Date Presented 04/05/19
Primary Author and Speaker: Caceti Dobrowolski
Additional Authors and Speakers: Ann Chapleau
PURPOSE: The purpose of this scoping review was to assess the efficacy of Internet-based interventions (IBI) as a mental health intervention for college students. IBI is an emerging treatment model designed to improve access to care, and it fits within the OT scope of practice, but little is known of its use and outcomes among college students, who have high rates of unmet mental health needs.
DESIGN: A scoping review was implemented to assess the research findings related to IBI with college students. The scoping review method includes a comprehensive summary of published data as well as analysis of findings. Scoping reviews are a relevant method when researchers seek to collect and organize existing evidence related to an intervention strategy and apply that evidence to a new area of practice where gaps in the literature exist (Eschenfelder & Gavalas, 2017). Scoping reviews allow researchers to start with a broad research question and inclusion and exclusion criteria to be refined over the course of the study.
METHOD: The scoping review procedures used for this study followed those of Arksey and O’Malley (2005):
1. Identifying and refining the research question
2. Identifying relevant studies by following a structured search study
3. Selecting studies using a multi-stage individual approach to refine exclusion criteria
4. Obtaining results by charting the data through critical appraisal of the studies
5. Synthesizing and summarizing findings related to mental health interventions on college campuses
The initial research focus was to determine the effectiveness of IBI as a possible intervention for college students. Over the course of the study, this evolved into more specific questions including: What structure of IBI, guided vs. unguided, is more beneficial for college students seeking mental health services? What are the long term outcomes of IBI as a mental health intervention for college students? What frequency/duration of IBI for mental health is most successful for the college student population?
Research for this study began with a search of three databases – PsycInfo, Wiley, and Pubmed- using the following key words: Internet Based Intervention, mental health, and college. The following inclusion criteria guided the initial search of the database: Studies had to be peer-reviewed, written in English language, study IBI for mental health in some way, and include participants classified as young adults.
RESULTS: The initial inclusion criteria yielded 400 peer-reviewed articles to be considered in this study and 19 were retained after critical appraisal and refinement of the research questions. The research evidence supported IBI as an effective mental health intervention for college students. Analysis of the 19 studies consisting of two systematic reviews, ten randomized controlled trials, and seven individual intervention studies revealed significant improvements in symptom reduction and perceived well-being. Symptoms of depression and anxiety were most frequently studied. In addition, researchers consistently reported that IBI resulted in improved access to services due to decreased cost and increased anonymity.
CONCLUSION: IBI can be a resource to reach students who may be unable or unwilling to access traditional services. However, there is still limited data clearly defining the scope and components of IBI, warranting additional research. IBI is a modified treatment approach, accomodating each student's needs and preferences. This approach to care is consistent with OT, which has a history of innovation and use of technology to improve quality of life. OTs can play a key role in direct care, consultation, and advocacy to promote this area of practice.
References
Eschenfelder, V. G. & Gavalas, C. M. (2017). Joint attention and occupations for children and families living with autism spectrum disorder: A scoping review. The Open Journal of Occupational Therapy 5(4). https://doi.org/10.15453/2168-6408.1349
Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. http://dx.doi.org/10.1080/1364557032000119616
