Strength-based capacity-building interventions to promote adolescents' mental health: A systematic review and meta-analysis

Strength-based capacity-building interventions have the potential to enhance an individual's capacity to improve their mental health. A systematic review and meta-analysis was conducted to examine the effectiveness of these interventions on mental health literacy, resilience, self-efficacy, and positive thinking in adolescents without pre-existing mental/psychiatric diagnoses/conditions. CINAHL, Embase, PsycINFO, PubMed, Web of Science, the Cochrane Library, and CNKI were searched from inception to June 2024. Two reviewers independently conducted the study screening, risk of bias assessment, and data extraction. Leave-one-out sensitivity and subgroup analyses were used to reduce the heterogeneity of the studies and their findings. Forty-seven interventional studies were included, with approaches mainly consisting of psychoeducation, individual skill training (e.g., emotional regulation, mindfulness), and supportive peer feedback. Capacity-building interventions (in 27 studies) improved the levels of mental health literacy (SMD = 1.70, 95% CI[0.57, 2.84], I2 = 97%, n = 4) and resilience (SMD = 0.51, 95% CI[0.26, 0.76], I2 = 89%, n = 16) in the short-term (< 1 month) and resilience in the long-term (> 6 months; SMD = 0.29, 95% CI[0.03, 0.55], I2 = 39%, n = 3) post-intervention. While there were limited studies evaluated on positive thinking and self-efficacy and thus unable to perform meta-analysis on these outcomes, the medium-term effects on resilience show no statistical significance (1-6 months; n = 4). However, the effects on depression and anxiety were nonsignificant. Combined approaches to capacity-building interventions that incorporate two or more theoretical frameworks/models within one intervention could enhance adolescents' resilience (SMD = 0.24, 95% CI[0.13, 0.35], I2 = 22%, n = 3). Combining positive psychology with other mental health approaches in interventions might boost adolescents' resilience in short-term but there were limited studies and thus insufficient evidence to evaluate the medium- and long-term effectiveness of these combined approaches. Further rigorous large-scale randomized controlled trials are recommended to provide stronger evidence.