Digital Mental Health Interventions for Depression, Anxiety, and Enhancement of Psychological Well-Being Among College Students: Systematic Review

Emily G Lattie, Elizabeth C Adkins, Nathan Winquist, Colleen Stiles-Shields, Q Eileen Wafford, Andrea K Graham, Emily G Lattie, Elizabeth C Adkins, Nathan Winquist, Colleen Stiles-Shields, Q Eileen Wafford, Andrea K Graham

Abstract

Background: College students are increasingly reporting common mental health problems, such as depression and anxiety, and they frequently encounter barriers to seeking traditional mental health treatments. Digital mental health interventions, such as those delivered via the Web and apps, offer the potential to improve access to mental health treatment.

Objective: This study aimed to review the literature on digital mental health interventions focused on depression, anxiety, and enhancement of psychological well-being among samples of college students to identify the effectiveness, usability, acceptability, uptake, and adoption of such programs.

Methods: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (registration number CRD42018092800), and the search strategy was conducted by a medical research librarian in the following databases: MEDLINE (Ovid), EMBASE (Elsevier), PsycINFO (EbscoHost), the Cochrane Library (Wiley), and Web of Science (Thomson Reuters) from the date of inception to April 2019. Data were synthesized using a systematic narrative synthesis framework, and formal quality assessments were conducted to address the risk of bias.

Results: A total of 89 studies met the inclusion criteria. The majority of interventions (71/89, 80%) were delivered via a website, and the most common intervention was internet-based cognitive behavioral therapy (28, 31%). Many programs (33, 37%) featured human support in the form of coaching. The majority of programs were either effective (42, 47%) or partially effective (30, 34%) in producing beneficial changes in the main psychological outcome variables. Approximately half of the studies (45, 51%) did not present any usability or acceptability outcomes, and few studies (4, 4%) examined a broad implementation of digital mental health interventions on college campuses. Quality assessments revealed a moderate-to-severe risk of bias in many of the studies.

Conclusions: Results suggest that digital mental health interventions can be effective for improving depression, anxiety, and psychological well-being among college students, but more rigorous studies are needed to ascertain the effective elements of these interventions. Continued research on improving the user experience of, and thus user engagement with, these programs appears vital for the sustainable implementation of digital mental health interventions on college campuses.

Keywords: eHealth; mHealth; mental health; students; universities.

Conflict of interest statement

Conflicts of Interest: None declared.

©Emily G Lattie, Elizabeth C Adkins, Nathan Winquist, Colleen Stiles-Shields, Q Eileen Wafford, Andrea K Graham. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.07.2019.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.

References

    1. Pinder-Amaker S, Bell C. A bioecological systems approach for navigating the college mental health crisis. Harv Rev Psychiatry. 2012;20(4):174–88. doi: 10.3109/10673229.2012.712842.
    1. Eisenberg D, Hunt J, Speer N. Help seeking for mental health on college campuses: review of evidence and next steps for research and practice. Harv Rev Psychiatry. 2012;20(4):222–32. doi: 10.3109/10673229.2012.712839.
    1. Lipson SK, Lattie EG, Eisenberg D. Increased rates of mental health service utilization by US college students: 10-year population-level trends (2007-2017) Psychiatr Serv. 2019 Jan 1;70(1):60–3. doi: 10.1176/appi.ps.201800332.
    1. Auerbach RP, Mortier P, Bruffaerts R, Alonso J, Benjet C, Cuijpers P, Demyttenaere K, Ebert DD, Green JG, Hasking P, Murray E, Nock MK, Pinder-Amaker S, Sampson NA, Stein DJ, Vilagut G, Zaslavsky AM, Kessler RC, WHO WMH-ICS Collaborators WHO world mental health surveys international college student project: prevalence and distribution of mental disorders. J Abnorm Psychol. 2018 Oct;127(7):623–38. doi: 10.1037/abn0000362.
    1. Eisenberg D, Golberstein E, Gollust SE. Help-seeking and access to mental health care in a university student population. Med Care. 2007 Jul;45(7):594–601. doi: 10.1097/MLR.0b013e31803bb4c1.
    1. Eisenberg D, Hunt J, Speer N, Zivin K. Mental health service utilization among college students in the United States. J Nerv Ment Dis. 2011 May;199(5):301–8. doi: 10.1097/NMD.0b013e3182175123.
    1. Mowbray CT, Megivern D, Mandiberg JM, Strauss S, Stein CH, Collins K, Kopels S, Curlin C, Lett R. Campus mental health services: recommendations for change. Am J Orthopsychiatry. 2006 Apr;76(2):226–37. doi: 10.1037/0002-9432.76.2.226.
    1. Xiao H, Carney DM, Youn SJ, Janis RA, Castonguay LG, Hayes JA, Locke BD. Are we in crisis? National mental health and treatment trends in college counseling centers. Psychol Serv. 2017 Nov;14(4):407–15. doi: 10.1037/ser0000130.
    1. Renton T, Tang H, Ennis N, Cusimano MD, Bhalerao S, Schweizer TA, Topolovec-Vranic J. Web-based intervention programs for depression: a scoping review and evaluation. J Med Internet Res. 2014 Sep 23;16(9):e209. doi: 10.2196/jmir.3147.
    1. Rai M, Vigod SN, Hensel JM. Barriers to office-based mental health care and interest in e-communication with providers: a survey study. JMIR Ment Health. 2016 Aug 1;3(3):e35. doi: 10.2196/mental.6068.
    1. Kass AE, Balantekin KN, Fitzsimmons-Craft EE, Jacobi C, Wilfley DE, Taylor CB. The economic case for digital interventions for eating disorders among United States college students. Int J Eat Disord. 2017 Mar;50(3):250–8. doi: 10.1002/eat.22680.
    1. Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One. 2010 Oct 13;5(10):e13196. doi: 10.1371/journal.pone.0013196.
    1. Karyotaki E, Riper H, Twisk J, Hoogendoorn A, Kleiboer A, Mira A, Mackinnon A, Meyer B, Botella C, Littlewood E, Andersson G, Christensen H, Klein JP, Schröder J, Bretón-López J, Scheider J, Griffiths K, Farrer L, Huibers MJ, Phillips R, Gilbody S, Moritz S, Berger T, Pop V, Spek V, Cuijpers P. Efficacy of self-guided internet-based cognitive behavioral therapy in the treatment of depressive symptoms: a meta-analysis of individual participant data. JAMA Psychiatry. 2017 Apr 1;74(4):351–9. doi: 10.1001/jamapsychiatry.2017.0044.
    1. Firth J, Torous J, Nicholas J, Carney R, Pratap A, Rosenbaum S, Sarris J. The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry. 2017 Oct;16(3):287–98. doi: 10.1002/wps.20472. doi: 10.1002/wps.20472.
    1. Firth J, Torous J, Nicholas J, Carney R, Rosenbaum S, Sarris J. Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. J Affect Disord. 2017 Dec 15;218:15–22. doi: 10.1016/j.jad.2017.04.046.
    1. Farrer L, Gulliver A, Chan JK, Batterham PJ, Reynolds J, Calear A, Tait R, Bennett K, Griffiths KM. Technology-based interventions for mental health in tertiary students: systematic review. J Med Internet Res. 2013 May 27;15(5):e101. doi: 10.2196/jmir.2639.
    1. Davies EB, Morriss R, Glazebrook C. Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: a systematic review and meta-analysis. J Med Internet Res. 2014 May 16;16(5):e130. doi: 10.2196/jmir.3142.
    1. Harrer M, Adam SH, Baumeister H, Cuijpers P, Karyotaki E, Auerbach RP, Kessler RC, Bruffaerts R, Berking M, Ebert DD. Internet interventions for mental health in university students: a systematic review and meta-analysis. Int J Methods Psychiatr Res. 2019 Jun;28(2):e1759. doi: 10.1002/mpr.1759.
    1. Glasgow RE, Phillips SM, Sanchez MA. Implementation science approaches for integrating eHealth research into practice and policy. Int J Med Inform. 2014 Jul;83(7):e1–11. doi: 10.1016/j.ijmedinf.2013.07.002.
    1. Mohr DC, Cheung K, Schueller SM, Hendricks BC, Duan N. Continuous evaluation of evolving behavioral intervention technologies. Am J Prev Med. 2013 Oct;45(4):517–23. doi: 10.1016/j.amepre.2013.06.006.
    1. Pham Q, Wiljer D, Cafazzo JA. Beyond the randomized controlled trial: a review of alternatives in mHealth clinical trial methods. JMIR Mhealth Uhealth. 2016 Sep 9;4(3):e107. doi: 10.2196/mhealth.5720.
    1. Fleming T, Bavin L, Lucassen M, Stasiak K, Hopkins S, Merry S. Beyond the trial: systematic review of real-world uptake and engagement with digital self-help interventions for depression, low mood, or anxiety. J Med Internet Res. 2018 Dec 6;20(6):e199. doi: 10.2196/jmir.9275.
    1. McCurdie T, Taneva S, Casselman M, Yeung M, McDaniel C, Ho W, Cafazzo J. mHealth consumer apps: the case for user-centered design. Biomed Instrum Technol. 2012;46(s2):49–56. doi: 10.2345/0899-8205-46.s2.49.
    1. Zapata BC, Fernández-Alemán JL, Idri A, Toval A. Empirical studies on usability of mHealth apps: a systematic literature review. J Med Syst. 2015 Feb;39(2):1. doi: 10.1007/s10916-014-0182-2.
    1. Georgsson M, Staggers N. Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics. J Am Med Inform Assoc. 2016 Jan;23(1):5–11. doi: 10.1093/jamia/ocv099.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. doi: 10.1371/journal.pmed.1000097.
    1. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016 Dec 5;5(1):210. doi: 10.1186/s13643-016-0384-4.
    1. Beck AT, Steer RA, Brown GK. BDI-II, Beck Depression Inventory: Manual. San Antonio, Texas: The Psychological Corporation; 1996.
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606–13. doi: 10.1046/j.1525-1497.2001.016009606.x.
    1. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988 Dec;56(6):893–7. doi: 10.1037//0022-006X.56.6.893.
    1. Peterson RA, Reiss S. Anxiety Sensitivity Index Manual. Worthington, Ohio: International Diagnostic Systems; 1992.
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385–96. doi: 10.2307/2136404.
    1. Ryff CD, Keyes CL. The structure of psychological well-being revisited. J Pers Soc Psychol. 1995 Oct;69(4):719–27. doi: 10.1037/0022-3514.69.4.719.
    1. Sauro J. A Practical Guide to the System Usability Scale: Background, Benchmarks & Best Practices. Denver, Colarado: Measuring Usability LLC; 2011.
    1. Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65–76. doi: 10.1007/s10488-010-0319-7.
    1. Higgins JP, Sterne JA, Savović J, Page MJ, Hróbjartsson A, Boutron I, Reeves B, Eldridge S. A revised tool for assessing risk of bias in randomized trials. In: Chandler J, McKenzie J, Boutron I, Welch V, editors. Cochrane Methods 2016. New Jersey: Wiley; 2016. p. 29.
    1. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins J. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. Br Med J. 2016 Oct 12;355:i4919. doi: 10.1136/bmj.i4919.
    1. Snilstveit B, Oliver S, Vojtkova M. Narrative approaches to systematic review and synthesis of evidence for international development policy and practice. J Dev Econ. 2012 Sep 27;4(3):409–29. doi: 10.1080/19439342.2012.710641.
    1. Siddaway AP, Wood AM, Hedges LV. How to do a systematic review: a best practice guide for conducting and reporting narrative reviews, meta-analyses, and meta-syntheses. Annu Rev Psychol. 2019 Dec 4;70:747–70. doi: 10.1146/annurev-psych-010418-102803.
    1. Baumeister RF, Leary MR. Writing narrative literature reviews. Rev Gen Psychol. 1997;1(3):311–20. doi: 10.1037//1089-2680.1.3.311.
    1. Alvarez LM, Cortés SJ, León SO, Estrella J, Sánchez SJ. Computer program in the treatment for major depression and cognitive impairment in university students. Comput Human Behav. 2008 May;24(3):816–26. doi: 10.1016/j.chb.2007.02.013.
    1. Arpin-Cribbie C, Irvine J, Ritvo P. Web-based cognitive-behavioral therapy for perfectionism: a randomized controlled trial. Psychother Res. 2012;22(2):194–207. doi: 10.1080/10503307.2011.637242.
    1. Booker JA, Dunsmore JC. Expressive writing and well-being during the transition to college: comparison of emotion-disclosing and gratitude-focused writing. J Soc Clin Psychol. 2017 Sep;36(7):580–606. doi: 10.1521/jscp.2017.36.7.580.
    1. Braithwaite SR, Fincham FD. A randomized clinical trial of a computer based preventive intervention: replication and extension of ePREP. J Fam Psychol. 2009 Feb;23(1):32–8. doi: 10.1037/a0014061.
    1. Buglione SA, DeVito AJ, Mulloy JM. Traditional group therapy and computer-administered treatment for test anxiety. Anxiety Stress Coping. 1990 Jun;3(1):33–9. doi: 10.1080/08917779008248739.
    1. Chiauzzi E, Brevard J, Thum C, Thurn C, Decembrele S, Lord S. MyStudentBody-Stress: an online stress management intervention for college students. J Health Commun. 2008 Sep;13(6):555–72. doi: 10.1080/10810730802281668.
    1. Cohen GE, Kerr BA. Computer-mediated counseling: an empirical study of a new mental health treatment. Comput Human Behav. 1999 Apr 22;15(4):13–26. doi: 10.1300/J407v15n04_02.
    1. Cukrowicz KC, Joiner TE. Computer-based intervention for anxious and depressive symptoms in a non-clinical population. Cogn Ther Res. 2007 Apr 4;31(5):677–93. doi: 10.1007/s10608-006-9094-x.
    1. Day V, McGrath PJ, Wojtowicz M. Internet-based guided self-help for university students with anxiety, depression and stress: a randomized controlled clinical trial. Behav Res Ther. 2013 Jul;51(7):344–51. doi: 10.1016/j.brat.2013.03.003.
    1. Ellis LA, Campbell AJ, Sethi S, O'Dea BM. Comparative randomized trial of an online cognitive-behavioral therapy program and an online support group for depression and anxiety. J Cyber Ther Rehabil. 2011;4(4):461–7.
    1. Fernandez E, Brechtel M, Mercer A. Personal and simulated computer-aided counseling: perceived versus measured counseling outcomes for college students. J Coll Stud Dev. 1986;27(3):224–8.
    1. Fitzpatrick KK, Darcy A, Vierhile M. Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (WOEBOT): a randomized controlled trial. JMIR Ment Health. 2017 Jun 6;4(2):e19. doi: 10.2196/mental.7785.
    1. Frazier P, Meredith L, Greer C, Paulsen JA, Howard K, Dietz LR, Qin K. Randomized controlled trial evaluating the effectiveness of a web-based stress management program among community college students. Anxiety Stress Coping. 2015;28(5):576–86. doi: 10.1080/10615806.2014.987666.
    1. Frith E, Loprinzi P. Can Facebook reduce perceived anxiety among college students? Randomized controlled exercise trial using the transtheoretical model of behavior change. JMIR Ment Health. 2017 Dec 8;4(4):e50. doi: 10.2196/mental.8086.
    1. Geisner IM, Varvil-Weld L, Mittmann AJ, Mallett K, Turrisi R. Brief web-based intervention for college students with comorbid risky alcohol use and depressed mood: does it work and for whom? Addict Behav. 2015 Mar;42:36–43. doi: 10.1016/j.addbeh.2014.10.030.
    1. Grassi A, Gaggioli A, Riva G. New technologies to manage exam anxiety. Stud Health Technol Inform. 2011;167:57–62.
    1. Guille C, Zhao Z, Krystal J, Nichols B, Brady K, Sen S. Web-based cognitive behavioral therapy intervention for the prevention of suicidal ideation in medical interns: a randomized clinical trial. JAMA Psychiatry. 2015 Dec;72(12):1192–8. doi: 10.1001/jamapsychiatry.2015.1880.
    1. Harris SR, Kemmerling RL, North MM. Brief virtual reality therapy for public speaking anxiety. Cyberpsychol Behav. 2002 Dec;5(6):543–50. doi: 10.1089/109493102321018187.
    1. Hintz S, Frazier PA, Meredith L. Evaluating an online stress management intervention for college students. J Couns Psychol. 2015 Apr;62(2):137–47. doi: 10.1037/cou0000014.
    1. Hoppitt L, Illingworth JL, MacLeod C, Hampshire A, Dunn BD, Mackintosh B. Modifying social anxiety related to a real-life stressor using online cognitive bias modification for interpretation. Behav Res Ther. 2014 Jan;52:45–52. doi: 10.1016/j.brat.2013.10.008.
    1. Kenardy J, McCafferty K, Rosa V. Internet-delivered indicated prevention for anxiety disorders: a randomized controlled trial. Behav Cognit Psychother. 2003;31(3):279–89. doi: 10.1017/S1352465803003047.
    1. King CA, Eisenberg D, Zheng K, Czyz E, Kramer A, Horwitz A, Chermack S. Online suicide risk screening and intervention with college students: a pilot randomized controlled trial. J Consult Clin Psychol. 2015 Jun;83(3):630–6. doi: 10.1037/a0038805.
    1. Koydemir S, Sun-Selışık ZE. Well-being on campus: testing the effectiveness of an online strengths-based intervention for first year college students. Br J Guid Counc. 2015 Nov 16;44(4):434–46. doi: 10.1080/03069885.2015.1110562.
    1. Kvillemo P, Brandberg Y, Bränström R. Feasibility and outcomes of an internet-based mindfulness training program: a pilot randomized controlled trial. JMIR Ment Health. 2016 Jul 22;3(3):e33. doi: 10.2196/mental.5457.
    1. Levin ME, Pistorello J, Seeley JR, Hayes SC. Feasibility of a prototype web-based acceptance and commitment therapy prevention program for college students. J Am Coll Health. 2014;62(1):20–30. doi: 10.1080/07448481.2013.843533.
    1. Levin ME, Hayes SC, Pistorello J, Seeley JR. Web-based self-help for preventing mental health problems in universities: comparing acceptance and commitment training to mental health education. J Clin Psychol. 2016 Mar;72(3):207–25. doi: 10.1002/jclp.22254.
    1. Levin ME, Haeger JA, Pierce BG, Twohig MP. Web-based acceptance and commitment therapy for mental health problems in college students: a randomized controlled trial. Behav Modif. 2017 Dec 1;41(1):141–62. doi: 10.1177/0145445516659645.
    1. Lintvedt OK, Griffiths KM, Sørensen K, Østvik AR, Wang C, Eisemann M, Waterloo K. Evaluating the effectiveness and efficacy of unguided internet-based self-help intervention for the prevention of depression: a randomized controlled trial. Clin Psychol Psychother. 2013;20(1):10–27. doi: 10.1002/cpp.770.
    1. Mailey EL, Wójcicki TR, Motl RW, Hu L, Strauser DR, Collins KD, McAuley E. Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial. Psychol Health Med. 2010 Dec;15(6):646–59. doi: 10.1080/13548506.2010.498894.
    1. Mak WW, Chan AT, Cheung EY, Lin CL, Ngai KC. Enhancing web-based mindfulness training for mental health promotion with the health action process approach: randomized controlled trial. J Med Internet Res. 2015 Jan 19;17(1):e8. doi: 10.2196/jmir.3746.
    1. Mak WW, Chio FH, Chan AT, Lui WW, Wu EK. The efficacy of internet-based mindfulness training and cognitive-behavioral training with telephone support in the enhancement of mental health among college students and young working adults: randomized controlled trial. J Med Internet Res. 2017 Dec 22;19(3):e84. doi: 10.2196/jmir.6737.
    1. Melnyk BM, Amaya M, Szalacha LA, Hoying J, Taylor T, Bowersox K. Feasibility, acceptability, and preliminary effects of the COPE online cognitive-behavioral skill-building program on mental health outcomes and academic performance in freshmen college students: a randomized controlled pilot study. J Child Adolesc Psychiatr Nurs. 2015 Aug;28(3):147–54. doi: 10.1111/jcap.12119.
    1. Morris J, Firkins A, Millings A, Mohr C, Redford P, Rowe A. Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context. Anxiety Stress Coping. 2016 Dec;29(4):415–31. doi: 10.1080/10615806.2015.1058924.
    1. Mullin A, Dear BF, Karin E, Wootton BM, Staples LG, Johnston L, Gandy M, Fogliati V, Titov N. The UniWellbeing course: a randomised controlled trial of a transdiagnostic internet-delivered cognitive behavioural therapy (CBT) programme for university students with symptoms of anxiety and depression. Internet Interventions. 2015 May;2(2):128–36. doi: 10.1016/j.invent.2015.02.002.
    1. Musiat P, Conrod P, Treasure J, Tylee A, Williams C, Schmidt U. Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention. PLoS One. 2014;9(4):e93621. doi: 10.1371/journal.pone.0093621.
    1. Nguyen-Feng VN, Frazier PA, Greer CS, Howard KG, Paulsen JA, Meredith L, Kim S. A randomized controlled trial of a web-based intervention to reduce distress among students with a history of interpersonal violence. Psychol Violence. 2015;5(4):444–54. doi: 10.1037/a0039596.
    1. Nguyen-Feng VN, Frazier PA, Greer CS, Meredith L, Howard K, Paulsen J. Testing the efficacy of three brief web-based interventions for reducing distress among interpersonal violence survivors. Transl Issues Psychol Sci. 2016;2(4):439–48. doi: 10.1037/tps0000099.
    1. Nguyen-Feng VN, Greer CS, Frazier P. Using online interventions to deliver college student mental health resources: evidence from randomized clinical trials. Psychol Serv. 2017 Nov;14(4):481–9. doi: 10.1037/ser0000154.
    1. Nordmo M, Sinding AI, Carlbring P, Andersson G, Havik OE, Nordgreen T. Internet-delivered cognitive behavioural therapy with and without an initial face-to-face psychoeducation session for social anxiety disorder: a pilot randomized controlled trial. Internet Interv. 2015 Nov;2(4):429–36. doi: 10.1016/j.invent.2015.10.003.
    1. Orbach G, Lindsay S, Grey S. A randomised placebo-controlled trial of a self-help internet-based intervention for test anxiety. Behav Res Ther. 2007 Mar;45(3):483–96. doi: 10.1016/j.brat.2006.04.002.
    1. Radhu N, Daskalakis ZJ, Arpin-Cribbie CA, Irvine J, Ritvo P. Evaluating a web-based cognitive-behavioral therapy for maladaptive perfectionism in university students. J Am Coll Health. 2012;60(5):357–66. doi: 10.1080/07448481.2011.630703.
    1. Räsänen P, Lappalainen P, Muotka J, Tolvanen A, Lappalainen R. An online guided ACT intervention for enhancing the psychological wellbeing of university students: a randomized controlled clinical trial. Behav Res Ther. 2016 Mar;78:30–42. doi: 10.1016/j.brat.2016.01.001.
    1. Richards D, Timulak L. Satisfaction with therapist-delivered vs self-administered online cognitive behavioural treatments for depression symptoms in college students. Br J Guid Counc. 2013 Apr;41(2):193–207. doi: 10.1080/03069885.2012.726347.
    1. Richards D, Timulak L, Hevey D. A comparison of two online cognitive-behavioural interventions for symptoms of depression in a student population: the role of therapist responsiveness. Couns Psychother Res. 2013 Sep;13(3):184–93. doi: 10.1080/14733145.2012.733715.
    1. Richards D, Timulak L, Rashleigh C, McLoughlin O, Colla A, Joyce C, Doherty G, Sharry J, Duffy D, Anderson-Gibbons M. Effectiveness of an internet-delivered intervention for generalized anxiety disorder in routine care: a randomised controlled trial in a student population. Internet Interv. 2016 Nov;6:80–8. doi: 10.1016/j.invent.2016.10.003.
    1. Santucci LC, McHugh RK, Elkins RM, Schechter B, Ross MS, Landa CE, Eisen S, Barlow DH. Pilot implementation of computerized cognitive behavioral therapy in a university health setting. Adm Policy Ment Health. 2014 Jul;41(4):514–21. doi: 10.1007/s10488-013-0488-2.
    1. Seligman ME, Schulman P, Tryon AM. Group prevention of depression and anxiety symptoms. Behav Res Ther. 2007 Jun;45(6):1111–26. doi: 10.1016/j.brat.2006.09.010.
    1. Tillfors M, Carlbring P, Furmark T, Lewenhaupt S, Spak M, Eriksson A, Westling BE, Andersson G. Treating university students with social phobia and public speaking fears: internet delivered self-help with or without live group exposure sessions. Depress Anxiety. 2008;25(8):708–17. doi: 10.1002/da.20416.
    1. Yang W, Ding Z, Dai T, Peng F, Zhang JX. Attention bias modification training in individuals with depressive symptoms: a randomized controlled trial. J Behav Ther Exp Psychiatry. 2015 Dec;49(Pt A):101–11. doi: 10.1016/j.jbtep.2014.08.005.
    1. Asbury ET, Casey J, Desai K. Family eJournal: benefits of online guided group journaling for women. J Public Ment Health. 2018 Sep 17;17(3):135–41. doi: 10.1108/JPMH-01-2018-0008.
    1. Auyeung L, Mo PK. The efficacy and mechanism of online positive psychological intervention (PPI) on improving well-being among Chinese university students: a pilot study of the best possible self (BPS) intervention. J Happiness Stud. 2018 Nov 26;:1–6. doi: 10.1007/s10902-018-0054-4.
    1. Bedford LA, Dietch JR, Taylor DJ, Boals A, Zayfert C. Computer-guided problem-solving treatment for depression, PTSD, and insomnia symptoms in student veterans: a pilot randomized controlled trial. Behav Ther. 2018 Dec;49(5):756–67. doi: 10.1016/j.beth.2017.11.010.
    1. Braithwaite SR, Fincham FD. ePREP: computer based prevention of relationship dysfunction, depression and anxiety. J Soc Clin Psychol. 2007 May;26(5):609–22. doi: 10.1521/jscp.2007.26.5.609.
    1. Eustis EH, Hayes-Skelton SA, Orsillo SM, Roemer L. Surviving and thriving during stress: a randomized clinical trial comparing a brief web-based therapist-assisted acceptance-based behavioral intervention versus waitlist control for college students. Behav Ther. 2018 Dec;49(6):889–903. doi: 10.1016/j.beth.2018.05.009.
    1. Flett JA, Hayne H, Riordan BC, Thompson LM, Conner TS. Mobile mindfulness meditation: a randomised controlled trial of the effect of two popular apps on mental health. Mindfulness. 2018 Oct 31;10(5):863–76. doi: 10.1007/s12671-018-1050-9.
    1. Freeman E, Barker C, Pistrang N. Outcome of an online mutual support group for college students with psychological problems. Cyberpsychol Behav. 2008 Oct;11(5):591–3. doi: 10.1089/cpb.2007.0133.
    1. Fulmer R, Joerin A, Gentile B, Lakerink L, Rauws M. Using psychological artificial intelligence (Tess) to relieve symptoms of depression and anxiety: randomized controlled trial. JMIR Ment Health. 2018 Dec 13;5(4):e64. doi: 10.2196/mental.9782.
    1. Gibbel MR. ETD Home. Bowling Green, Ohio: Bowling Green State University; 2010. Evaluating a Spiritually Integrated Intervention for Depressed College Students .
    1. Greer C. University Digital Conservancy Home. Minnesota: University of Minnesota; 2015. An Online Mindfulness Intervention to Reduce Stress and Anxiety Among College Students .
    1. Hall BJ, Xiong P, Guo X, Sou EK, Chou UI, Shen Z. An evaluation of a low intensity mHealth enhanced mindfulness intervention for Chinese university students: a randomized controlled trial. Psychiatry Res. 2018 Dec;270:394–403. doi: 10.1016/j.psychres.2018.09.060.
    1. Harrer M, Adam SH, Fleischmann RJ, Baumeister H, Auerbach R, Bruffaerts R, Cuijpers P, Kessler RC, Berking M, Lehr D, Ebert DD. Effectiveness of an internet- and app- based intervention for college students with elevated stress: randomized controlled trial. J Med Internet Res. 2018 Dec 23;20(4):e136. doi: 10.2196/jmir.9293.
    1. Lee RA, Jung ME. Evaluation of an mHealth app (DeStressify) on university students' mental health: pilot trial. JMIR Ment Health. 2018 Jan 23;5(1):e2. doi: 10.2196/mental.8324.
    1. McCall HC, Richardson CG, Helgadottir FD, Chen FS. Evaluating a web-based social anxiety intervention among university students: randomized controlled trial. J Med Internet Res. 2018;20(3):e91. doi: 10.2196/jmir.8630.
    1. Mogoaşe C, Brăilean A, David D. Can concreteness training alone reduce depressive symptoms? A randomized pilot study using an internet-delivered protocol. Cognit Ther Res. 2013 Jan 3;37(4):704–12. doi: 10.1007/s10608-012-9514-z.
    1. Rose RD, Buckey JC, Zbozinek TD, Motivala SJ, Glenn DE, Cartreine JA, Craske MG. A randomized controlled trial of a self-guided, multimedia, stress management and resilience training program. Behav Res Ther. 2013 Feb;51(2):106–12. doi: 10.1016/j.brat.2012.11.003.
    1. Sagon AL, Danitz SB, Suvak MK, Orsillo SM. The mindful way through the semester: evaluating the feasibility of delivering an acceptance-based behavioral program online. J Contextual Behav Sci. 2018 Jul;9:36–44. doi: 10.1016/j.jcbs.2018.06.004.
    1. Saleh D, Camart N, Sbeira F, Romo L. Can we learn to manage stress? A randomized controlled trial carried out on university students. PLoS One. 2018;13(9):e0200997. doi: 10.1371/journal.pone.0200997.
    1. Sarniak RH. Carolina Digital Repository. Chapel Hill, NC: The University of North Carolina at Chapel Hill; 2009. The effects of an online intervention designed to cultivate positive emotions on emotional and health outcomes in college students .
    1. Stallman HM, Ohan JL, Chiera B. Reducing distress in university students: a randomised control trial of two online interventions. Aust Psychol. 2018 Nov 19;54(2):125–31. doi: 10.1111/ap.12375.
    1. Taitz I. Learning lucid dreaming and its effect on depression in undergraduates. Int J Dream Res. 2011;4(2):117–26. doi: 10.11588/ijodr.2011.2.9123.
    1. Villani D, Riva D. Presence and relaxation: a preliminary controlled study. PsychNol J. 2008;6(1):7–25.
    1. Howell AN, Rheingold AA, Uhde TW, Guille C. Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students. Cogn Behav Ther. 2018 Dec 11;:1–21. doi: 10.1080/16506073.2018.1533575. (forthcoming)
    1. Benton SA, Heesacker M, Snowden SJ, Lee G. Therapist-assisted, online (TAO) intervention for anxiety in college students: TAO outperformed treatment as usual. Prof Psychol Res Pr. 2016;47(5):363–71. doi: 10.1037/pro0000097.
    1. Carey TA, Haviland J, Tai SJ, Vanags T, Mansell W. MindSurf: a pilot study to assess the usability and acceptability of a smartphone app designed to promote contentment, wellbeing, and goal achievement. BMC Psychiatry. 2016 Dec 12;16(1):442. doi: 10.1186/s12888-016-1168-z.
    1. Finlay-Jones A, Kane R, Rees C. Self-compassion online: a pilot study of an internet-based self-compassion cultivation program for psychology trainees. J Clin Psychol. 2017 Jul;73(7):797–816. doi: 10.1002/jclp.22375.
    1. Haas A, Koestner B, Rosenberg J, Moore D, Garlow SJ, Sedway J, Nicholas L, Hendin H, Mann JJ, Nemeroff CB. An interactive web-based method of outreach to college students at risk for suicide. J Am Coll Health. 2008;57(1):15–22. doi: 10.3200/JACH.57.1.15-22.
    1. Horgan A, McCarthy G, Sweeney J. An evaluation of an online peer support forum for university students with depressive symptoms. Arch Psychiatr Nurs. 2013 Apr;27(2):84–9. doi: 10.1016/j.apnu.2012.12.005.
    1. Kaczmarek LD, Kashdan TB, Kleiman EM, Baczkowski B, Enko J, Siebers A, Szäefer A, Król M, Baran B. Who self-initiates gratitude interventions in daily life? An examination of intentions, curiosity, depressive symptoms, and life satisfaction. Pers Individ Dif. 2013 Oct;55(7):805–10. doi: 10.1016/j.paid.2013.06.013.
    1. Kim EH, Coumar A, Lober WB, Kim Y. Addressing mental health epidemic among university students via web-based, self-screening, and referral system: a preliminary study. IEEE Trans Inf Technol Biomed. 2011 Mar;15(2):301–7. doi: 10.1109/TITB.2011.2107561.
    1. Levin ME, Pistorello J, Hayes SC, Seeley JR, Levin C. Feasibility of an acceptance and commitment therapy adjunctive web-based program for counseling centers. J Couns Psychol. 2015 Jul;62(3):529–36. doi: 10.1037/cou0000083.
    1. Moir F, Fernando AT, Kumar S, Henning M, Moyes SA, Elley CR. Computer assisted learning for the mind (CALM): the mental health of medical students and their use of a self-help website. N Z Med J. 2015 Mar 27;128(1411):51–8.
    1. North MM, Schoeneman CM, Mathis JR. Virtual reality therapy: case study of fear of public speaking. Stud Health Technol Inform. 2002;85:318–20. doi: 10.3233/978-1-60750-929-5-318.
    1. Sharry J, Davidson R, McLoughlin O, Doherty G. A service-based evaluation of a therapist-supported online cognitive behavioral therapy program for depression. J Med Internet Res. 2013 Jun 27;15(6):e121. doi: 10.2196/jmir.2248.
    1. Spadaro KC, Hunker DF. Exploring the effects of an online asynchronous mindfulness meditation intervention with nursing students on stress, mood, and cognition: a descriptive study. Nurse Educ Today. 2016 Apr;39:163–9. doi: 10.1016/j.nedt.2016.02.006.
    1. Trockel M, Manber R, Chang V, Thurston A, Taylor CB. An e-mail delivered CBT for sleep-health program for college students: effects on sleep quality and depression symptoms. J Clin Sleep Med. 2011 Jun 15;7(3):276–81. doi: 10.5664/JCSM.1072. doi: 10.5664/JCSM.1072.
    1. Williams A, Larocca R, Chang T, Trinh NH, Fava M, Kvedar J, Yeung A. Web-based depression screening and psychiatric consultation for college students: a feasibility and acceptability study. Int J Telemed Appl. 2014;2014:580786. doi: 10.1155/2014/580786. doi: 10.1155/2014/580786.
    1. Wilson FR, Omeltschenko L, Yager GG. Coping with test stress: microcomputer software for treatment of test anxiety. J Behav Ther Exp Psychiatry. 1991 Jun;22(2):131–9. doi: 10.1016/0005-7916(91)90008-S.
    1. Palacios JE, Richards D, Palmer R, Coudray C, Hofmann SG, Palmieri PA, Frazier P. Supported internet-delivered cognitive behavioral therapy programs for depression, anxiety, and stress in university students: open, non-randomised trial of acceptability, effectiveness, and satisfaction. JMIR Ment Health. 2018 Dec 14;5(4):e11467. doi: 10.2196/11467.
    1. Fleischmann R, Harrer M, Zarski AC, Baumeister H, Lehr D, Ebert DD. Patients' experiences in a guided internet- and app-based stress intervention for college students: a qualitative study. Internet Interv. 2018 Jun;12:130–40. doi: 10.1016/j.invent.2017.12.001.
    1. García-Magariño I, Bedia MG, Palacios-Navarro G. FAMAP: A Framework for Developing m-Health Apps. Proceedings of the Trends and Advances in Information Systems and Technologies; WorldCIST'18; March 27-29, 2018; Naples, Italy. 2018. pp. 850–9.
    1. Henriques G, Keffer S, Abrahamson C, Horst SJ. Exploring the effectiveness of a computer-based heart rate variability biofeedback program in reducing anxiety in college students. Appl Psychophysiol Biofeedback. 2011 Jun;36(2):101–12. doi: 10.1007/s10484-011-9151-4.
    1. Brooke J. SUS-a quick and dirty usability scale. J Usability Stud. 1996;189(194):4–7.
    1. Attkisson CC, Zwick R. The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plann. 1982;5(3):233–7. doi: 10.1016/0149-7189(82)90074-X.
    1. Andrews G, Basu A, Cuijpers P, Craske MG, McEvoy P, English CL, Newby JM. Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: an updated meta-analysis. J Anxiety Disord. 2018 Dec;55:70–8. doi: 10.1016/j.janxdis.2018.01.001.
    1. Ebert DD, Zarski AC, Christensen H, Stikkelbroek Y, Cuijpers P, Berking M, Riper H. Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials. PLoS One. 2015;10(3):e0119895. doi: 10.1371/journal.pone.0119895.
    1. Fortney JC, Curran GM, Hunt JB, Cheney AM, Lu L, Valenstein M, Eisenberg D. Prevalence of probable mental disorders and help-seeking behaviors among veteran and non-veteran community college students. Gen Hosp Psychiatry. 2016;38:99–104. doi: 10.1016/j.genhosppsych.2015.09.007.
    1. Fortney JC, Curran GM, Hunt JB, Lu L, Eisenberg D, Valenstein M. Mental health treatment seeking among veteran and civilian community college students. Psychiatr Serv. 2017 Aug 1;68(8):851–5. doi: 10.1176/appi.ps.201600240.
    1. Sontag-Padilla L, Woodbridge MW, Mendelsohn J, D'Amico EJ, Osilla KC, Jaycox LH, Eberhart NK, Burnam AM, Stein BD. Factors affecting mental health service utilization among California public college and university students. Psychiatr Serv. 2016 Dec 1;67(8):890–7. doi: 10.1176/appi.ps.201500307.
    1. Hanel PH, Vione KC. Do student samples provide an accurate estimate of the general public? PLoS One. 2016;11(12):e0168354. doi: 10.1371/journal.pone.0168354.
    1. Torous J, Nicholas J, Larsen ME, Firth J, Christensen H. Clinical review of user engagement with mental health smartphone apps: evidence, theory and improvements. Evid Based Ment Health. 2018 Aug;21(3):116–9. doi: 10.1136/eb-2018-102891.
    1. Chiu TM, Eysenbach G. Stages of use: consideration, initiation, utilization, and outcomes of an internet-mediated intervention. BMC Med Inform Decis Mak. 2010 Nov 23;10:73. doi: 10.1186/1472-6947-10-73.
    1. Price M, Yuen EK, Goetter EM, Herbert JD, Forman EM, Acierno R, Ruggiero KJ. mHealth: a mechanism to deliver more accessible, more effective mental health care. Clin Psychol Psychother. 2014;21(5):427–36. doi: 10.1002/cpp.1855.
    1. Stiles-Shields C, Montague E, Lattie EG, Schueller SM, Kwasny MJ, Mohr DC. Exploring user learnability and learning performance in an app for depression: usability study. JMIR Hum Factors. 2017 Aug 11;4(3):e18. doi: 10.2196/humanfactors.7951.
    1. Vilardaga R, Rizo J, Kientz JA, McDonell MG, Ries RK, Sobel K. User experience evaluation of a smoking cessation app in people with serious mental illness. Nicotine Tob Res. 2016 May;18(5):1032–8. doi: 10.1093/ntr/ntv256.
    1. Vilardaga R, Rizo J, Zeng E, Kientz JA, Ries R, Otis C, Hernandez K. User-centered design of learn to quit, a smoking cessation smartphone app for people with serious mental illness. JMIR Serious Games. 2018 Jan 16;6(1):e2. doi: 10.2196/games.8881.
    1. Sarkar U, Gourley GI, Lyles CR, Tieu L, Clarity C, Newmark L, Singh K, Bates DW. Usability of commercially available mobile applications for diverse patients. J Gen Intern Med. 2016 Dec;31(12):1417–26. doi: 10.1007/s11606-016-3771-6.
    1. Stiles-Shields C, Holmbeck GN. JPP student journal club commentary: smartphone-delivered interventions for pediatric populations: improving methodologies to address concerns of feasibility and efficacy. J Pediatr Psychol. 2018 Jun 1;43(5):485–7. doi: 10.1093/jpepsy/jsy018.
    1. Lattie EG, Ho J, Sargent E, Tomasino KN, Smith JD, Brown CH, Mohr DC. Teens engaged in collaborative health: the feasibility and acceptability of an online skill-building intervention for adolescents at risk for depression. Internet Interv. 2017 Jun;8:15–26. doi: 10.1016/j.invent.2017.02.003.
    1. Greenhalgh T, Wherton J, Papoutsi C, Lynch J, Hughes G, A'Court C, Hinder S, Fahy N, Procter R, Shaw S. Beyond adoption: a new framework for theorizing and evaluating nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability of health and care technologies. J Med Internet Res. 2017 Dec 1;19(11):e367. doi: 10.2196/jmir.8775.
    1. Wozney L, McGrath PJ, Gehring ND, Bennett K, Huguet A, Hartling L, Dyson MP, Soleimani A, Newton AS. eMental healthcare technologies for anxiety and depression in childhood and adolescence: systematic review of studies reporting implementation outcomes. JMIR Ment Health. 2018 Jun 26;5(2):e48. doi: 10.2196/mental.9655.
    1. Vis C, Mol M, Kleiboer A, Bührmann L, Finch T, Smit J, Riper H. Improving implementation of eMental health for mood disorders in routine practice: systematic review of barriers and facilitating factors. JMIR Ment Health. 2018 Mar 16;5(1):e20. doi: 10.2196/mental.9769.
    1. Hill C, Creswell C, Vigerland S, Nauta MH, March S, Donovan C, Wolters L, Spence SH, Martin JL, Wozney L, McLellan L, Kreuze L, Gould K, Jolstedt M, Nord M, Hudson JL, Utens E, Ruwaard J, Albers C, Khanna M, Albano AM, Serlachius E, Hrastinski S, Kendall PC. Navigating the development and dissemination of internet cognitive behavioral therapy (iCBT) for anxiety disorders in children and young people: a consensus statement with recommendations from the #iCBTLorentz Workshop Group. Internet Interv. 2018 Jun;12:1–10. doi: 10.1016/j.invent.2018.02.002.
    1. Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012 Mar;50(3):217–26. doi: 10.1097/MLR.0b013e3182408812.

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