The Effect of Interventions That Target Multiple Modifiable Health Behaviors on Symptoms of Anxiety and Depression in Young People: A Meta-Analysis of Randomized Controlled Trials

The Effect of Interventions That Target Multiple Modifiable Health Behaviors on Symptoms of Anxiety and Depression in Young People: A Meta-Analysis of Randomized Controlled Trials

Authors
Bourke, M. Patten, R. K. Dash, S. Pascoe, M. Craike, M. Firth, J. Bailey, A. Jacka, F. Parker, A. G.
Year
2021
Journal
Journal of Adolescent Health
Volume
24
Pages
24
PURPOSE This meta-analysis aimed to determine the effect of interventions targeting multiple modifiable health behaviors (i.e., physical activity/sedentary behaviors, nutrition/diet, sleep, substance use) on depression and anxiety in young people. METHODS A search of electronic databases from inception until May 2020 was conducted. Randomized controlled trials (RCTs) that explicitly targeted at least two modifiable health behaviors, measured anxiety or depression at baseline and after intervention using a validated instrument, and included participants with an average age between 12 and 25 years were included. The effect of interventions was synthesized using random effects meta-analysis. RESULTS A total of 14 RCTs reporting on depression and six RCTs reporting on anxiety were included in the quantitative synthesis. Results showed that although interventions targeting multiple modifiable health behaviors did not produce significant reductions in symptoms of depression (g = -.16, 95% confidence interval [CI] = [-.34, .02], 95% prediction interval [PI] = [-.80, .48], very low certainty evidence) or anxiety (g = -.55, 95% CI = [-1.36, .26], 95% PI = [-3.48, 2.83], very low certainty evidence) across all young people, there was a significant difference in the effect of interventions on depression based on intervention type (Q = 8.37, df = 2, p = .012). Specifically, interventions targeting multiple modifiable health behaviors delivered to groups of young people with an elevated risk of depression had a favorable effect (g = -.28, 95% CI = [-.52, -.05], 95% PI = [-1.04, .47]) on symptoms of depression compared with controls. CONCLUSIONS Although not universally effective, this meta-analysis establishes the potential efficacy of targeted interventions aiming to improve multiple modifiable health behaviors to address depression in young people at elevated risk of depression. More research is needed to understand the effect of such interventions on symptoms of anxiety in young people.

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Type of intervention

Preventive- and Promotive Health Interventions

Topic

Mental Health Problems and Disorders

Emotional Problems

Depression and Depressed Mood

Anxiety Problems

Anxiety and Anxiousness

Eating Disorders

Other Problems

Sleep Disorders

Drugs and Gambling

Illegal Drugs

Intervention

Psychological Treatments

Cognitive Behavioral Therapy, Behavioral Therapy and Cognitive Therapy

The organization of interventions

E-health interventions

Public Health Interventions

Physical Activity

Alternative Treatment

Nutritional Supplements and Nutrition

Age group

Adolescents (13-18 years)

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