Digital Public Health Interventions for the Promotion of Mental Well-Being and Health Behaviors among University Students: a Rapid Review (Preprint)

Abstract

BACKGROUND Student life offers many opportunities for personal development; however, this transitional phase often also poses challenges to mental health. Various factors associated with university life, such as academic stress and financial burdens, have been found to exacerbate psycho-logical distress and contribute to increased alcohol and substance use among students. OBJECTIVE Our aim is to closely examine i) components of available digital public health interventions (DPHIs), ii) to evaluate their effectiveness for promoting well-being, health behaviors, and reducing symptoms of mental disorders among university students and iii) to rate the quality of the evidence identified in this rapid review. METHODS We conducted a rapid review to capture the evidence on DPHIs for university students. We adhered to the methodological criteria recommended by the Cochrane Rapid Reviews Meth-ods Group and PRISMA. The literature search was performed in Ovid MEDLINE to look for keywords related to university students, mental well-being, mental health, and DPHIs. Only articles published between June 2018 and June 2023, written in English, and reporting studies with a randomized controlled trial design or observational studies were considered. The selec-tion was carried out in two steps: 1) Screening of titles and abstracts by two independent re-viewers 2) Screening of full texts by three independent reviewers. RESULTS From the 1,134 initially found articles, 1,132 remained for screening after removing duplicates. Of these, 1,098 did not meet the inclusion criteria, leaving 24 articles for data extraction. The studies were conducted between 2018 and 2023 in ten countries. In 16% of the studies, inter-ventions were specifically implemented during the COVID-19 pandemic. All included studies used an experimental design, with 72% of the studies having two intervention arms, and one study having up to eight intervention arms. i) Of the intervention components in the included studies, 18 used web-based platforms, while six used smartphone apps. Interventions were aimed at improving mental health (68%), reducing substance use (28%), promoting physical activity (PA) (36%), and changing dietary and eating habits (16%). ii) 42% of the included studies were able to demonstrate significant effects in the desired direction for mental health, 4% for substance use, 25% for PA, and 8% for eating behavior. iii) The quality assessment revealed that 58% of studies were rated with "some concerns”, indicating moderate bias, while 29% were rated as “high risk”, suggesting considerable bias affecting outcome validity. CONCLUSIONS This rapid review comprehensively summarized intervention components of DPHIs. Further, the findings of this review provide significant insights into the effectiveness of DPHIs targeting mental well-being and health behaviors among university students. The studies included in the analysis demonstrate varying degrees of success across different domains, highlighting both the potential and limitations of DPHIs.