TY - JOUR
T1 - The Effect of Interventions That Target Multiple Modifiable Health Behaviors on Symptoms of Anxiety and Depression in Young People
T2 - A Meta-Analysis of Randomized Controlled Trials
AU - Bourke, Matthew
AU - Patten, Rhiannon K
AU - Dash, Sarah
AU - Pascoe, Michaela
AU - Craike, Melinda
AU - Firth, Joseph
AU - Bailey, Alan
AU - Jacka, Felice
AU - Parker, Alexandra G
N1 - Funding Information:
J.F. is supported by a University of Manchester Presidential Fellowship (P123958) and a UK Research and Innovation Future Leaders Fellowship (MR/T021780/1). F.N.J. has received support from the Brain and Behaviour Research Institute, the National Health and Medical Research Council (NHMRC), Australian Rotary Health , the Geelong Medical Research Foundation , the Ian Potter Foundation , and The University of Melbourne . A.G.P. has received support from the National Health and Medical Research Council (NHMRC).
Funding Information:
Conflicts of interest: J.F. has received honoraria/consultancy fees from Atheneum , ParachuteBH , and Nirakara , independent of this work. F.N.J. has received industry support for research from Meat and Livestock Australia , Woolworths Limited, the A2 Milk Company, and Be Fit Foods; philanthropic support from the Fernwood Foundation , Wilson Foundation, the JTM Foundation, the Serp Hills Foundation, the Roberts Family Foundation, and the Waterloo Foundation; and travel support and speakers honoraria from Sanofi-Synthelabo , Janssen Cilag , Servier , Pfizer , Network Nutrition , Angelini Farmaceutica , Eli Lilly , and Metagenics . F.N.J. has written two books for commercial publication.
Publisher Copyright:
© 2021 Society for Adolescent Health and Medicine
PY - 2022/2
Y1 - 2022/2
N2 - 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.
AB - 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.
KW - anxiety
KW - common mental disorders
KW - depression
KW - diet
KW - health behaviors
KW - meta-analysis
KW - nutrition
KW - physical activity
KW - sleep
KW - substance use
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pure_starter&SrcAuth=WosAPI&KeyUT=WOS:000789211700007&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.jadohealth.2021.08.005
DO - 10.1016/j.jadohealth.2021.08.005
M3 - Review article
C2 - 34580029
SN - 1879-1972
VL - 70
SP - 208
EP - 219
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 2
ER -