[ , ]
A second literature flow deepens personal beliefs that individuals develop about change initiatives. Personal appraisals about individual ability to face change actions, ie, “change self-efficacy”, 30 is referred to being factors making individuals more likely willing to accommodate and accept the change. 65 Individual’s pessimistic viewpoint about management ability to be effective in change implementation, ie “cynicism about organizational change”, 55 may jeopardise organizational change accomplishment, 47 as well as the middle managers’ strategy commitment. 63 The group contains 4 papers ( Table 1 ).
The third flow of literature proposes the adoption of a multi-level approach to organizational change and places emphasis on the change outcomes. Merging the individual-focused micro perspective and the organizational-oriented macro perspective, with inflows from meso-level theory 68 may contribute to obtaining a comprehensive vision on organizational change. Change type and change method should be converging to attain the intended change outcome. 58 The group contains 4 papers ( Table 1 .
Consistent with past studies, this step of literature review through CNA shows that works emphasized the need to give emphasis on individual perceptions towards change. The research trajectory appeared to be unexplored in healthcare. Interestingly, a comprehensive framework involving micro-meso and macro perspective to evaluate change actions and the importance of change outcome was found to be emerging trends only in the general literature on organisational change.
The use of keyword analysis is intended to confirm or to extend this initial finding on existing research streams related to the topic of organisational change in healthcare.
The first cluster includes approaches to manage change organization within the production context, 91 by illustrating applications in terms of product development 85 and impact on supply chain management. 83 The cluster is composed of 26 papers.
The second cluster reports supportive tools for change management, by emphasizing the importance of formal and informal communication to promote employees’ commitment to change. 75 The cluster is mainly composed of 7 papers.
The third cluster enlarges supportive and boosting tools of organizational change, containing IT applications such as a monitoring system for organizational development activities, 96 team-based simulations improving readiness for change in university setting, 73 and as a means for gaining business-IT alignment. 77 The cluster is mainly composed of 6 papers.
The fourth cluster encompasses the key role of participation for learning within change, 107 even debating a mix of learning styles to sustain successfully organizational change initiative in the healthcare context. 92 The cluster is mainly composed of 5 papers.
The fifth cluster copes with the performance management issue, by soliciting a change in organizational values to enhance a successful performance management reform. 82 Performance issue in the healthcare context is viewed as an outcome after the organizational change process. 76 Change management’s research address the related performance management issue, but the papers reviewed do not offer structured models or approaches. This is consistent with the result debated in the citation network analysis. The cluster is mainly composed of 6 papers.
The sixth cluster focuses on sustainability change initiatives in Higher Education Institutions. 80 Corporate sustainability issue is even addressed to pinpoint the effects of applying sustainability change efforts. 74 The cluster is mainly composed of 8 papers.
The core of the seventh cluster appears to emphasize the dual nature of change, including organizational and technological aspects (eg, 81 , 84 ), and suggests the need for an in-depth analysis on who has the “role of enabler” in change initiatives. This step was already addressed in the citation network analysis, where Choi and Ruona (2011b) 66 quote Rogers (1983) 48 and Rogers (2003) 49 for “the importance of readiness for change through the innovation-decision process model”. The cluster is mainly composed of 9 papers.
Within the eighth cluster, a first subject investigates the factors affecting physicians’ behaviour in technology-driven changes, assuming that clinicians’ beliefs on technology-induced improvements of patients’ care play a critical role. 93 Scholars address the issue in light of the theory of planned behaviour, 93 or by proposing an ad hoc framework where an impact assessment of individual acceptance should be a step before introducing new IoT technology in workflow. Debate on the individual behaviours involved in healthcare organizational changes points out individuals factors such as “personality, social identity and emotional intelligence” 105 influence coping strategies’ choice to tackle change-related stress, as complementary perspective.
A second related subject focuses on the managerial approach to change, revealing that, on one hand, unclear supporting methods by seniors managers may weak middle managers’ change activities, 88 on the other hand, for hospital managers, fully physicians’ involvement in technology-driven changes should impact positively on physicians’ attitude. 93
The relationship between innovation and change in the healthcare context should be explored. Both external and internal factors trigger the need for change in healthcare organizations. For instance, the current epidemiological and demographic transition is provoking a shifting of care’s need towards users affected by chronic diseases. This is leading to a compulsory changing in the healthcare organizational framework. Likewise, the need to make health processes more efficient, for instance, forms another triggering factor, the inside one, for organizational change. Therefore, the organizational change issue should be investigated by bearing in mind these multiple boosts to changing. This supports the need to investigate deeply the concept of change and innovation in a healthcare setting, by seeking to outline the boundaries of organizational change and innovation. In particular, the analysis should start investigating the issue by emphasizing on the fact that micro-context should not be assumed simply as a backcloth to action. 15
The resistance to organizational change initiative arises when professional logic comes into contrast with the management one. 18 In this regard, the future research should investigate the effect of a “local ownership” 18 of the problems behind the change in order to be recognized as relevant critical issues in the organizations by the professionals. Thus, it becomes a priority to seek a new concept of leadership where the recipients of the change can themselves be those who manage the leaders with the possibility to hinder or sustain proactively their leadership. 18 Healthcare organizations are moving towards multifaceted systems. As the work by Augl (2012) 76 pointed out in cluster number 5 of keyword analysis, the health system might be regarded as a set of social systems where organizations may be considered as communication systems. In this regard, the author suggested a new approach to change management by modifying the current communication paths to contextual collaboration. 76 Integrated systems need three pillars as institutional integration (ie, laws), management integration (ie, operational tools) and professional integration (ie, team), which are not mutually exclusive. 6 The cluster includes 31 documents.
Tables 2 and and3 3 display the 8 clusters obtained by VOS (Visualization of Similarities) clustering technique.
Clusters (1-4) Obtained by VOS (Visualization of Similarities) Clustering Technique
Cluster 1 | Cluster 2 | Cluster 3 | Cluster 4 |
---|---|---|---|
Engineering Change Management | Change | Change Management | Organizational Culture |
Knowledge Management | Leadership | Project Management | Resistance |
Transformational Leadership | Communication | Higher Education | Discourse |
Commitment To Change | Management | Implementation | Sensemaking |
Organizational Learning | Action Research | Information Technology | Participation |
Strategic Planning | Evaluation | Organization | Ethnography |
Strategy | Human Resource Management | E-Learning | Health Care |
Organizational Development | Training | Simulation | |
Attitudes | Organization Development | Learning | |
Change Process | Organization Change | Organizational Change Management | |
Readiness For Change | Collaboration | Culture | |
Quality Improvement | Education | ||
Supply Chain |
Clusters (5-8) Obtained by VOS (Visualization of Similarities) Clustering Technique
Cluster 5 | Cluster 6 | Cluster 7 | Cluster 8 |
---|---|---|---|
Innovation | Resistance to Change | Case Study | Organizational Change |
Job Satisfaction | Sustainability | Risk | Organizational Change |
Organizational Changes | Transformation | ERP | Institutional Theory |
Performance | Strategic Change | Integration | Healthcare |
Motivation | Corporate Social Responsibility | Emotions | |
Creativity | Public Sector | ||
Quantitative Research | |||
Australia | |||
e-Government | |||
Organizational Performance | |||
Stress |
Two contexts emerge clearly from the analysis.
The manufacturing context and the healthcare context. The former analyses the issue of organisational change also concerning supply chain management; the latter pays attention to the attitude of the clinician towards change initiatives linked to the introduction of new technology. Of the remaining clusters, some of them relate the topic of change to the adoption of support systems (IT applications – cluster 3) or support strategies (formal and informal communication – cluster 2; participation – cluster 4) for the implementation of change; further clusters tackle the topic of change as a tool to improve performance management (cluster 5) or combine it with sustainable change initiatives and the concept of innovation.
The keyword analysis shows that the general literature streams obtained in the previous CNA analysis are not yet developed in the healthcare context, although interest in the individual’s attitude to change seems to be an emerging approach.
With the analysis carried out so far, a growing interest in the most recent literature on the individual-change relationship emerges (ie, 66 ). The subject is developed by scholars from different perspectives. Some authors focus on the psychological mechanisms that induce the individual to change, deepening the individual perception of change both as a skill that the individual recognizes inadequately pursuing a specific change initiative (ie, 30 ), and as the personal belief on the management’s ability to properly implement a change initiative (ie, 66 ). Furthermore, the literature analysed warns that the individual-organizational change relationship is a broad and articulated subject, which cannot be confined to “change recipients” only, but which deserves adequate study also concerning to the “change agents” themselves (ie, 63 ).
The contributions discussed in this paper clearly define the need to deal with acceptance of change from the perspective of the individual. What the general literature on the subject seems to offer, however, is a reading that does not allow linking the individual’s attitude towards change to the specific organizational context in which the change itself will be implemented, especially in the case of complex organizations. Martínez-García and Hernández-Lemus (2013) 38 recognize for example that
health systems are paradigmatic examples of human organizations that merge a multitude of different professional and disciplinary characteristics in a critical performance environment.
The extensive analysis reported on the topic allows contextualizing the organizational change initiatives in the healthcare world, where the individual-change relationship is central and can offer additional ideas on the profile of change recipients.
The research line takes a position on change recipients, by paying attention to the effects that organizational change causes on persons or, in other words, on the psychological aspects of the organizational change. 68 A unified framework of organizational change perspectives (ie, micro, meso and macro), to connect jointly the individual change acceptance to economic and sociological perspectives, 68 is missing, except one work. 68
Change outcome and organizational performance in change initiative appear to be not adequately explored. The work (see 58 ) illustrates only conceptual models. Studies aimed at identifying and testing empirically specific performance measures in the organizational change context appear to be missing.
Moving to the “second-order analysis”, based on co-occurrence keywords analysis, the results confirm and extend the preliminary understanding provided by the citation network analysis. A summary of the results is provided in the table number 4 ( Table 4 ). Cluster 8 provides some insights on the state of art in the healthcare research field. Beyond case studies, the topic becomes relevant only relative to the spreading of digital services in the care system. Other studies (eg, 62 ), retrieved in the previous step, describe a potential stream of organizational change issues in the healthcare context. Notably, these works address change management only concerning the negative health impact for the individual, without paying attention to the individual behaviour change. Moreover, the papers available do not point out change management in the specific context of professionalized organizations. Therefore, studies aimed at investigating the nature of change that characterizes the healthcare professionalized organizations are needed.
Summary of Results Obtained by Co-Occurrence Keywords Analysis
Clusters | Research Trajectory | Articles |
---|---|---|
1 | Organizational Change in the manufacturing context | [ , , , , , , ] |
2 | Communication and training’s effect on organizational change and impact on leaders and employees | [ , , , , ] |
3 | Information Technology and simulation as supportive tool to implement change initiatives | [ , , , ] |
4 | Participation and learning to facilitate the organizational changes | [ , , ] |
5 | Performance management issue in organizational change context and bottom-up change initiatives | [ , , ] |
6 | Human dimension involved in the sustainability change initiatives | [ , ] |
7 | Understanding the role of enabler in change initiatives | [ , , , , , , , ] |
8 | The need of specific change’s models for healthcare organizations | [ , , , , , ] |
In summary, the literature reviewed informed us that three potential streams were not yet fully explored. Change management in the context of healthcare organizations, performance evaluations and innovation-organizational change relationship was the most evident gaps found out.
Nevertheless, the present work debates individual-level perspective on the change as a prominent dimension to tackle in designing change initiatives, albeit individual and organizational issues related to change should not be viewed as detached. This stimulates to set aside a polarized perspective on organizational change.
The performed review traces a clear step in the production research on the subject. The findings suggest that literature is seeking to overcome a traditional duality approach between “managerial change agent (the good) and resisters to change (the bad)”, 5 , 22 , 56 by paying attention to the critical role of attitude towards organizational change. Especially in the healthcare context, the literature reviewed highlighted an evident imbalance of scientific production in favour of individual effects of changing. This would be consistent with the literature stream identified, which has been moved to an integrated perspective in the organization’s vision during a change management initiative.
Technology and organization appear to be a double face of the change, being strictly related, but there is not a common perspective in defining the role of enabler for those variables. In this respect, further research should address the above-mentioned issue in the organizational change context.
Likewise, a specific investigation on organizational change and the healthcare field is encouraged. Healthcare organizations ought to adopt change models fitting their specific needs of change. Overall literature stream traces a systemic perspective, whereby an individual, organizational and expected outcome of change should be milestones of any organizational change action.
Healthcare organizations receive multiple external and internal stimuli of change.
The increasing dominancy of chronic diseases is forcing to shift the care gravity’s centre on the patient, by modulating the processes of providing the services according to the user and his changing needs. 21 , 31 The availability of new health technologies is changing the way through which health organizations offer services and deliver values (eg, e-health). New technologies are speeding up the demographic changeover and are increasing the economic burden for the NHS. 10 Health organizations are transforming their organizational models, eg, collaborative networks; 8 integrated hospital-local care; 39 , 42 sharing services 17 for reducing administrative costs. 51
The converging outcome lies on strengthen the equity, the value and the sustainability of healthcare.
In this regard, starting from the micro-level analysis, professionals needs’ integration with the organizational design and the individual technology acceptance should be pursued. Exploratory studies may be useful.
Research on change management is gaining momentum and offering many stimuli. Therefore, the development of research lines to deepen the topic is important, especially in the healthcare field.
The authors report no conflicts of interest in this work.
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There is moderate-certainty evidence that behaviour change interventions are associated with increased physical activity levels among older hospitalised patients.
This study from Canada found that one in three young adults with ADHD had a lifetime alcohol use disorder, and that young adults with ADHD were also three times more likely to develop a substance use disorder. Targeted outreach and interventions for this extremely vulnerable population are warranted.
According to this study, resuming evictions in summer 2020 was associated with increased COVID-19 incidence and mortality in US states, with an estimated 433,700 excess cases and 10,700 excess deaths. Explore more research on COVID-19 in a curated collection from the AJE: https://academic.oup.com/aje/pages/covid-19
The British Occupational Hygiene Society (BOHS) developed a control banding matrix for employers and others to help assess the risks of COVID-19 infection, and calls for further work to validate the reliability of the tool. Browse the Annals' collection on occupational hygiene for virus protection: https://academic.oup.com/annweh/pages/covid-19
In 1777, George Washington ordered a mandatory inoculation program for his troops, in what would become the first mass immunization mandate in the US. This archival article discussess and contextualizes immunization practices for US Armed Forces.
Responding to concerns that that face mask use could elicit a false sense of security and lead to riskier behaviours, this study from Denmark found that mask use overall correlated positively with protective behaviours.
While medical practice is often undermined by subsequent investigation, randomized trials relevant to primary care generally hold up over time.
This study shows the potential for using social media influencers to inspire positive engagements on pro-vaccine health messaging. For more content on accurate information's importance for public health, browse the latest article collection from HER: https://academic.oup.com/her/pages/covid-19
Current emergency response planning does not have adequate coverage to maintain health systems functionality for essential health service delivery alongside emergency-specific interventions and healthcare. The findings from this study can help align health emergency planning with broader population health needs.
This case study shows that that ongoing efforts are needed to improve sustainability of nutrition policy and programmes to address all diet-related diseases.
This review article outlines evidence for a range of institutional measures and behaviour-change measures, and highlights research and knowledge gaps.
The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since World War II in Western Europe or the breakup of the Soviet Union in Eastern Europe.
The authors propose an update to the Equator’s Consolidated criteria for reporting qualitative research (COREQ) checklist, with the aim of enhancing inclusivity.
This study confirms previous findings on a low risk of SARS-CoV-2 reinfection. If confirmed, these findings suggest that more targeted restriction policies can be applied to the subjects that recovered after a first infection. Read highly cited papers on COVID-19 from the Journal of Public Health: https://academic.oup.com/jpubhealth/pages/covid-19
Given the Delta variant's high reproductive number associated with higher transmissibility, in a context of globally still low vaccine coverage rates and lower vaccine effectiveness, public health and social measures will need to be substantially strengthened. A high reproductive number also means that much higher vaccine coverage rates need to be achieved compared to the originally assumed.
Neurological complications are rare in children suffering from COVID-19. Still, these children are at risk of developing seizures and encephalopathy, more in those suffering from severe illness.
The researchers examined support for and perceived impact of e-cigarette sales restrictions. Findings suggest that bans on flavored vape products could have a positive impact on lower-risk users, but that other young adult user subgroups may not experience benefit.
An editorial from the earlier stages of the pandemic highlights the importance of properly fitted respirators for worker safety and outlines occupational hygiene measures.
Guidelines for safe mass drug administration for neglected tropical diseases were developed in a COVID-19 context; training and implementation were assessed through an observation checklist.
For more research on the impact of COVID-19 on NTDs, explore the March 2021 special issue: https://academic.oup.com/trstmh/issue/115/3
Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study
Trajectories of Alcohol Use and Related Harms for Managed Alcohol Program Participants over 12 Months Compared with Local Controls: A Quasi-Experimental Study
Estimating the Effect of Social Distancing Interventions on COVID-19 in the United States
Selecting Controls for Minimizing SARS-CoV-2 Aerosol Transmission in Workplaces and Conserving Respiratory Protective Equipment Supplies
What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?
Denialism: what is it and how should scientists respond?
Acute cooling of the feet and the onset of common cold symptoms
The effect of falsely balanced reporting of the autism–vaccine controversy on vaccine safety perceptions and behavioral intentions
Climate change: an urgent priority for health policy and systems research
Power, control, communities and health inequalities I: theories, concepts and analytical frameworks
Research ethics in context: understanding the vulnerabilities, agency and resourcefulness of research participants living along the Thai–Myanmar border
Tobacco smoking and mortality among Aboriginal and Torres Strait Islander adults in Australia
Quality and safety in the time of Coronavirus: design better, learn faster
Years of life lost associated with COVID-19 deaths in the United States
In-flight transmission of SARS-CoV-2: a review of the attack rates and available data on the efficacy of face masks
Stability of the Initial Diagnosis of Autism Spectrum Disorder by DSM-5 in Children: A Short-Term Follow-Up Study
Impact of Tobacco Smoking on the Risk of COVID-19: A Large Scale Retrospective Cohort Study
Mental health of staff working in intensive care during COVID-19
The benefits and costs of social distancing in high- and low-income countries
A classification tree to assist with routine scoring of the Clinical Frailty Scale
Recent Advances in the Potential of Positive Allosteric Modulators of the GABAB Receptor to Treat Alcohol Use Disorder
The recent oubreak of smallpox in Meschede, West Germany
Your Hair or Your Service: An Issue of Faith for Sikh Healthcare Professionals During the COVID-19 Pandemic
Emerging Infections: Pandemic Influenza
Identifying the views of adolescents in five European countries on the drivers of obesity using group model building
Novel multi-virus rapid respiratory microbiological point-of-care testing in primary care: a mixed-methods feasibility evaluation
Public health crisis in the refugee community: little change in social determinants of health preserve health disparities
In search of ‘community’: a critical review of community mental health services for women in African settings
COVID-19, a tale of two pandemics: novel coronavirus and fake news messaging
Disrupting vaccine logistics
Use of directed acyclic graphs (DAGs) to identify confounders in applied health research: review and recommendations
Measurement and monitoring patient safety in prehospital care: a systematic review
Black Lives Matter protests and COVID-19 cases: relationship in two databases
The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China
Severe Malnutrition and Anemia Are Associated with Severe COVID in Infants
A Single-Arm, Open-Label, Pilot, and Feasibility Study of a High Nicotine Strength E-Cigarette Intervention for Smoking Cessation or Reduction for People With Schizophrenia Spectrum Disorders Who Smoke Cigarettes
Healthcare workers and protection against inhalable SARS-CoV-2 aerosols
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npj Digital Medicine volume 7 , Article number: 253 ( 2024 ) Cite this article
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E-mental health (EMH) interventions gain increasing importance in the treatment of mental health disorders. Their outpatient efficacy is well-established. However, research on EMH in inpatient settings remains sparse and lacks a meta-analytic synthesis. This paper presents a meta-analysis on the efficacy of EMH in inpatient settings. Searching multiple databases (PubMed, ScienceGov, PsycInfo, CENTRAL, references), 26 randomized controlled trial (RCT) EMH inpatient studies ( n = 6112) with low or medium assessed risk of bias were included. A small significant total effect of EMH treatment was found ( g = 0.3). The effect was significant both for blended interventions ( g = 0.42) and post-treatment EMH-based aftercare ( g = 0.29). EMH treatment yielded significant effects across different patient groups and types of therapy, and the effects remained stable post-treatment. The results show the efficacy of EMH treatment in inpatient settings. The meta-analysis is limited by the small number of included studies.
Mental health disorders represent a prevalent set of clinical conditions associated with substantial personal and economic burdens. However, despite their prevalence and impact, there exists a conspicuous deficit in the provision of effective treatment 1 , 2 , 3 , 4 . Across Europe, estimates suggest that 15–40% of the population experiences some form of mental disorder, yet fewer than one-third of these cases receive treatment that meets the established standards of adequacy 5 , 6 , 7 , 8 , 9 .
One reason for the lack of adequate treatment of mental disorders are structural supply issues, for example caused by a shortage of mental healthcare providers in more rural areas 10 . Furthermore, negative attitudes towards mental health treatments hinder seeking help especially in mild to moderate cases 11 . Finally, prompt access to mental health treatment is paramount for its efficacy, yet mental health facilities and specialists often impose prolonged waiting periods spanning several months 12 . These extended waiting intervals amplify the economic strain of mental disorders 13 , exacerbate clinical manifestations 14 , 15 , diminish treatment adherence, and elevate dropout rates 16 , 17 . In summary, providing adequate mental health treatment is complicated by a variety of structural issues leading to several other problems like economic and patients’ personal costs.
E-mental health (EMH) interventions aim to provide adequate treatment of mental health disorders through technological means and channels, such as app- or web-based systems, text messages, videos, or digital monitoring. Here, the term EMH is used to describe any digitally delivered interventions with the goal of improving mental health outcomes. Due to the easy accessibility of EMH products, such interventions have many advantages: They can 1) fill structural supply gaps for rural areas, 2) bridge long waiting times for in-person mental health treatment, and 3) provide additional anonymity for those concerned about stigmatization 18 , 19 . Thus, EMH tools have the potential to be a viable method to overcome the various issues hindering adequate mental health treatment.
In outpatient settings, EMH interventions are effective tools to treat mental disorders according to several meta-analyses, including the treatment of anxiety and depression 20 , 21 , 22 eating disorders 23 , posttraumatic stress 24 , or work-related stress 25 . Furthermore, EMH interventions find predominantly positive acceptance from both patients and mental health practitioners 26 , 27 , 28 . Thus, EMH interventions are viable and accepted tools in the treatment of mental disorders in outpatient settings.
Inpatient treatment signals an especially high need for timely and adequate intervention and is indicated for cases considered too severe for outpatient treatment 29 . Inpatient interventions can profit from supportive EMH procedures either to bridge waiting times, to blend with in-person interventions, or to ensure stabilization and relapse prevention in aftercare treatments. Especially the implementation of post-treatment aftercare improves the chances of a favorable and sustained development 30 , 31 , 32 . Thus, EMH treatment can be an important factor in the long-term success of inpatient treatments. Adequate aftercare enhances rehabilitation according to several reviews and meta-analyses 33 , 34 , 35 . Randomized controlled trials (RCT) exist on EMH treatment as add-ons to regular inpatient interventions 36 and aftercare 37 . Furthermore, a systematic review 38 found support for the efficacy of EMH aftercare treatments but was limited by the small number of studies. Yet as of now, there are to our knowledge no meta-analyses on the use of EMH in inpatient treatments, nor are there meta-analyses on EMH for inpatient aftercare. In addition, the systematic review on EMH inpatient care is several years old and does not incorporate the more recent research 38 .
The present study seeks to summarize the findings of previous RCTs on EMH treatments in inpatient settings in a meta-analysis. In addition, the risk of bias of the studies are assessed 39 . Specifically, this meta-analysis seeks to investigate 1) the total effect of EMH treatments on mental health outcomes in inpatient settings; 2) the effects of EMH treatments, divided into interventions and aftercare treatments; 3) the effect of EMH treatments in relationship depending on the mental health disorder; 4) the effect of type of therapy on EMH efficacy; 5) the effects of follow-up measures on EMH interventions are investigated to test long-term effects; and 6) the assessment of bias of the currently published RCT literature. Furthermore, post-hoc analyses were conducted to investigate 1) the role of EMH medium (e.g., app-based, web-based, SMS-based) on EMH treatment efficacy, and 2) the effect of the type of control group on EMH efficacy.
A total of 26 research studies containing 123 effects and a sample size of n = 6112 ( intervention group = 3041, control group = 3071) were included. A summary of the included studies is shown in Table 1 . Five studies used blended treatment during inpatient stay while 21 studies conducted post-inpatient aftercare treatment. The most common patient groups (according to the number of studies) were eating disorders ( k = 7) followed by mood disorders ( k = 6), transdiagnostic ( k = 4), psychotic disorders ( k = 3), return to work treatments ( k = 2), mental comorbidities with somatic disorders ( k = 2), anxiety disorders ( k = 1), and substance abuse ( k = 1).
Thirteen out of 26 studies utilized a passive control group for which participants did not receive any type of active treatment (e.g., waiting list); eight studies used an active control group with an active treatment alternative to the EMH treatment (e.g., aftercare e-mail reminders for mental health tools, psychoeducation, rehabilitation activities, or psychosocial support such as counsling); five studies used an active control group to which the EMH treatment as added to in the intervention group; finally, one study used both active and passive control groups.
Three studies used SMS-based EMH interventions. Eighteen studies used web-based interventions such as SUMMIT 40 , IN@ 41 , HEINS 42 , Deprexis 37 , 43 , 44 , GSA Online 45 , and EDINA 46 . Five studies used app-based tools such as MCT & More 47 and Mindshift 36 . Each specified tool was used by only one study except for Deprexis, which was used in three studies.
Out of all included studies, 17 were conducted in Germany, two in Sweden and USA respectively, and one in Hungary, Iran, Finland, Canada, and Australia, respectively.
Study search and selection flow is depicted in Fig. 1 .
Flowchart depicting study selection. The first selection of 726 studies was found in five different databases. Following the evaluation by exclusion criteria, 30 studies were selected for risk of bias evaluation. After four studies were excluded for risk of bias, 26 studies were included in the meta-analysis. EMH e-mental health, RCT randomized controlled trial.
Four studies were rated as high risk of bias and excluded from the analysis. Out of the remaining studies, 19 were rated as medium risk of bias and seven as low risk of bias. Among the most common bias concerns were asymmetrical attrition rates in control and intervention groups, high attrition rates with unclear reasons, alternating allocations (rather than random allocation), and inadequate information on blinding procedures (e.g., no specifications for statements such as “the procedure was blinded”). All four high risk studies were excluded also due to unclear, high, or uneven attrition rates between groups.
The risk assessment is summarized in Table 1 .
Preliminary analyses were conducted to test for publication bias using funnel plot and p -curve analyses.
Funnel plots with effect sizes plotted against standard errors are depicted in Fig. 2a .
Funnel plot across all effects ( a ) and after excluding studies with the largest standard errors ( b ). The funnel plots depict the effect sizes (Hedges’ g ) plotted against the studies’ (reversed) standard errors. Asymmetry analyses found a significant asymmetry ( a ), but not when excluding four effects with the largest standard errors ( b ). As the effect size remains unaltered, the results do not indicate publication bias.
Publication bias would express itself in a preference for publishing significant compared to non-significant results. Because smaller studies need a higher effect size to reach significant effects compared to larger studies, an asymmetrical distribution with more smaller studies with larger effect sizes compared to larger studies would indicate publication bias. A regression analysis using standard error as a predictor of effect sizes suggests significant asymmetry ( z = 3.6, p < 0.001, i = 123 effects).
Publication bias can be controlled by excluding the smallest studies 48 . After excluding studies with the largest standard errors ( i = 4 effects, 3% of the total effects), another regression test showed no indicators of funnel plot asymmetry (z = 1.89, p = 0.058, i = 119, Fig. 2b ). The total effect size remained unaltered ( g = 0.33 [0.2, 0.46], p < 0.001), showing that the publication bias correction did not impact the results. Thus, the results do not indicate publication bias.
P -curve analysis was used to investigate publication bias further. A right-skewed p -curve would indicate an existing effect while a left-skewed p -curve would indicate publication bias or p -hacking as the latter curve would result from a tendency to acquire significant p -values of just below .05 despite the absence of a true effect indicated by a higher rate of results with smaller p -values. The p -curve is depicted in Fig. 3 .
P -curve including the meta-analysis’ 109 significant effects, compared to a hypothetical null-effect curve and a hypothetical 33% power effect curve. Analysis shows a significant right skewedness, indicating the existence of a true effect.
Out of all effects, i = 109 effects provided a significant effect size of p < 0.05, out of which i = 108 showed a p -value of p < 0.025. The significant right-skewedness test ( p binominal < 0.001, z Full = -65.51, z Half = -64.65, p Half < 0.001) suggested the existence of a true effect. Furthermore, the non-significant flatness test ( p binominal = 1, z Full = 64.13, z Half = 65.88, p Half = 1) provided no indicators that a true effect is not present.
In total, both funnel plot and p -curve analysis show no indicators of publication bias or p -hacking, and that the observed effect is true.
A summary of all results is presented in Fig. 4 .
Effect sizes, confidence intervals, and number of effects across conditions, controlled for study. Note. Total = across all data; relevant effects = only effects of measures relevant to the mental condition are included; blended = treatment with EMH blended with inpatient care; aftercare = treatment after inpatient care. CBT cognitive-behavioural therapy, PD Psychodynamic therapy.
Total effect size with study as random effect revealed a significant positive effect of EMH intervention ( g = 0.3 [0.2, 0.39], p < .001, k = 118). When only including effects of measures relevant to the mental disorder symptoms (e.g., Beck depression scores for depressive disorder patients) and removing measures not directly related to the mental disorder’s symptoms or clinical outcomes (e.g., social support, self-esteem), effect size increased ( g = 0.36 [0.22, 0.5], p < 0.001, k = 83).
As expected given the variety of study designs and conditions, significant heterogeneity was observed for both the total effect (Q(117) = 408.25, p < .001) and when including only clinically relevant outcomes (Q(82) = 647.91, p < 0.001).
By-treatment type analysis revealed that both blended interventions during inpatient stay ( g = 0.42 [0.27, 0.58], p < 0.001, k = 19) and aftercare treatments following inpatient stay ( g = 0.29 [0.24, 0.34], p < 0.001, k = 99) showed significant effects.
By-condition analysis revealed significant effects of EMH interventions for eating disorder ( g = 0.19 [0.07, 0.32], p = .003, k = 17), mood disorder ( g = 0.38 [0.28, 0.49], p < 0.001, k = 22), psychotic disorder ( g = 0.43 [0.27, 0.58], p < 0.001, k = 10), return to work ( g = 0.21 [0.12, 0.3], p < 0.001, k = 24), and transdiagnostic patients ( g = 0.4 [0.31, 0.49], p < 0.001, k = 34). No significant effects were found for anxiety disorders ( g = 0.35 [−0.22, 0.93], p = 0.23, k = 3), mental comorbidity with somatic disorders ( g = 0.19 [−0.02, 0.39], p = 0.072, k = 6), and substance abuse ( g < 0.01 [−0.27, 0.28], p = 0.964, k = 2).
Analysis by type of therapy revealed significant effects for cognitive behavioural therapy (CBT)-based treatments ( g = 0.26 [0.18, 0.34], p < 0.001, k = 43) and psychodynamic (PD) treatments ( g = 0.35 [0.27, 0.43], p < 0.001, k = 39).
To investigate potential effects of measurement time (e.g., a decrease of intervention efficacy for longer intervals after treatment), a linear mixed model with measurement time as the fixed effect and study as the random effect for effect sizes was calculated. Results showed no significant effect of measurement time ( t (61) = −00.97, p = 0.337), showing no indication that the strength of the treatment effect is influenced by the time passed between intervention and measurement.
Post-hoc analyses were conducted to investigate differences between EMH medium/channel and effects of type of control group. EMH medium analysis revealed significant effects for EMH tools implemented as web-based tools ( g = 0.32, CI [0.25, 0.37], p < 0.001) and multimedia interventions ( g = 0.79, CI [0.29, 1.29], p = 0.002). Effects for app-based and SMS-based EMH tools were not significant. However, multimedia was used by only one study 43 . The only specific EMH tool used by multiple studies was Deprexis, which showed a significant effect ( g = 0.61, CI [0.46, 0.77], p < 0.001).
Control group analysis revealed that EMH interventions significantly improve mental health outcomes compared to passive controls (no active treatment; g = 0.29, CI [0.19, 0.39], p < .001), active controls (active treatment alternative to EMH; g = 0.32, CI [0.24, 0.4], p < .001), and active controls to which the EMH intervention was added to in the intervention condition ( g = 0.3, CI [0.22, 0.39], p < 0.001). Thus, EMH interventions show efficacy compared to active treatments and usual and when used in addition to usual treatments.
Few studies focused on patients affected by anxiety disorders, complicating interpretations of the presented results. Meanwhile, studies with transdiagnostic patients often included patients with anxiety disorders and measured anxiety symptoms (e.g., GAD-7). To gain further insight into the effects of EMH treatment on anxiety disoders, an additional post-hoc analysis has been conducted measuring the efficacy of EMH treatment on anxiety symptoms specifically. The analysis showed a significant effect on anxiety symptoms ( g = 0.39, CI [0.18, 0.59], p < 0.001).
EMH procedures have shown to be a viable tool for the treatment of mental disorders, yet research on EMH in inpatient settings is relatively sparse. The current work presents, to our knowledge, the first meta-analysis providing evidence for the efficacy of EMH in inpatient treatment and aftercare. We found a significant small effect of EMH treatment ( g = 0.3).When focusing on disorder symptoms and clinically relevant outcomes, the effect size is further increased (g = 0.36), signalling that EMH procedures are suitable as interventions tailored to mental disorders in inpatient settings. A preliminary analysis further found no indicators of publication bias or p -hacking within the literature.
The effect remained significant when dividing the studies into the common implementation types of EMH, first when blended with in-person inpatient treatment ( g = 0.42) and second as an aftercare treatment following inpatient intervention ( g = 0.29). The majority of studies (21 out of 26) used an aftercare setting with the goal to ensure stabilization and prevent relapse of inpatient cases. Inpatient cases tend to be more severe compared to outpatient cases, with worse post-treatment outcomes when not sufficiently supported by aftercare following discharge 30 , 31 , 32 . The present results suggest that EMH can provide such an effective tool, closing an important mental health supply gap.
By-disorder analysis found that EMH was especially effective for psychotic disorders ( g = 0.42), transdiagnostic patient groups ( g = 0.4), and mood disorders ( g = 0.38). The results are comparable to meta-analyses finding small yet significant effects of EMH in outpatient settings for mood disorders 22 , providing evidence that the effects are comparable to inpatient settings.
The positive effect of EMH treatment for psychotic disorders is surprising given that EMH interventions may worsen psychotic patients’ concerns about technology and being recorded due to psychopathological paranoid tendencies 49 . Furthermore, the effect contrasts the negative outcomes reported in studies investigating psychotic patients 42 , 50 , 51 . While the results complement previous research on the effectiveness of EMH outpatient treatments for schizophrenia and psychosis 52 , the usage of EMH interventions for psychotic disorders remains not well developed, and their efficacy cannot be reliably estimated with the current research. For inpatient settings, SMS-based aftercare reminders for medication adherence did not improve patient outcomes 50 . The HEINS web-based aftercare program containing multiple modules (including psychoeducation, crisis plans, contacts to psychiatrists, and supportive monitoring) meanwhile showed positive user acceptance and adherence 42 , and Horyzons, an online social therapy aftercare program containing multiple features (including psychoeducation, skill development support, peer-to-peer conversations, and expert support), improved patient employment and reduced emergency room visits compared to usual care 51 . Given that both Horyzons and HEINS are interactive support units containing multiple modules, the results suggest that more extensive EMH treatment is needed to ensure aftercare of patients with psychosis. Patients with severe illnesses such as psychosis may not be able to effectively utilize digital health tools. EMH tools are to be used with caution when treating patients with psychosis and should be used in addition to in-person treatment instead of an alternative.
For outpatient treatment, the efficacy of EMH treatment for anorexia nervosa is not well researched, potentially due to the severity of the disorder and the presumed necessity for face-to-face treatment by clinicians 21 . Out of seven studies investigating eating disorder patients, four focused mainly on bulimia nervosa 41 , 46 , 53 , 54 . When excluding a follow-up study 55 and a pilot RCT 56 , only one proper RCT study focused on anorexia nervosa 57 . Although the initial results are promising, caution should be taken when transferring the results onto patients with anorexia nervosa given that the disorder leads to severe consequences including somatic complications that may be insufficiently tracked and treated through digital means.
Meanwhile, no significant effects for anxiety symptoms, comorbidity with somatic disorders, or substance abuse disorders were found. However, only one study investigated anxiety symptoms 36 . Meanwhile, multiple studies with transdiagnostic patient groups included patients with anxiety disorders 37 , 39 , 58 . A post-hoc analysis focusing on anxiety symptoms revealed a significant effect ( g = 0.39). Inpatient treatment is typically not indicated for anxiety disorders, which may explain the low number of studies. Given that EMH interventions are effective in treating anxiety disorders in outpatient settings 22 , and that the post-hoc analysis revealed a significant improvement in anxiety symptoms, the current negative findings on EMH inpatient treatment for anxiety disorders are to be interpreted with caution. A similar caution can be expressed for the negative result on substance abuse patients, which has been investigated by only one study 59 . Furthermore, future research ought to differentiate effects of EMH for different anxiety diagnoses in inpatient care, as EMH outpatient treatment effectiveness has been found to differ across anxiety disorders 22 .
Analysis by type of therapy revealed the effectiveness of both CBT- ( g = 0.26) and PD- ( g = 0.35) based interventions, showing that EMH treatment is effective when based on either of these types of psychotherapy
Finally, the result that observation period did not affect outcomes indicates that EMH-based treatment effects do not deteriorate with time passed after treatment, indicating the long-term stability of the effects. However, the latest measurement used in this analysis was 24 months after treatment. Hence, results cannot be interpreted for longer periods.
In general, the meta-analysis shows the efficacy of EMH treatment across different mental health disorders and types of therapy. Hence, mental health treatment can profit from integrating EMH into the patient journey. Given that EMH add-on also significantly improves outcomes compared to a regular active control group ( g = 0.3), adding EMH to regular practices can improve overall treatment outcomes. Since treatment as usual tends to be minimal for aftercare treatment, EMH can facilitate long-term improvements and remission prevention following inpatient treatment since other aftercare practices are lacking or minimal. Especially web-based EMH treatment has been shown to be effective throughout multiple studies ( g = 0.32) compared to SMS- or app-based approaches. Hence, practitioners may use EMH tools both as additives and as alternatives to regular treatment, and especially for aftercare following inpatient treatment. Web-based EMH tools have shown efficacy in most studies.
The meta-analysis is limited by the small number of studies especially for subgroup analyses, as some subgroups (e.g., anxiety disorder or substance abuse patients, or whole health approaches) only include a single study each and can thus not be properly interpreted. Although a total effect was found with a sufficient number of trials, further RCT research is needed to conduct more conclusive meta-analyses for subgroup-related research areas.
The small number of studies precludes further interesting analyses relevant to the design and implementation of EMH methods. For example, a previous meta-analysis on outpatient settings found that specific EMH methods were more effective for certain disorders (e.g., chatbots for depression, mood monitoring features for anxiety). Such research questions may be tackled in future meta-analyses when an adequate number of RCTs have been conducted. Meta-analyses and reviews are generally limited by the terms used and search outputs when conducting literature searches. Even though two literature searches (February 2024 and July 2024) were done for this meta-analysis, it may still not include all relevant literature. Furthermore, this meta-analysis was not preregistered. However, all relevant documents are publicly available.
Specific neuropsychological and cognitive measures were excluded from this meta-analysis to focus the research on explicit mental health outcomes. However, mental health deficits often co-occur with cognitive deficits, for example in memory, concentration, or problem-solving tasks. Although disorder-specific questionnaire measures encompass the measurement of such deficits, future research can focus on the effect of EMH interventions for the improvement of cognitive skills in patients affected by mental health disorders specifically.
Out of all 26 included studies 20 were conducted in Western or Northern Europe (17 in Germany, two in Sweden, one in Finland), three were conducted in North America (two in the USA and one in Canada), one in Australia, one in Hungary, and one in Iran. Research from other regions, such as Africa or East Asia, was absent. This may be due to differences in healthcare systems in different regions, and treatments alternative to inpatient treatment for more severe health cases. Thus, the results of this meta-analysis are mainly derived from studies conducted in countries with populations majorly of European descent. In order to generalize the reported findings, future research may aim to investigate EMH tools in more diverse populations.
Engagement and adherence are major concerns when applying EMH tools 60 , 61 , 62 , 63 . Effects of EMH on attrition were mitigated in this analysis by including group attrition effects in the RoB assessment: in fact, all four high risk studies were excluded due to unclear or uneven attrition rates. Engagement can be defined as usage as intended, measured for example through use frequency or completion 60 . Various included studies excluded participants with low engagement despite completion 41 and hence controlled for low engagement. Included studies mostly did not report direct effects on engagement on outcomes. One study found no effect of EMH tool use (assessed via logs) on symptom severity 56 . Similarly, other studies did not find a correlation between EMH use frequency and symptom improvement 47 , completed models and symptom improvement 64 , or differences between high- and low-frequency users 59 . Meanwhile, the number of completed EMH courses did significantly improve symptoms in patients with anorexia nervosa 55 . Although there are only few studies and results are not consistent, the results nevertheless indicate that use frequency or intensity does generally not affect the treatment efficacy. Finally, some studies report improved engagement in the intervention compared to a control group 65 , 66 , indicating that EMH intervention may improve engagement behaviour. Future research may investigate effects of such engagement when implementing EMH tools.
Given that various measurement outcomes were used and summarized to generalize a wider range of findings, results do not consistently reflect the most clinically relevant outcomes (e.g., remission or relapse rates) which were only reported by six studies for varying mental disorders. Instead, the majority of research studies relied on symptom questionnaires. In total, a majority of the studies included were assessed with some concerns regarding risk of bias. Due to the low number of high-quality research with low bias and large sample sizes, results should be interpreted with some degree of caution. EMH implementations furthermore involve certain risks 67 such as a lack of quality standards 68 , data privacy issues 18 , or a lack of digital literacy by practitioners 19 . Despite promising results in this meta analysis, in the context of such risks, more high quality RCT research is necessary for a more rigorous assessment of EMH efficacy.
In conclusion, the results indicate that EMH procedures are an effective tool in the treatment and aftercare of inpatients, especially for psychotic, mood disorder, and eating disorder, and patient groups combining different diagnoses. EMH tools can be used both in addition to in-person treatment and when in-person treatment is not available, e.g., for aftercare. Future research should investigate effects of EMH tools for the inpatient treatment of specific disorders and the relevance of the specific tools used. Larger sample sizes and randomized trials are warranted to substantiate these effects.
This review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 69 and Cochrane Handbook guidelines for meta-analyses and systematic reviews 39 .
The literature databases SciencGov, PsycInfo, PubMed, and CENTRAL were searched for published literature. In addition, the ProQuest Database was searched for dissertation theses, and ICTRP and ClinicalTrials were searched for trial result registers.
To aim for high sensitivity according to Cochrane guidelines 39 , we used multiple search terms in relation to the following topics: e-mental health (digital, online, e-mental health, technology-based, web-based, internet-based, mobile-based), treatment setting (psychotherapy, psychiatric, psychosomatic), inpatient setting (inpatient, ward patient, hospitalized), and experimental design (RCT, randomized controlled trial). The search term used corresponds to the following: (“digital” OR “online” OR “e-mental health” OR “technology-based” OR “web-based” OR “internet-based” OR “mobile-based”) AND (“psychotherapy” OR “psychiatric” OR “psychosomatic”) AND (“inpatient” OR “ward patient” OR “hospitalized”) AND (“RCT” OR “randomized controlled trial”). Two researchers conducted the literature search in February 2024. Literature search was performed in English and German.
A secondary search was conducted in July 2024 by extending the search to use the terms “e-health”, “mhealth”, and “telemedicine”, and using the mesh terms “digital health”, “telemedicine”, “psychotherapy”, “psychosomatic medicine”, and “inpatients” if applicable, for the databases CENTAL and PubMed. The secondary literature search did not yield any new viable studies.
We included research studies providing EMH interventions during inpatient treatment or aftercare following inpatient treatment, and studies investigating psychiatric symptoms co-occurring in patients hospitalized for physical conditions (e.g., stress or depression symptoms in cancer patients). Cluster and pilot RCTs were included as well.
Studies were excluded if they 1) did not investigate the effect of EMH intervention or aftercare methods, 2) did not investigate inpatients (either during or after inpatient intervention), 3) did not investigate mental health measures as treatment outcomes (e.g., only focusing on somatic symptoms or acceptability of the intervention; specific neuropsychological or cognitive outcomes like problem-solving skills were also excluded), 4) were not randomized controlled trials, 5) did not provide sufficient information to extract the relevant data (e.g., outcome measures or sample sizes), and 6) showed a high risk of bias assessed via the Risk of Bias tool (see next section) 39 . Neuropsychological or cognitive were excluded to focus the meta-analysis on mental health treatment effects. Although cognitive or neuropsychological deficits can be symptoms of mental health disorders, symptom-focused measures of mental health deficits (e.g., depressiveness questionnaires for clinical depression) provide a more discriminative estimation of mental health deficits.
Three independent raters took part in the literature selection. In case of disagreements, the raters discussed the study until agreement was found.
Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2) 39 . RoB 2 is designed to assess the risk of an RCT’s bias by classifying the level of risk for the following domains: random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, and selective reporting. Examples of risk of bias include non-random or semi-random participant grouping (incl. alternating allocation); high, uneven, or unexplained participant attrition between groups; lack of blinding; or unreported discrepancies between the study protocol and study. If no information on a domain was provided, the particular domain was assessed with medium risk.
Domains were rated on three levels: low, medium, or high risk of bias. Research studies with a high risk of bias were excluded from the analysis.
For the total analyses, only measures related to clinical symptoms and psychosocial performance were included. These include: metric variables of disorder-related incidents (relapses, readmissions, abstinence, admissions); disorder-related symptom severity measurements; general psychopathology, well-being, or quality of life; employment-related measures (when relevant); and specific mental or psychosocial measures expected to correlate with symptom severity (e.g., self-esteem, positive and negative affect, stress). All relevant measures in a study were included in an analysis and controlled by treating study as a random effect.
To investigate the relevant research questions, studies and measures were categorized by the following system.
EMH treatment type was categorized into either blended intervention (EMH was implemented into the inpatient setting) or aftercare treatment (EMH was provided after completing inpatient setting).
The variable Disorder type was classified into the following categories based on the patient group investigated in the study: anxiety disorders (ICD-10 diagnoses F40 and F41), eating disorders (ICD-10 diagnoses F50) mood disorders (ICD-10 diagnoses F3), psychotic disorders (ICD-10 diagnoses F2), substance abuse disorders (ICD-10 diagnoses F1x.2), or their DSM-5 diagnostic equivalents. A study treating patient groups from different categories was classified as transdiagnostic . A study was categorized as somatic comorbidity if the effects of EMH interventions on mental health outcomes in somatic inpatient groups were investigated (e.g., stress or anxiety symptoms in cancer patients). Finally, the category return to work was used for studies focussing on outcomes related to workplace reintegration following inpatient care.
The variable type of therapy was classified according to the type of therapy the EMH intervention was based on according to the authors. If no type of therapy was mentioned, the variable was valued as not available .
Data was summarized on multiple variables: author, title, year, country, type (aftercare, blended treatment), treated mental disorder, somatic illness (if present), digital method, type of therapy, type of control group (active, passive), outcome measure, follow-up, sample sizes, and outcome results (means, standard deviations, odds ratios, effect sizes). Data was extracted by one rater and verified by two other independent raters. Study characteristics were tabulated according to the planned subgroup analyses. Studies with insufficient data were excluded from the (sub-)analyses.
Hedges’ g was used to report effect sizes as it outperforms Cohen’s d for small sample sizes. Cohen’s d effect sizes and variances were transformed to Hedges’ g values and variances using the following formulas 48 :
When a study reported odds ratio (OR) values, values were first transformed into Cohen’s d using the following formula 48 :
Cohen’s d values were then transformed into Hedges’ g according to Formula 1.
Heterogeneity was tested and pre-assumed given the variety of setups in research studies and subgroup analyses were therefore decided a priori. Fixed-random effects models were used with study as a random factor. To assess the results’ robustness, the total effect is analysed two times, first using the whole range of data, and second using only outcomes that are clinically relevant (limited to symptom severity and clinical outcomes). Effects’ certainty and confidence were assessed through risk of bias assessment according to Cochrane guidelines and by investigating publication bias using funnel plot and p -curve analyses. The meta-analysis was not preregistered. No protocol is available for the meta-analysis. Confidence was assessed by calculating confidence intervals from standard errors.
Post-hoc analyses were decided after the data was analysed for the main hypotheses. Post-hoc analyses included the effect of EMH medium, the role of control group, and the effect of EMH on anxiety symptoms specifically.
Data including the complete list of searched literature, the included studies, extracted data, and risk assessment are publicly available at https://osf.io/bc59e . Thus, all data is provided to replicate assessment of literature according to inclusion criteria and risk of bias, as well as all data necessary to replicate the analyses.
The R code for the analysis is publicly available at https://osf.io/bc59e . Main and subgroup analyses and visualization of results were conducted via RStudio (ver. 2021.9.1.0, R version 4.1.2). The R packages dmetar and metafor were used for the analyses 70 , 71 .
Borges, G. et al. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. J. Clin. Psychiatry 71 , 1617–1628 (2010).
PubMed PubMed Central Google Scholar
Doran, C. M. & Kinchin, I. A review of the economic impact of mental illness. Aust. Health Rev. 43 , 43 (2019).
PubMed Google Scholar
Vos, T. et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: A systematic analysis for the global burden of disease study 2016. Lancet 390 , 1211–1259 (2017).
Google Scholar
Santomauro, D. F. et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet 398 , 1700–1712 (2021).
Ahmed, N. et al. Mental health in Europe during the COVID-19 pandemic: A systematic review. Lancet Psychiatry 10 , 537–556 (2023).
Alonso, J. et al. Prevalence of mental disorders in Europe: Results from the European study of the epidemiology of Mental Disorders (esemed) project. Acta Psychiatr. Scandinavica 109 , 21–27 (2004).
Sacco, R., Camilleri, N., Eberhardt, J., Umla-Runge, K. & Newbury-Birch, D. A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe. European Child & Adolescent Psychiatry https://doi.org/10.1007/s00787-022-02131-2 (2022).
Wittchen, H. U. et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur. Neuropsychopharmacol. 21 , 655–679 (2011).
PubMed CAS Google Scholar
Zuberi, A. et al. Prevalence of mental disorders in the WHO Eastern Mediterranean Region: A systematic review and meta-analysis. Front. Psychiatry 12 , (2021).
Jacobi, F. et al. Psychische Störungen in der Allgemeinbevölkerung. Der Nervenarzt 85 , 77–87 (2014).
Andrade, L. H. et al. Barriers to mental health treatment: Results from the WHO World Mental Health Surveys. Psychol. Med. 44 , 1303–1317 (2013).
EU-Compass for action on Mental Health and well-being. Public Health Available at: https://health.ec.europa.eu/non-communicable-diseases/mental-health/eu-compass-action-mental-health-and-well-being_en (Accessed: 21st May 2024).
Koopmanschap, M. A., Brouwer, W. B. F., Hakkaart-van Roijen, L. & van Exel, N. J. A. Influence of waiting time on cost-effectiveness. Soc. Sci. Med. 60 , 2501–2504 (2005).
Reichert, A. & Jacobs, R. The impact of waiting time on patient outcomes: Evidence from early intervention in psychosis services in England. Health Econ. 27 , 1772–1787 (2018).
van Dijk, D. A. et al. Worse off by waiting for treatment? the impact of waiting time on clinical course and treatment outcome for depression in routine care. J. Affect. Disord. 322 , 205–211 (2023).
Sherman, M. L., Barnum, D. D., Buhman-Wiggs, A. & Nyberg, E. Clinical intake of child and adolescent consumers in a rural community mental health center: Does wait-time predict attendance? Community Ment. Health J. 45 , 78–84 (2008).
Williams, M. E., Latta, J. & Conversano, P. Eliminating the wait for Mental Health Services. J. Behav. Health Serv. Res. 35 , 107–114 (2007).
Köhnen, M., Dirmaier, J. & Härter, M. Potenziale und Herausforderungen von E-mental-health-interventionen in der Versorgung Psychischer störungen. Fortschr. der Neurologie · Psychiatr. 87 , 160–164 (2019).
Weitzel, E. C. et al. E-mental health in Germany — what is the current use and what are experiences of different types of health care providers for patients with mental illnesses? Arch. Public Health 81 , 1–6 (2023).
Bolinski, F. et al. The effect of E-mental health interventions on academic performance in university and college students: A meta-analysis of randomized controlled trials. Internet Interventions 20 , 100321 (2020).
PubMed PubMed Central CAS Google Scholar
Firth, J. et al. Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. J. Affect. Disord. 218 , 15–22 (2017).
Linardon, J. et al. Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta‐analysis of 176 randomized controlled trials. World Psychiatry 23 , 139–149 (2024).
Linardon, J., Shatte, A., Messer, M., Firth, J. & Fuller-Tyszkiewicz, M. E-mental health interventions for the treatment and prevention of eating disorders: An updated systematic review and meta-analysis. J. Consulting Clin. Psychol. 88 , 994–1007 (2020).
Simblett, S., Birch, J., Matcham, F., Yaguez, L. & Morris, R. A systematic review and meta-analysis of E-mental health interventions to treat symptoms of posttraumatic stress. JMIR Mental Health 4 , (2017).
Stratton, E. et al. Effectiveness of ehealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis. PLOS ONE 12 , (2017).
Löbner, M. et al. What comes after the trial? an observational study of the real-world uptake of an e-mental health intervention by general practitioners to reduce depressive symptoms in their patients. Int. J. Environ. Res. Public Health 19 , 6203 (2022).
Rost, T. et al. User acceptance of computerized cognitive behavioral therapy for depression: Systematic review. Journal of Medical Internet Research 19 , (2017).
Wangler, J. & Jansky, M. How can primary care benefit from Digital Health Applications? – a quantitative, explorative survey on attitudes and experiences of General Practitioners in Germany. BMC Digital Health 2 , 1–14 (2024).
Zipfel, S., Herzog, W., Kruse, J. & Henningsen, P. Psychosomatic medicine in Germany: More timely than ever. Psychother. Psychosom. 85 , 262–269 (2016).
Franz, M. et al. Stationäre Tiefenpsychologisch Orientierte psychotherapie bei Depressiven Störungen (stop-D) - erste befunde einer naturalistischen, multizentrischen Wirksamkeitsstudie. Z. f.ür. Psychosomatische Med. und Psychotherapie 61 , 19–35 (2015).
Gönner, S., Bischoff, C., Ehrhardt, M. & Limbacher, K. Effekte therapiezielorientierter Kognitiv-Verhaltenstherapeutischer Nachsorgemaßnahmen auf den therapietransfer im Anschluss an eine Stationäre psychosomatische Rehabilitationsbehandlung. Die Rehabilitation 45 , 369–376 (2006).
Zeeck, A., Wietersheim, Jvon, Weiss, H., Beutel, M. & Hartmann, A. The INDDEP Study: Inpatient and day hospital treatment for depression – symptom course and predictors of change. BMC Psychiatry 13 , 100 (2013).
Giel, K. E. et al. Efficacy of post-inpatient aftercare treatments for anorexia nervosa: A systematic review of randomized controlled trials. J. Eat. Disord. 9 , 129 (2021).
Hegedüs, A., Kozel, B., Richter, D. & Behrens, J. Effectiveness of transitional interventions in improving patient outcomes and service use after discharge from psychiatric inpatient care: A systematic review and meta-analysis. Front. Psychiatry 10 , 969 (2020).
Vittengl, J. R., Clark, L. A., Dunn, T. W. & Jarrett, R. B. Reducing relapse and recurrence in Unipolar Depression: A comparative meta-analysis of cognitive-behavioral therapy’s effects. J. Consulting Clin. Psychol. 75 , 475–488 (2007).
Sharma, G. et al. Brief app-based cognitive behavioral therapy for anxiety symptoms in psychiatric inpatients: Feasibility randomized controlled trial. JMIR Formative Res. 6 , e38460 (2022).
Zwerenz, R. et al. Transdiagnostic, psychodynamic web-based self-help intervention following inpatient psychotherapy: Results of a feasibility study and randomized controlled trial. JMIR Ment. Health 4 , e41 (2017).
Hennemann, S., Farnsteiner, S. & Sander, L. Internet- and Mobile-based aftercare and relapse prevention in mental disorders: A systematic review and recommendations for Future Research. Internet Interventions 14 , 1–17 (2018).
Cochrane Handbook for Systematic Reviews of interventions. (Cochrane, 2019).
Kordy, H. et al. Internet-delivered disease management for recurrent depression: A multicenter randomized controlled trial. Psychother. Psychosom. 85 , 91–98 (2016).
Jacobi, C. et al. Web-based aftercare for women with bulimia nervosa following inpatient treatment: Randomized controlled efficacy trial. J. Med. Internet Res. 19 , e321 (2017).
Gallinat, C. et al. Feasibility of an intervention delivered via mobile phone and internet to improve the continuity of care in schizophrenia: A randomized controlled pilot study. Int. J. Environ. Res. Public Health 18 , 12391 (2021).
Nolte, S. et al. Do sociodemographic variables moderate effects of an internet intervention for mild to moderate depressive symptoms? an exploratory analysis of a randomised controlled trial (evident) including 1013 participants. BMJ Open 11 , e041389 (2021).
Abadi, M. et al. Achieving whole health: A preliminary study of TCMLH, a group-based program promoting self-care and empowerment among veterans. Health Educ. Behav. 49 , 347–357 (2021).
Becker, J., Kreis, A., Beutel, M. E. & Zwerenz, R. Wirksamkeit der Internetbasierten, Berufsbezogenen Nachsorge GSA-online im Anschluss an die stationäre psychosomatische Rehabilitation: Ergebnisse einer randomisiert Kontrollierten Studie. Die Rehabilitation 61 , 276–286 (2022).
Gulec, H. et al. A randomized controlled trial of an internet-based posttreatment care for patients with eating disorders. Telemed. e-Health 20 , 916–922 (2014).
Bruhns, A., Lüdtke, T., Moritz, S. & Bücker, L. A mobile-based intervention to increase self-esteem in students with depressive symptoms: Randomized controlled trial. JMIR mHealth uHealth 9 , e26498 (2021).
Borenstein, M. Computing effect sizes for meta-analysis. (Wiley-Blackwell, 2011).
Philippe, T. J. et al. Digital Health Interventions for delivery of mental health care: Systematic and comprehensive meta-review. JMIR Ment. Health 9 , e35159 (2022).
Välimäki, M., Kannisto, K. A., Vahlberg, T., Hätönen, H. & Adams, C. E. Short text messages to encourage adherence to medication and follow-up for people with psychosis (mobile.net): Randomized controlled trial in Finland. J. Med. Internet Res. 19 , e245 (2017).
Alvarez‐Jimenez, M. et al. The Horyzons Project: A randomized controlled trial of a novel online social therapy to maintain treatment effects from specialist first‐episode psychosis services. World Psychiatry 20 , 233–243 (2021).
Clarke, S., Hanna, D., Mulholland, C., Shannon, C. & Urquhart, C. A systematic review and meta-analysis of digital health technologies effects on psychotic symptoms in adults with psychosis. Psychosis 11 , 362–373 (2019).
Bauer, S., Okon, E., Meermann, R. & Kordy, H. Technology-enhanced maintenance of treatment gains in eating disorders: Efficacy of an intervention delivered via text messaging. J. Consulting Clin. Psychol. 80 , 700–706 (2012).
Bauer, S., Okon, E., Meermann, R. & Kordy, H. SMS-Nachsorge: Sektorenübergreifende Versorgung für patientinnen mit bulimia nervosa. Verhaltenstherapie 23 , 204–209 (2013).
Fichter, M. M., Quadflieg, N. & Lindner, S. Internet-based relapse prevention for anorexia nervosa: Nine- month follow-up. J. Eat. Disord. 1 , 23 (2013).
Neumayr, C., Voderholzer, U., Tregarthen, J. & Schlegl, S. Improving aftercare with technology for anorexia nervosa after intensive inpatient treatment: A pilot randomized controlled trial with a therapist‐guided smartphone app. Int. J. Eat. Disord. 52 , 1191–1201 (2019).
Fichter, M. M. et al. Does internet-based prevention reduce the risk of relapse for anorexia nervosa? Behav. Res. Ther. 50 , 180–190 (2012).
Ebert, D., Tarnowski, T., Gollwitzer, M., Sieland, B. & Berking, M. A transdiagnostic internet-based maintenance treatment enhances the stability of outcome after inpatient cognitive behavioral therapy: A randomized controlled trial. Psychother. Psychosom. 82 , 246–256 (2013).
Harrington, K. F. et al. Web-based smoking cessation intervention that transitions from inpatient to outpatient: Study protocol for a randomized controlled trial. Trials 13 , 123 (2012).
Kernebeck, S., Busse, T. S., Ehlers, J. P. & Vollmar, H. C. Adhärenz digitaler Interventionen im Gesundheitswesen: Definitionen, Methoden und offene Fragen [Adherence to digital health interventions: definitions, methods, and open questions]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 64 , 1278–1284 (2021). OctGermanEpub 2021 Sep 24. PMID: 34559252; PMCID: PMC8492574.
Sieverink, F., Kelders, S. M. & van Gemert-Pijnen, J. E. Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence. J. Med Internet Res 19 , e402 (2017). Dec 6PMID: 29212630; PMCID: PMC5738543.
Beatty, L. & Binnion, C. A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions. Int J. Behav. Med 23 , 776–794 (2016). DecPMID: 26957109.
Eysenbach, G. The law of attrition. J. Med. Internet Res. 7 , e11 (2005). Mar 31PMID: 15829473; PMCID: PMC1550631.
Norlund, F. et al. Internet-based cognitive behavioral therapy for symptoms of depression and anxiety among patients with a recent myocardial infarction: The U-CARE heart randomized controlled trial. J. Med. Internet Res. 20 , e88 (2018).
Holländare, F. et al. Randomized trial of internet-based relapse prevention for partially remitted depression. Acta Psychiatr. Scandinavica 124 , 285–294 (2011).
Zwerenz, R. et al. Online self-help as an add-on to inpatient psychotherapy: Efficacy of a new blended treatment approach. Psychother. Psychosom. 86 , 341–350 (2017).
Ebert, D. D. et al. Internet- and mobile-based psychological interventions: Applications, efficacy, and potential for improving mental health. Eur. Psychologist 23 , 167–187 (2018).
Weitzel, E. C. et al. E-mental-health und Digitale Gesundheitsanwendungen in Deutschland. Der Nervenarzt 92 , 1121–1129 (2021).
Page, M. J. et al. The Prisma 2020 statement: An updated guideline for reporting systematic reviews. BMJ. https://doi.org/10.1136/bmj.n71 (2021).
Harrer, M., Cuijpers, P., Furukawa, T. A. & Ebert, D. D. Doing meta-analysis with R https://doi.org/10.1201/9781003107347 (2021).
Viechtbauer, W. Conducting meta-analyses inrwith themetaforpackage. J. Stat. Softw. 36 , (2010).
Bischoff, C. et al. Wirksamkeit von Handheld-Gestütztem Selbstmanagement (e-coaching) in der rehabilitationsnachsorge. Verhaltenstherapie 23 , 243–251 (2013).
Ebert, D. et al. Web-basierte rehabilitationsnachsorge nach stationärer Psychosomatischer Therapie (W-rena). Die Rehab. 52 , 164–172 (2013).
CAS Google Scholar
Schmädeke, S. & Bischoff, C. Wirkungen smartphonegestützter Psychosomatischer Rehabilitationsnachsorge (eATROS) Bei depressiven Patienten. Verhaltenstherapie 25 , 277–286 (2015).
Willems, R. A. et al. Short‐term effectiveness of a web‐based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: Randomized controlled trial. Psycho-Oncol. 26 , 222–230 (2016).
Zwerenz, R. et al. Evaluation of a transdiagnostic psychodynamic online intervention to support return to work: A randomized controlled trial. PLOS ONE 12 , e0176513 (2017).
Schlicker, S., Ebert, D. D., Middendorf, T., Titzler, I. & Berking, M. Evaluation of a text-message-based maintenance intervention for major depressive disorder after inpatient cognitive behavioral therapy. J. Affect. Disord. 227 , 305–312 (2018).
Zwerenz, R. et al. Improving the Course of Depressive Symptoms After Inpatient Psychotherapy Using Adjunct Web-Based Self-Help: Follow-Up Results of a Randomized Controlled Trial. J. Med. Internet Res. 21 , e13655 (2019).
Shaygan, M., Yazdani, Z. & Valibeygi, A. The effect of online multimedia psychoeducational interventions on the resilience and perceived stress of hospitalized patients with COVID-19: A pilot cluster randomized parallel-controlled trial. BMC Psychiatry 21 , 93 (2021).
Levis, M. et al. An implementation and effectiveness study evaluating Conflict Analysis in VA residential substance abuse services: Whole health informed self-guided online care. EXPLORE 18 , 688–697 (2022).
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Alexander Diel, Isabel Carolin Schröter, Anna-Lena Frewer, Christoph Jansen, Anita Robitzsch, Martin Teufel & Alexander Bäuerle
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Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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A.D. drafted the manuscript, conducted study search and selection, analysed the data, and revised the manuscript. I.S. and A.L.F. revised the manuscript and validated study search and selection. C.J., A.B., M.T., A.R., and G.G.D. revised the manuscript. M.T. acquired resources and funding.
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Diel, A., Schröter, I.C., Frewer, AL. et al. A systematic review and meta analysis on digital mental health interventions in inpatient settings. npj Digit. Med. 7 , 253 (2024). https://doi.org/10.1038/s41746-024-01252-z
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Here is a sample of abstracts from the clinical research conducted at the NIH Clinical Center and published in a peer-reviewed medical journal in 2022. Links to the full text and video formats are provided if available.
Published in: Critical Care Medicine (December 2022)
COVID-19 has taught doctors about preparedness as it relates to emerging infections and clinical trials. Researchers must take the progress made in clinical trial design and infrastructure and build on it, so we are ready to answer research and efficacy questions regarding novel therapeutics for future emerging infections.
Read the article .
Published in: The Lancet (December 2022)
Children with severe intellectual disabilities encounter inequities in pain-related care, yet little pain research includes them. Since they are unable to verbally communicate their pain, it creates challenges for their participation in pain research. However, improving the ethical guidelines for pain research and applying a framework for assessing clinical research is possible.
Published in: Nature Microbiology (December 2022)
Scientists used a multi-disciplinary analysis of blood, faeces, and liver tissue to characterize the gut-liver axis of patients with Hepatitis C virus (HCV). This study gives insight into the gut–liver axis in HCV and non-HCV liver diseases, and provides a foundation for future therapies.
Published in: Institute of Electrical and Electronics Engineers (IEEE) (November 2022)
Neural Networks show great potential for minimizing preprocessing steps in Brain-Computer Interface systems. Scientists tested novel methods to rapidly detect brain signals prior to moving the ankle, for use in neurofeedback training for motor rehabilitation.
Published in: The International Journal for Computer Assisted Radiology and Surgery (November 2022)
Scientists succeeded in using Artificial Intelligence technology to assist in lymph node detection. This detection can be critical in assessing lymphadenopathy (swelling of lymph nodes) and may lead to a better control of infection and cancer spread (metastases).
Published in: JACC: Advances (October 2022)
Researchers compared outcomes for patients with primary cardiac diagnoses admitted to either noncardiac or cardiac intensive care units (ICUs). Initial analysis showed better outcomes in cardiac ICUs, while noncardiac ICUs favored after including concurrent noncardiac critical illnesses. Highlights importance of Critical Care Medicine training for cardiologists managing critical illnesses in cardiac ICUs.
Published in: Frontiers in Human Neuroscience (September 2022)
Researchers compared the difference in how muscles work together in children with cerebral palsy and children with typical development using three different walking conditions on a treadmill. The former group were more affected by the changes in walking conditions.
Published in: SLEEP Advances (September 2022)
Researchers reviewed 28 laboratory and field-based studies that had either objective or subjective measurements of sleep or fatigue. Shorter sleep durations, short off-duty time, and early-morning start times were associated with slower reaction times, more lapses in attention, and premature responses on psychomotor vigilance tests.
Published in: Neuropharmacology (September 2022)
Studies suggest preliminary evidence that psychedelic-assisted psychotherapy may provide robust and sustained quality-of-life improvements for patients in life-threatening or palliative situations. These patients experienced less anxiety, depression, suicidal ideation and existential distress. More rigorous research is recommended to further assess effectiveness of these psychedelic therapies.
Published in: The Lancet Journal (September 2022)
Reliance on SARS-CoV-2 test positivity alone to identify cases of COVID-19 hospitalizations could have introduced misclassification bias in a study assessing the severity of SARS-CoV-2 omicron and delta variants.
Published in: Circulation (August 2022)
Risk prediction in pulmonary arterial hypertension (PAH) remains a major challenge. Cell-free DNA (cfDNA) is a noninvasive marker of cellular injury and its significance in pulmonary arterial hypertension (PAH) is unknown. In two PAH cohorts, plasma cfDNA was measured and found elevated in patients with PAH compared with healthy controls and increases with disease severity.
Published in: Frontiers in Psychiatry (August 2022)
Chronic sleep disturbances from heavy alcohol use may contribute to a sustained inflammatory state. Researchers examined pro-inflammatory cytokines in individuals with alcohol use disorder (AUD) and found associations with inflammation and alcohol consumption, sleep quality, anxiety and depression. Further research on inflammation in individuals with AUD is needed.
Published in: AIDS (July 2022)
Using advanced imaging (PET/CT), we found low glucose metabolism in the liver of untreated people living with HIV had improved, but did not resolve completely after long-term antiretroviral therapy. Residual liver metabolic changes in people with HIV after treatment should be further evaluated.
Published in: JMIR Publications (June 2022)
Researchers developed a protocol outlining methods to review research studying sleep and the gut microbiome. This research has been undertaken to determine the methodologies used to quantify sleep and the microbiome and synthesize microbiome responses associated with healthy/unhealthy sleep.
Published in: Intensive Care Medicine (May 2022)
Severe community-acquired pneumonia (CAP) requiring Intensive Care Unit admission causes significant morbidity and mortality. Treatments directed at reducing inflammation in severe CAP have potential benefit. In a randomized multi-center trial of 586 patients with severe CAP, corticosteroid treatment did not significantly reduce 60-day mortality.
Published in: Developmental Medicine & Child Neurology (May 2022)
Autism spectrum disorder (ASD) is a neurodevelopmental condition with early childhood symptoms. As a result, there is growing movement toward identifying ASD during early, more rapid periods of brain development to initiate interventions sooner. However, while two different approaches show positive effects on outcomes, the added benefits of earlier interventions still lack strong evidence.
Published in: AJOB Empirical Bioethics (April 2022)
During the COVID-19 pandemic, frontline workers faced a series of challenges balancing family and work responsibilities. This article focuses on frontline workers’ perspectives on making work-life-community decisions in light of their increased COVID-19 exposure.
Published in: Radiology (April 2022)
Researchers investigate computed tomography (CT) biomarkers that may be associated with the presence of type 2 diabetes using fully automated deep learning. The researchers found changes in the pancreases of patients as early as 7 years before the patients were diagnosed with diabetes.
Published in: Investigative Radiology (March 2022)
CT imaging was used to predict the distribution of chemotherapy following intra-arterial delivery of drug-releasing microspheres to a woodchuck liver tumor. This “drug mapping” concept could improve drug targeting and coverage of tumors, reducing side effects and improving treatment outcomes for patients with liver cancer.
Published in: PubMed (March 2022)
Researchers compared atherosclerotic plaque in major arteries of the abdomen and pelvis of men with and without prostate cancer. The atherosclerotic plaque in prostate cancer patients did not differ from the normal control group, but were closely associated with age and heart disease.
Published in: Journal of Clinical Apheresis (March 2022)
In a case series of 18 healthy stem cell donors who received a common stimulation regimen, a protein that is commonly associated with heart failure increased transiently in their blood. The long-term impact on donor's health is pending evaluation.
Published in: Clinical Microbiology and Infection (February 2022)
As antibiotic-resistant bacteria spread globally, there is an increasing need for experts to provide recommendations on how to treat these infections. In this editorial, the strengths and weaknesses of the recommendations by the Infectious Diseases Society of America and European Society of Clinical Microbiology and Infectious Diseases are highlighted.
Published in: PubMed (February 2022)
In a pilot clinical trial, 28 of 42 patients with metastatic breast cancer naturally raised immune lymphocytes targeting the expressed products of their cancer mutations. Three of six patients treated with these lymphocytes exhibited cancer regression. This experimental treatment may be an option for patients with metastatic breast cancer.
Published in: American Journal of Physiology | Lung Cellular and Molecular Physiology (January 2022)
High-resolution cardiac MRI demonstrated that mineralocorticoid receptor blockade improved ventricular interdependence in a rat model of pulmonary arterial hypertension (PAH). This supports the use of advanced cardiac imaging in an ongoing clinical trial of spironolactone in PAH patients at the NIH Clinical Center.
Published in: Global Advances in Health and Medicine (January 2022)
The face and content validity of the NIH Healing Experiences in All Life Stressors (NIH-HEALS) was assessed in a population of cancer patients in Uganda. Some minor changes are recommended to culturally adapt this survey for the local context.
Published in: The New England Journal of Medicine (January 2022)
Researchers review various perspectives, barriers, and approaches regarding the age for informed consent and medical decision-making for COVID-19 vaccination among adolescents aged 12-17. Allowing adolescents to independently consent to the vaccination could increase vaccine uptake in this population.
Read more articles about research in the NIH Clinical Center in 2022.
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A first-of-its kind analysis of data collected from England's annual health survey found that of the people who reported their health as "poor," those living in areas of high deprivation are likely to have worse health than those living in the least deprived areas. The research has been published in BMJ Public Health .
This could mean that we are underestimating health inequalities across England, and could have implications for public health practice and policy informed by self-reported health data.
Researchers from Queen Mary University of London and the University of Warwick analyzed data collected from over 14,000 participants of the 2017 and 2018 waves of the Health Survey for England. They compared participants' simple self-reported health (SRH) statements with a more detailed health-related quality of life measure, EQ-5D, which was collected at the same time.
The analysis assessed differences in the relationship between SRH and EQ-5D by Index of Multiple Deprivation (IMD) quintile, a widely-used measure of deprivation.
The study found that self-reported good health declined with increasing deprivation, from 82.9% in the least deprived quintile to 63.9% in the most deprived quintile. Analysis also found that participants living in the most deprived two quintiles of areas in England who report poor health have lower EQ-5D scores—and therefore worse health—than would be expected based on their deprivation quintile and SRH status.
While additional research is needed to explore this further and quantify any impact on measures such as healthy life expectancy that incorporate SRH data, this study suggests that basing public health funding and interventions on SRH alone could result in an underestimation of health inequalities based on deprivation .
Oyinlola Oyebode, Professor of Public Health, at Queen Mary University of London, said, "Self-reported health is a widely used measure of health, most importantly, in England, we use it to calculate healthy life expectancy. Our analysis suggests that using self-reported health might underestimate socio-economic health inequalities , which may mean that resources and interventions are not appropriately targeted to the most vulnerable neighborhoods or people."
Rosanna Fforde, Honorary Research Fellow at the University of Warwick and Consultant in Public Health at Sandwell Council, said, "Understanding any systematic variation in how people self-report their health is important because this single question measure of health is so widely used, including in large surveys and the Census.
"The resultant large number of responses provides us with valuable granular insights into patterns of health, but this also means that it is important to explore whether 'good' health means the same thing to everyone."
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This page offers a thorough list of 100 public health nursing research paper topics , categorized into ten distinct sections, each focusing on different facets of public health nursing. The spectrum of topics encompasses everything from communicable diseases and maternal and child health to global health and health policy and management. This comprehensive list is designed to assist students and researchers in selecting an appropriate topic for their research paper and contributing to the expanding body of knowledge in this vital nursing specialty. The article also explores the importance of public health nursing, examining various aspects such as health promotion, prevention, and community health. Additionally, iResearchNet’s writing services are introduced, providing students the opportunity to order a custom public health nursing research paper on any topic, coupled with a call-to-action encouraging students to leverage this service.
The field of public health nursing is vast and multifaceted, encompassing a wide range of topics that address the health and well-being of communities and populations. Research in this area is critical for the development of evidence-based interventions and strategies that can lead to improved health outcomes. In this section, we present a comprehensive list of public health nursing research paper topics, categorized into ten distinct areas, to help students and researchers find a topic that resonates with their interests and contributes to this essential field.
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Research in public health nursing is critical for the development of effective interventions and strategies that can lead to improved health outcomes for individuals and communities. The public health nursing research paper topics listed above encompass a wide range of issues affecting the health and well-being of populations, reflecting the current challenges faced by public health nursing professionals. By conducting research in these areas, students and researchers can contribute to the growing body of knowledge in this essential field of nursing and help address the pressing health challenges faced by communities around the world.
Introduction
Public health nursing is a critical and distinct field of nursing practice that focuses on the promotion of health and prevention of diseases in communities and populations. Public health nurses work in various settings, including health departments, schools, community health centers, and non-profit organizations, to improve the health and well-being of individuals and communities. Their role involves assessing the health needs of a community, developing and implementing health promotion and disease prevention programs, and advocating for policies that support public health. The significance of public health nursing in the community cannot be overstated, as it plays a pivotal role in addressing the current public health challenges faced by communities around the world.
Broad Range of Public Health Nursing Research Paper Topics
Public health nursing encompasses a wide range of topics, reflecting the diverse and multifaceted nature of public health challenges. As such, public health nursing research paper topics can vary widely, from communicable diseases and maternal and child health to environmental health and health policy and management. The research conducted in these areas is essential for the development of evidence-based interventions and strategies that can lead to improved health outcomes for individuals and communities.
Role of Nurses in Addressing Current Public Health Challenges
Public health nurses play a crucial role in addressing current public health challenges. They assess the health needs of a community, develop and implement health promotion and disease prevention programs, and advocate for policies that support public health. Moreover, public health nurses work collaboratively with other healthcare professionals and community stakeholders to improve the health and well-being of individuals and communities. Their role is particularly important in addressing health disparities and promoting health equity in disadvantaged populations. Public health nurses have the knowledge, skills, and expertise to develop and implement evidence-based interventions that can lead to improved health outcomes for individuals and communities. By conducting research in the areas mentioned above, public health nurses can contribute to the growing body of knowledge in this essential field of nursing and help address the pressing health challenges faced by communities around the world.
Public health nursing is a critical field of nursing practice that plays a pivotal role in addressing current public health challenges faced by communities around the world. The broad range of public health nursing research paper topics reflects the diverse and multifaceted nature of public health challenges. By conducting research in these areas, students and researchers can contribute to the growing body of knowledge in this essential field of nursing and help address the pressing health challenges faced by communities around the world.
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Public health nursing is a critical and complex field that addresses the pressing health challenges faced by communities around the world. Conducting research in this field is essential for developing evidence-based interventions and strategies that can lead to improved health outcomes for individuals and communities. iResearchNet is committed to supporting students and researchers in this important field by providing top-quality, custom written public health nursing research papers. With our team of expert degree-holding writers, comprehensive research, and customized solutions, you can be confident that you will receive a research paper that meets your specific needs. Order your custom public health nursing research paper from iResearchNet and let us help you succeed in your academic and professional endeavors.
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F inding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you've landed on this post, chances are you're looking for a healthcare-related research topic, but aren't sure where to start. Here, we'll explore a variety of healthcare-related research ideas and topic thought-starters across ...
Since 2020, COVID-19 has been a hot-button topic in medicine, along with the long-term symptoms in those with a history of COVID-19. Examples of COVID-19-related research topics worth exploring include: The long-term impact of COVID-19 on cardiac and respiratory health. COVID-19 vaccination rates.
151+ Public Health Research Topics [Updated 2024] The important area of public health research is essential to forming laws, influencing medical procedures, and eventually enhancing community well-being. As we delve into the vast landscape of public health research topics, it's essential to understand the profound impact they have on society.
100 Healthcare Research Paper Topics. The field of healthcare research encompasses a vast array of topics that are crucial for understanding, improving, and transforming healthcare practices. As students in the health sciences, you have the opportunity to explore these diverse areas and contribute to the knowledge base of healthcare research.
23 Surgery Research Topics. 24 Radiology Research Paper Topics. 25 Anatomy and Physiology Research Paper Topics. 26 Healthcare Management Research Paper Topics. 27 Medical Ethics Research Paper Topics. 28 Environmental Health and Pollution Research Paper Topics. 29 Conclusion. Writing an original and compelling research paper is a daunting task ...
This page provides a comprehensive list of medical research paper topics divided into 20 categories, each with 10 unique subjects. The categories span across various subfields, including anatomy and physiology, diseases, epidemiology, health and fitness, health disparities, healthcare, kinesiology, mental health, pharmacology, and veterinary ...
The New England Journal of Medicine (NEJM) is a weekly general medical journal that publishes new medical research and review articles, and editorial opinion on a wide variety of topics of ...
Public Health-Related Research Topics. Evaluating the impact of community-based obesity prevention programs in urban areas. Analyzing the effectiveness of public smoking bans on respiratory health outcomes. Investigating the role of health education in reducing the prevalence of HIV/AIDS in sub-Saharan Africa.
Featuring authors from around the world, these papers highlight valuable research from an international community. Browse all Top 25 subject area collections here .
Analysis of data related to the Ukraine famine of 1932-1933 shows that in utero exposure to famine increases the risk of adult type 2 diabetes by more than twofold. Karen O'Leary. Research ...
Additionally, we will outline the crucial elements that every health-related research paper should incorporate. Furthermore, we've compiled a comprehensive list of 300+ health-related research topics for medical students in 2023. These include categories like mental health, public health, nutrition, chronic diseases, healthcare policy, and more.
Artificial intelligence (AI) is a powerful and disruptive area of computer science, with the potential to fundamentally transform the practice of medicine and the delivery of healthcare. In this review article, we outline recent breakthroughs in the application of AI in healthcare, describe a roadmap to building effective, reliable and safe AI ...
Medical research topics are the ideas or concepts related to health and medicine. They often explore new treatments, developments in diagnosis, prevention of illnesses, or even the effects of lifestyle choices. The scope of topics in medicine is vast and can include such aspects: Clinical medicine. Biomedical research.
Pediatric Nursing Research Topics. Assess the impact of parental involvement in pediatric asthma treatment adherence. Explore challenges related to chronic illness management in pediatric patients. Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.
Few papers discussed healthcare professionals' behaviour, and those available focused on technology-led changes perspective. ... the citation network analysis is designed to trace the active research streams on the topic of organizational change and to have a preliminary assessment of the extent to which these patterns are present even among ...
Discover the articles that are trending right now, and catch up on current topics in Public Health and related disciplines. We will update our collection every few weeks; come back to this page to be on top of the latest conversations in Public Health and Medicine. Previously featured articles are listed here.
Artificial intelligence (AI) has been developing rapidly in recent years in terms of software algorithms, hardware implementation, and applications in a vast number of areas. In this review, we summarize the latest developments of applications of AI in biomedicine, including disease diagnostics, living assistance, biomedical information ...
Human Health Affected by Changing Ecological Environment in the Rapid Urbanization. Yunhui Zhang. Dr Md Galal Uddin. Jing Yang. Domenico Cicchella. 225 views. The most cited cited journal in its field, which promotes discussion around inter-sectoral public health challenges spanning health promotion to climate change, transportation ...
Health Research Paper Topics. This list of health research paper topics addresses the interaction of behavioral, psychological, emotional, social, cultural, and biological factors with physical health outcomes, such as heart disease, cancer, arthritis, diabetes, and chronic pain. Thus, the core philosophy of the field of health is threefold: (1 ...
Public health research topics are areas of study within the larger field of public health. They cover diverse issues like community health, disease prevention, and health policies. These research topic ideas help us understand and improve global healthcare. They can explore various factors like environmental impacts on public overall wellbeing ...
Research. Strategy and Development; Implementation and Impact; Integrity and Oversight; Practice. In the School; ... Our topic pages offer a one-stop-shop for insights, experts, and offerings by areas of interest. ... Johns Hopkins Bloomberg School of Public Health 615 N. Wolfe Street, Baltimore, MD 21205. Footer social. LinkedIn; Facebook ...
Topics in Health Affairs journal, Forefront, briefs and other content cover a wide swath of health policy matters and health services research. Fields range from economics to political science to ...
This paper presents a meta-analysis on the efficacy of EMH in inpatient settings. ... relation to the following topics: e-mental health (digital, online, e-mental health, technology-based, web ...
This research guide is designed to provide resources and tips for how to perform different types of research for healthcare information. Each tab will walk you through the different databases and resources for the various aspects of healthcare. ... and societal topics. Next: Cost Effectiveness Analyses >> Last Updated: Sep 16, 2024 3:45 PM; URL ...
While the link between diabetes and periodontal disease is known, the impact of diabetes treatment on periodontal health is less well understood. Research published in Diabetes, Obesity and ...
This research has been undertaken to determine the methodologies used to quantify sleep and the microbiome and synthesize microbiome responses associated with healthy/unhealthy sleep. ... Published in: Global Advances in Health and Medicine (January 2022) The face and content validity of the NIH Healing Experiences in All Life Stressors (NIH ...
Comparative Effectiveness Review No. 275. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 75Q80120D00006.) AHRQ Publication No. 24-EHC032. Rockville, MD: Agency for Healthcare Research and Quality; September 2024. Posted final reports are located on the Effective Healthcare Program search page.
Muldoon will demystify and explore cancer and chronic disease research, along with the external factors in science, medicine and industry that influence innovation and care, during his public lecture "Cancer and Chronic Disease in the American Healthcare Ecosystem" Tuesday, Sept. 24, at 5:15 p.m. in Gearhart Hall Auditorium (GEAR 26).
The research has been published in BMJ Public Health. A first-of-its kind analysis of data collected from England's annual health survey found that of the people who reported their health as "poor ...
This page offers a thorough list of 100 public health nursing research paper topics, categorized into ten distinct sections, each focusing on different facets of public health nursing. The spectrum of topics encompasses everything from communicable diseases and maternal and child health to global health and health policy and management.