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Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis

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  • Elizabeth Stratton
  • Amit Lampit
  • Isabella Choi
  • Rafael A Calvo
  • Samuel B Harvey
  • Nicholas Glozier

Abstract

Background: Many organisations promote eHealth applications as a feasible, low-cost method of addressing mental ill-health and stress amongst their employees. However, there are good reasons why the efficacy identified in clinical or other samples may not generalize to employees, and many Apps are being developed specifically for this group. The aim of this paper is to conduct the first comprehensive systematic review and meta-analysis evaluating the evidence for the effectiveness and examine the relative efficacy of different types of eHealth interventions for employees. Methods: Systematic searches were conducted for relevant articles published from 1975 until November 17, 2016, of trials of eHealth mental health interventions (App or web-based) focused on the mental health of employees. The quality and bias of all identified studies was assessed. We extracted means and standard deviations from published reports, comparing the difference in effect sizes (Hedge’s g) in standardized mental health outcomes. We meta-analysed these using a random effects model, stratified by length of follow up, intervention type, and whether the intervention was universal (unselected) or targeted to selected groups e.g. “stressed”. Results: 23 controlled trials of eHealth interventions were identified which overall suggested a small positive effect at both post intervention (g = 0.24, 95% CI 0.13 to 0.35) and follow up (g = 0.23, 95% CI 0.03 to 0.42). There were differential short term effects seen between the intervention types whereby Mindfulness based interventions (g = 0.60, 95% CI 0.34 to 0.85, n = 6) showed larger effects than the Cognitive Behaviour Therapy (CBT) based (g = 0.15, 95% CI 0.02 to 0.29, n = 11) and Stress Management based (g = 0.17, 95%CI -0.01 to 0.34, n = 6) interventions. The Stress Management interventions however differed by whether delivered to universal or targeted groups with a moderately large effect size at both post-intervention (g = 0.64, 95% CI 0.54 to 0.85) and follow-up (g = 0.69, 95% CI 0.06 to 1.33) in targeted groups, but no effect in unselected groups. Interpretation: There is reasonable evidence that eHealth interventions delivered to employees may reduce mental health and stress symptoms post intervention and still have a benefit, although reduced at follow-up. Despite the enthusiasm in the corporate world for such approaches, employers and other organisations should be aware not all such interventions are equal, many lack evidence, and achieving the best outcomes depends upon providing the right type of intervention to the correct population.

Suggested Citation

  • Elizabeth Stratton & Amit Lampit & Isabella Choi & Rafael A Calvo & Samuel B Harvey & Nicholas Glozier, 2017. "Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-23, December.
  • Handle: RePEc:plo:pone00:0189904
    DOI: 10.1371/journal.pone.0189904
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    References listed on IDEAS

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    Cited by:

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    2. Nkiruka D Eze & Céu Mateus & Tiago Cravo Oliveira Hashiguchi, 2020. "Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-24, August.
    3. Hui-Chuan Hsu & Tsuann Kuo & Ju-Ping Lin & Wei-Chung Hsu & Chia-Wen Yu & Yen-Cheng Chen & Wan-Zhen Xie & Wei-Chiang Hsu & Ya-Lan Hsu & Mu-Ting Yu, 2018. "A Cross-Disciplinary Successful Aging Intervention and Evaluation: Comparison of Person-to-Person and Digital-Assisted Approaches," IJERPH, MDPI, vol. 15(5), pages 1-19, May.
    4. Anya Johnson & Shanta Dey & Helena Nguyen & Markus Groth & Sadhbh Joyce & Leona Tan & Nicholas Glozier & Samuel B Harvey, 2020. "A review and agenda for examining how technology-driven changes at work will impact workplace mental health and employee well-being," Australian Journal of Management, Australian School of Business, vol. 45(3), pages 402-424, August.
    5. Liana Lentz & Lorraine Smith-MacDonald & David C. Malloy & Gregory S. Anderson & Shadi Beshai & Rosemary Ricciardelli & Suzette Bremault-Phillips & R. Nicholas Carleton, 2022. "A Qualitative Analysis of the Mental Health Training and Educational Needs of Firefighters, Paramedics, and Public Safety Communicators in Canada," IJERPH, MDPI, vol. 19(12), pages 1-19, June.
    6. Maria Armaou & Stathis Konstantinidis & Holly Blake, 2019. "The Effectiveness of Digital Interventions for Psychological Well-Being in the Workplace: A Systematic Review Protocol," IJERPH, MDPI, vol. 17(1), pages 1-12, December.
    7. Art van Schaaijk & Karen Nieuwenhuijsen & Monique Frings-Dresen, 2019. "Work Ability and Vitality in Coach Drivers: An RCT to Study the Effectiveness of a Self-Management Intervention during the Peak Season," IJERPH, MDPI, vol. 16(12), pages 1-17, June.

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