Web-based program | 6 months 15 min of recordings/day | 2 months 4 months 6 months | 3.3% | Significant effects. WITHIN: Mindfulness training increased students’ resilience and emotional intelligence. |
27 | Zheng et al. (2021) (CHN, c-RCT) | Seventh grade students from secondary schools (13.5) | 1. REAP + health session 2. Control, health session | 954 | 20-20-20 rule | Peer-to-peer live streaming app • Workouts during recess • Live streaming or posting pictures of workout • Health information session | Homeschooling Online Mobile app + health training session | 2 weeks 4×15 min/day 1 training session | post-test | 6.1% | Significant effects (ITT). BETWEEN: Significant reduction in anxiety (β = −0.36) and eye strain (β = −0.15) in homeschooled children. |
General study design details
Participant characteristics
Setting
Risk of Bias
Intervention Characteristics
Availability
Domains and measures
Intervention length
Level of interaction
Level of professional support
Level of guidance
Level of digitization
Adherence and Attrition
Meta- and Sensitivity Analysis
Cluster | Effect size | Heterogeneity | ||||||
---|---|---|---|---|---|---|---|---|
n | g | 95% CI | p | I2 | 95% CI | p | 95% PI | |
Anxiety | 11 | 0.37 | [0.04, 0.70] | 0.031 | 91 | [87, 94] | <0.001 | [−0.73, 1.47] |
Outliers removeda | 9 | 0.16 | [0.02, 0.31] | 0.033 | 29 | [0, 67] | 0.183 | [−0.15, 0.48] |
Influence analysisb | 10 | 0.25 | [−0.02, 0.48] | 0.034 | 87 | [78, 92] | <0.001 | [−0.46, 0.97] |
Depressive symptoms | 11 | 0.19 | [−0.09, 0.46] | 0.163 | 87 | [79, 92] | <0.001 | [−0.71, 1.08] |
Outliers removedb | 10 | 0.07 | [−0.05, 0.19] | 0.198 | 46 | [0, 74] | 0.054 | [−0.21, 0.36] |
Influence analysisb | 10 | 0.07 | [−0.05, 0.19] | 0.198 | 46 | [0, 74] | 0.054 | [−0.21, 0.36] |
Externalizing symptoms | 6 | −0.22 | [−0.89, 0.45] | 0.434 | 93 | [87, 96] | <0.001 | [−2.08, 1.64] |
Outliers removedb | 5 | 0.03 | [−0.19, 0.25] | 0.719 | 0 | [0, 79] | 0.535 | [−0.25, 0.31] |
Influence analysisb | 5 | 0.03 | [−0.19, 0.25] | 0.719 | 0 | [0, 79] | 0.535 | [−0.25, 0.31] |
Internalizing symptoms | 10 | 0.03 | [−0.11, 0.18] | 0.624 | 72 | [47, 85] | <0.001 | [−0.36, 0.42] |
Outliers removed | – | – | – | – | – | – | – | – |
Influence analysisc | 9 | −0.02 | [−0.16, 0.12] | 0.714 | 40 | [0, 73] | 0.099 | [−0.31, 0.27] |
Protective factors | 11 | 0.40 | [−0.07, 0.88] | 0.089 | 99 | [98, 99] | <0.001 | [−1.26, 2.07] |
Outliers removedc | 10 | 0.13 | [0.05, 0.21] | 0.006 | 12 | [0, 53] | 0.332 | [0.05, 0.20] |
Influence analysisc | 10 | 0.13 | [0.05, 0.21] | 0.006 | 12 | [0, 53] | 0.332 | [0.05, 0.20] |
Stress | 7 | 0.13 | [−0.04, 0.31] | 0.107 | 61 | [11, 83] | 0,017 | [−0.26, 0.52] |
Outliers removed | – | – | – | – | – | – | – | – |
Influence analysisd | 6 | 0.09 | [−0.09, 0.27] | 0.266 | 42 | [0, 77] | 0.122 | [−0.27, 0.44] |
Well-being | 8 | 0.12 | [0.06, 0.18] | 0.003 | 0 | [0, 68] | 0.913 | [0.02, 0.22] |
Outliers removed | – | – | – | – | – | – | – | – |
Influence analysis | – | – | – | – | – | – | – | – |
Anxiety
Depressive symptoms
Externalizing symptoms
Internalizing symptoms
Protective factors
Stress
Well-being
Subgroup Analysis: Facilitators and Barriers
Group | Anxiety | Depressive symptoms | Internalizing symptoms | Protective factors | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | g | 95% CI | I2 | p | n | g | 95% CI | I2 | p | n | g | 95% CI | I2 | p | n | g | 95% CI | I2 | p | |
Setting | <0.001 | 0.109 | <0.001 | 0.130 | ||||||||||||||||
Homeschool | 1 | 0.86 | [0.72, 0.99] | – | – | – | – | – | 1 | −0.18 | [−0.31, −0.05] | – | – | – | – | – | ||||
Leisure | 4 | 0.04 | [−0.17, 0.25] | 0 | 5 | −0.02 | [−0.18, 0.14] | 4 | 5 | −0.06 | [−0.13, 0.02] | 0 | 4 | 0.09 | [0.00, 0.18] | 0 | ||||
Mixed | – | – | – | – | – | – | – | – | 3 | 0.20 | [−0.36, 0.76] | 36 | 4 | 0.26 | [−0.08, 0.59] | 30 | ||||
School | 6 | 0.51 | [−0.07, 1.09] | 91 | 6 | 0.34 | [−0.22, 0.89] | 89 | 1 | 0.25 | [0.13, 0.37] | – | 3 | 1.05 | [−1.97, 4.06] | 99 | ||||
Interaction | 0.622 | 0.777 | 0.420 | 0.731 | ||||||||||||||||
Considerable | 2 | 0.19 | [−1.07, 1.45] | 0 | 2 | 0.06 | [−2.41, 2.52] | 16 | 3 | 0.16 | [−0.65, 0.96] | 53 | 4 | 0.24 | [−0.04, 0.53] | 52 | ||||
None | 3 | 0.19 | [−0.47, 0.84] | 30 | 3 | 0.20 | [−0.20, 0.59] | 0 | – | – | – | – | 2 | 0.31 | [−0.29, 0.91] | 0 | ||||
Some | 6 | 0.45 | [−0.21, 1.11] | 95 | 6 | 0.23 | [−0.32, 0.78] | 93 | 7 | 0.00 | [−0.16, 0.15] | 77 | 5 | 0.51 | [−0.83, 1.85] | 99 | ||||
Support | 0.019 | 0.739 | 0.960 | 0.305 | ||||||||||||||||
Considerable | 1 | 0.31 | [0.19, 0.43] | - | 2 | 0.05 | [−1.65, 1.76] | 91 | 3 | 0.05 | [−0.48, 0.58] | 87 | 3 | 0.98 | [−2.14, 4.10] | 99 | ||||
None | 4 | 0.07 | [−0., 0.33] | 0 | 4 | 0.14 | [−0.14, 0.42] | 0 | 2 | 0.01 | [−1.27, 1.28] | 0 | 4 | 0.10 | [−0.05, 0.25] | 0 | ||||
Some | 6 | 0.59 | [−0.02, 1.20] | 90 | 5 | 0.27 | [−0.52, 1.05] | 91 | 5 | 0.04 | [−0.29, 0.36] | 67 | 4 | 0.20 | [−0.10, 0.51] | 2 | ||||
Guidance | 0.433 | 0.308 | 0.694 | <0.001 | ||||||||||||||||
Considerable | 5 | 0.56 | [−0.20, 1.32] | 92 | 5 | 0.36 | [−0.37, 1.10] | 89 | 1 | −0.20 | [−0.76, 0.36] | - | 2 | 0.31 | [−0.29, 0.91] | 0 | ||||
None | 1 | 0.15 | [−0.17, 0.47] | – | 2 | −0.02 | [−1.33, 1.30] | 45 | 4 | −0.01 | [−0.13, 0.11] | 0 | 4 | 0.11 | [0.03, 0.18] | 0 | ||||
Some | 5 | 0.25 | [−0.24, 0.75] | 93 | 4 | 0.12 | [−0.10, 0.34] | 15 | 5 | 0.06 | [−0.29, 0.41] | 86 | 5 | 0.66 | [−0.60, 1.93] | 99 | ||||
Digital | 0.847 | 0.205 | 0.133 | 0.509 | ||||||||||||||||
Fully digital | 10 | 0.36 | [0.00, 0.73] | 92 | 10 | 0.22 | [−0.07, 0.50] | 88 | 7 | −0.02 | [−0.18, 0.14] | 78 | 7 | 0.49 | [−0.33, 1.30] | 99 | ||||
Partly digital | 1 | 0.45 | [−0.40, 1.30] | – | 1 | −0.35 | [−1.20, 0.49] | – | 3 | 0.20 | [−0.36, 0.76] | 36 | 4 | 0.26 | [−0.08, 0.59] | 30 | ||||
Length | 0.673 | 0.180 | 0.147 | 0.325 | ||||||||||||||||
Long (>3 mo) | 1 | 0.15 | [−0.17, 0.47] | – | 2 | −0.02 | [−1.33, 1.30] | 45 | 2 | −0.04 | [−0.63, 0.54] | 0 | 4 | 0.12 | [−0.02, 0.26] | 29 | ||||
Mid (2-3 mo) | 4 | 0.19 | [−0.10, 0.48] | 38 | 4 | 0.17 | [0.03, 0.30] | 0 | 4 | 0.15 | [−0.08, 0.38] | 22 | 3 | 0.85 | [−2.56, 4.26] | 99 | ||||
Short (1 mo) | 2 | 0.49 | [−4.54, 5.52] | 92 | 1 | −0.09 | [−0.52, 0.34] | - | 3 | 0.03 | [−0.88, 0.94] | 79 | 1 | 0.46 | [0.06, 0.86] | – | ||||
Single session | 4 | 0.55 | [−0.61, 1.70] | 94 | 4 | 0.45 | [−0.50, 1.40] | 92 | 1 | −0.11 | [−0.47, 0.26] | - | 3 | 0.14 | [−0.52, 0.79] | 32 | ||||
Adherence | 0.950 | <0.001 | 0.547 | 0.599 | ||||||||||||||||
Consistent | 6 | 0.40 | [−0.24, 1.03] | 92 | 6 | 0.31 | [−0.23, 0.85] | 90 | 4 | −0.05 | [−0.26, 0.16] | 0 | 4 | 0.15 | [−0.17, 0.48] | 4 | ||||
Inconsistent | 4 | 0.32 | [−0.31, 0.96] | 94 | 3 | 0.18 | [0.07, 0.28] | 0 | 4 | 0.05 | [−0.26, 0.37] | 87 | 5 | 0.62 | [−0.66, 1.89] | 99 | ||||
ns | 1 | 0.45 | [−0.40, 1.30] | - | 2 | −0.09 | [−0.52, 0.35] | 0 | 2 | 0.18 | [−3.25, 3.61] | 85 | 2 | 0.23 | [−1.98, 2.43] | 66 | ||||
Attrition | 0.007 | 0.803 | 0.051 | 0.227 | ||||||||||||||||
Concern (>20%) | 7 | 0.14 | [−0.04, 0.33] | 46 | 7 | 0.14 | [0.05, 0.24] | 0 | 5 | 0.14 | [−0.14, 0.43] | 50 | 6 | 0.64 | [−0.32, 1.60] | 98 | ||||
Low (<20%) | 2 | 1.17 | [−2.96, 5.30] | 93 | 2 | 0.58 | [−7.92, 9.08] | 99 | 5 | −0.08 | [−0.21, 0.06] | 16 | 4 | 0.10 | [0.06, 0.14] | 0 | ||||
No attrition | 2 | 0.28 | [−0.75, 1.30] | 0 | 2 | 0.10 | [−4.18, 4.38] | 55 | – | – | – | – | 1 | 0.28 | [−0.11, 0.67] | – |