Who benefits from guided internet-based interventions? A systematic review of predictors and moderators of treatment outcome

Abstract

Objective: To our knowledge, no systematic review or meta-analysis has been conducted on all predictors or moderators of treatment outcome across diagnoses in guided internet-based interventions (IBIs) for adults. We aimed to aggregate the results of relevant studies and identify research gaps. Methods: After duplicate removal, 1615 articles, identified by searching the databases PsycInfo, Ovid Medline, and Pubmed and through snowballing, were screened following detailed in- and exclusion criteria in April and May 2021. Risk of bias (QUIPS) and intra- and interrater reliability for screening and risk of bias were assessed. Variables were grouped and categorized, then synthesized using vote counting based on direction of effect. Results: N=50 articles were included in the review. Seventy-seven predictors or moderators were generated, of which adherence, baseline symptoms, education, age, and gender were most frequently assessed. Adherence, treatment credibility, working alliance, and baseline scores emerged as conclusive predictors/moderators. Results for other variables were mainly inconsistent or inconclusive. Conclusion: Our review highlights that it is currently difficult to predict, across diagnoses, who will benefit from guided IBIs. Further rigorous research is needed to identify predictors and moderators based on a sufficient number of studies. PROSPERO registration: CRD42021242305.

The Role of Self-efficacy in Internet-based Interventions for Mental Health: A Systematic Review and Meta-analysis

“…On the other hand, one study found that higher self-efficacy was associated with a greater reduc�on in grief and two studies found no significant result for self-efficacy as a predictor. These conflic�ng results are in line with the review on transdiagnos�c predictors of therapy outcome in guided IBI by Haller et al (2023) that yielded inconsistent results for self-efficacy. In our study, a trend for the benefit of low self-efficacy at baseline was observed but given the small number of studies and the different symptoms of mental disorders they inves�gated, no firm conclusions can be drawn about whether high or low self-efficacy at baseline contributes to the response to IBI and for whom and under what condi�ons IBIs have different effects.…”

“…Samoocha et al (2010) found in a meta-analysis that IBI have a small posi�ve effect of SMD = 0.23 on self-efficacy measured with disease-specific self-efficacy scales (k = 9), while no effects were found for self-efficacy measured with general self-efficacy scales (k = 3). In a recent review of predictors of therapy outcome in guided IBI by Haller et al (2023) six studies that examined self-efficacy as a predictor of outcome were iden�fied and yielded inconsistent results. Self-efficacy is considered to be an important common factor of psychotherapy (Pfammater & Tschacher, 2016).…”

Exploration of the individual and combined effects of predictors of engagement, dropout, and change from digital interventions for recurrent binge eating

“…However, response rates vary, with up to 75% of individuals either disengaging from a digital intervention prematurely or remaining symptomatic (Fitzsimmons-Craft et al, 2020). Understanding participant characteristics that robustly predict [un]favorable outcomes is needed, as this could provide important prognostic information on a person's likely success with this mode of intervention delivery, leading to more tailored care plans (Haller et al, 2023).…”