INTRODUCTION: The COVID-19 pandemic has instigated the development of telemedicine-mediated provision of medications for opioid use disorder such as buprenorphine and methadone, referred to as TMOUD in this study. As services start to return to pre-pandemic norms, there is a debate around the role of TMOUD as addition to or replacement of the conventional cascade of care for people with opioid use disorder (PWOUD). This scoping review is designed to characterize existing TMOUD services and provide insights to enable a more nuanced discussion on the role of telemedicine in the care of PWOUD. METHODS: The literature search was conducted in OVID Medline, CINAHL, and PsycINFO, from inception up to and including April 2023, using the Joanna Briggs Institute methodology for scoping reviews. The review considered any study design that detailed sufficient descriptive information on a given TMOUD service. A data extraction form was developed to collect and categorize a range of descriptive characteristics of each discrete TMOUD model identified from the obtained articles. RESULTS: A total of 45 articles met the inclusion criteria, and from this, 40 discrete TMOUD services were identified. In total, 33 services were US-based, three from Canada, and one each from India, Ireland, the UK, and Norway. Through a detailed analysis of TMOUD service characteristics, four models of care were identified. These were TMOUD to facilitate inclusion health, to facilitate transitions in care, to meet complex healthcare needs, and to maintain opioid use disorder (OUD) service resilience. CONCLUSIONS: Characterizing TMOUD according to its functional benefits to PWOUD and OUD services will help support evidence-based policy and practice. Additionally, particular attention is given to how digital exclusion of PWOUD can be mitigated against.

The pressure of learning on students causes mental health problems in students. This can disrupt the student's academic process. The previous review still focused on the impact of digital mindfulness on students, but did not describe the various types of digital mindfulness on students' mental health. A digital image of mindfulness is needed to be a reference for health workers in providing health services to students. The purpose of this study is to describe types of digital-based mindfulness method to improve mental health in university students. The method used in this study was a scoping review. The databases used were CINAHL, PubMed, and Scopus. Search strategy used PRISMA for Scoping Review with keywords namely mindfulness, digital, mental health, and students. The inclusion criteria in this study were student samples, digital-based mindfulness therapy, randomized control trial and quasi-experiment designs, and publication year in the last 10 years (2014-2023). We found that 11 articles about digital-based mindfulness therapy is effective in improving mental health in college students. The types of digital mindfulness carried out are education, counseling, and meditation. Range of samples are 54-561 university students. In addition, there are also counseling services and therapy training guided by facilitators. Information is presented through video and audio that can be accessed at any time by students. Application development is needed by adding monitoring and evaluation features to monitor student compliance in conducting mindfulness therapy and counseling schedules. Then, the role of health workers through holistic mental health services by involving families can improve the process of developing services for students optimally.

BACKGROUND: Group trauma-focused cognitive behavior therapy (TF-CBT) is widely used to treat post-traumatic stress disorder (PTSD) in children and adolescents. However, the available evidence remains unclear. METHOD: PubMed, EMBASE, Cochrane, Web of Science, PsycINFO, CINAHL, ProQuest Dissertations, LILACS, and international trial registers were searched from database inception to April 30, 2022. We included randomized controlled trials (RCTs) that compared TF-CBT with any control condition for treating children and adolescents with PTSD. Analyses were performed using Review Manager version 5.3 and Stata 16.0. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. This study was registered with PROSPERO (CRD42020206096). RESULTS: Eleven RCTs involving 1942 patients were included. Group TF-CBT was significantly more effective than other treatments at post-treatment (standardized mean difference [SMD]: -0.43, 95% confidence interval [CI]: -0.65 to -0.22), follow-up (SMD: -0.33, 95% CI: -0.52 to -0.13), and in relieving depressive symptoms (SMD: -0.29, 95% CI: -0.49 to -0.09), but not in terms of acceptability. Subgroup analyses showed that group TF-CBT was superior to other treatments in studies including children with post-traumatic stress symptoms (PTSS) (SMD: -0.54, 95% CI: -0.79 to -0.28) and psychiatric comorbidities (SMD: -0.48, 95% CI: -0.72 to -0.23). LIMITATIONS: The small sample sizes of identified studies limited some findings. CONCLUSION: When considering effectiveness at post-treatment and follow-up or the reduction of depressive symptoms, group TF-CBT could be a good choice for children and adolescents with PTSD. Among these patients, those with PTSS or psychiatric comorbidities may benefit the most.

Objective: Internet-based cognitive behavior therapy (ICBT) may provide an accessible alternative to face-to-face treatment, but the evidence base in adolescents is limited. This systematic review and meta-analysis aims to comprehensively assess the efficacy of ICBT in addressing depression among adolescents. Methods: Four electronic databases were searched on June 8, 2023. Randomized controlled trials (RCTs) evaluating the efficacy of ICBT for depression in adolescents were included. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook. Furthermore, the GRADE approach was employed to gauge the certainty of the obtained evidence. Meta-analysis was conducted using RevMan 5.4, and Egger's test was implemented through Stata for assessment of potential publication bias. Results: A total of 18 RCTs involving 1683 patients were included. In comparison to control groups like attention control, waiting list, and treatment as usual, our meta-analysis findings elucidate a significant reduction in depression scores (SMD = -0.42, 95 % CI: [-0.74, -0.11], p .05). Conclusion: Results provide evidence of the efficacy of ICBT to reduce depressive and anxiety symptoms in adolescents. These research findings are of vital significance for the establishment of evidence-based treatment guidelines in the digital era. Trial registration: PROSPERO registration: CRD42021277562.

OBJECTIVE: To evaluate the effectiveness of VR therapy (VRT) for symptoms related to social anxiety disorder (SAD), namely fear and avoidance of social interactions and performance situations (FASIP), fear of negative evaluation (FNE), anxiety and depression, a systematic review and meta-analysis were performed. METHODS: Medline, PubMed, Science Direct, Web of Science, CINAHL, PsychINFO and Scopus were searched to include randomised controlled trials of VRT for SAD that met the criteria. A total of 15 RCTs with 720 participants published between 1998 and 2022 were included. Hedge's g with a 95 % confidence interval (CI) was adopted to compute the effect sizes. RESULTS: Results showed no difference between the effect of VRT and CBT on FASIP, FNE, anxiety and depression and a large effect size for VRT versus the waitlist control group on FASIP (g = -1.170, 95 % CI: -2.056-0.283; p < 0.010). The moderator analysis demonstrated that VRT was superior to the controlled group in addressing FASIP, FNE and anxiety when the sample size was smaller than 50 and the number of sessions was five or fewer. LIMITATIONS: Differences in hardware, software and intervention duration for VRT across studies. CONCLUSION: This study confirmed the feasibility of VRT in alleviating the FASIP in patients with SAD, with the waitlist control group as a comparison. However, the effectiveness of VRT was not significant in FASIP, FNE, anxiety and depression compared to cognitive behavioural therapy (CBT). Additional social interaction scenarios should be developed in VRT, standardised hardware should be used and the proper length of exposure time to VR should be determined to enhance the efficacy of VRT.

Background: Schizophrenia is among the most persistent and debilitating mental health conditions worldwide. The American Psychological Association (APA) has identified 10 psychosocial treatments with evidence for treating schizophrenia and these treatments are typically provided in person. However, in-person services can be challenging to access for people living in remote geographic locations. Remote treatment delivery is an important option to increase access to services; however, it is unclear whether evidence-based treatments for schizophrenia are similarly effective when delivered remotely. Study design: The current study consists of a series of systematic reviews and meta-analyses examining the evidence-base for remote-delivery of each of the 10 APA evidence-based treatments for schizophrenia. Results: Of the 10 treatments examined, only cognitive remediation (CR), cognitive-behavioral therapy (CBT), and family psychoeducation had more than 2 studies examining their efficacy for remote delivery. Remote delivery of CBT produced moderate effects on symptoms (g = 0.43) and small effects on functioning (g = 0.26). Remote delivery of CR produced small-moderate effects on neurocognition (g = 0.35) and small effects on functioning (g = 0.21). There were insufficient studies of family psychoeducation with equivalent outcome measures to assess quantitatively, however, studies of remotely delivered family psychoeducation suggested that it is feasible, acceptable, and potentially effective. Conclusions: Overall, the evidence-base for remotely delivered treatment for schizophrenia is limited. Studies to date suggest that remote adaptations may be effective; however, more rigorous trials are needed to assess efficacy and methods of remote delivery that are most effective.

Introduction: Personalization is a much-discussed approach to improve adherence and outcomes for Digital Mental Health interventions (DMHIs). Yet, major questions remain open, such as (1) what personalization is, (2) how prevalent it is in practice, and (3) what benefits it truly has. Methods: We address this gap by performing a systematic literature review identifying all empirical studies on DMHIs targeting depressive symptoms in adults from 2015 to September 2022. The search in Pubmed, SCOPUS and Psycinfo led to the inclusion of 138 articles, describing 94 distinct DMHIs provided to an overall sample of approximately 24,300 individuals. Results: Our investigation results in the conceptualization of personalization as purposefully designed variation between individuals in an intervention's therapeutic elements or its structure. We propose to further differentiate personalization by what is personalized (i.e., intervention content, content order, level of guidance or communication) and the underlying mechanism [i.e., user choice, provider choice, decision rules, and machine-learning (ML) based approaches]. Applying this concept, we identified personalization in 66% of the interventions for depressive symptoms, with personalized intervention content (32% of interventions) and communication with the user (30%) being particularly popular. Personalization via decision rules (48%) and user choice (36%) were the most used mechanisms, while the utilization of ML was rare (3%). Two-thirds of personalized interventions only tailored one dimension of the intervention. Discussion: We conclude that future interventions could provide even more personalized experiences and especially benefit from using ML models. Finally, empirical evidence for personalization was scarce and inconclusive, making further evidence for the benefits of personalization highly needed.

Psychiatry is one of the many medical subspecialties that have benefited from the advent of telemedicine. Substance abuse treatment via telepsychiatry expeditiously increased with the start of the pandemic and has brought changes to its rules and regulations. In this study, we focused on the prognosis of substance abuse patients treated with telepsychiatry, the various changes that occurred during the pandemic, and the difficulties faced by clinicians using telepsychiatry. PubMed and Google Scholar were searched for relevant articles between January 2010 and July 2022 using both broad and narrow keywords in addition to the MeSH (Medical Subject Heading) approach. The total number of records found was 765. Strict criteria for inclusion and exclusion ensured that only relevant information was collected. After removing duplicates, irrelevant studies, and research that did not meet the inclusion criteria, we were left with 373 studies from both electronic databases. From those, we ultimately retrieved 35 studies, which were subjected to a thorough content search and quality evaluation with the help of specialized instruments, and a total of 19 papers were included in our systematic review. We concluded that telepsychiatry use for substance abuse patients increased during the pandemic, and the prognosis of these patients treated with telepsychiatry was similar to that of in-person treatment. However, a combination of telepsychiatry with in-person sessions showed much better results.

BACKGROUND: People forced to leave their homes, such as refugees and internally displaced persons, are exposed to various stressors during their forced displacement, putting them at risk for mental disorders. OBJECTIVE: To summarize evidence on the efficacy of psychosocial interventions aiming to promote mental health and/or to prevent mental symptoms by fostering transdiagnostic skills in forcibly displaced persons of all ages. METHOD: Four databases and reference lists were searched for randomized controlled trials on interventions in this population on 11 March 2022. Thirty-six studies were eligible, 32 studies (comprising 5299 participants) were included in random-effects multilevel meta-analyses examining the effects of interventions on mental symptoms and positive mental health (e.g. wellbeing) as well as moderators to account for heterogeneity. OSF Preregistration-ID: 10.17605/OSF.IO/XPMU3 RESULTS: Our search resulted in 32 eligible studies, with 10 reporting on children/adolescents and 27 on adult populations. There was no evidence for favourable intervention effects in children/adolescents, with 44.4% of the effect sizes pointing to potentially negative effects yet remaining non-significant. For adult populations, our meta-analyses showed a close-to-significant favourable effect for mental symptoms, M(SMD) = 0.33, 95% CI [-0.03, 0.69], which was significant when analyses were limited to high-quality studies and larger for clinical compared to non-clinical populations. No effects emerged for positive mental health. Heterogeneity was considerable and could not be explained by various moderators (e.g. type of control, duration, setting, theoretical basis). Certainty of evidence was very low across all outcomes limiting the generalizability of our findings. CONCLUSION: The present review provides at most weak evidence for an effect favouring transdiagnostic psychosocial interventions over control conditions for adult populations but not for children and adolescents. Future research should combine the imperative of humanitarian aid in face of major crises with studying the diverse needs of forcibly displaced persons to improve and tailor future interventions.

Previous studies reported that virtual reality (VR)-based exposure therapy (VRET) was a clinically beneficial intervention for specific phobias. However, among VRET, VR-based graded exposure therapy (VR-GET) is little known about its efficacy on posttraumatic stress disorder (PTSD) symptoms. Therefore, this meta-analysis investigated the effects of VR-GET for PTSD symptoms. A literature search yielded seven randomized controlled trials. The differences between conditions regarding the primary outcome of PTSD symptoms in the effect size of the individual study were calculated using Hedges' g. The findings showed VR-GET showed a significantly larger effect size for PTSD symptoms (g = 1.100, p = 0.001), compared to controls. However, no significant difference between conventional VRET and controls was found for PTSD symptoms (g = -0.279, p = 0.970). These findings indicated the superiority of VR-GET for PTSD symptoms compared to controls, supporting the importance of immersive PTSD treatments. Nevertheless, the results need to be interpreted with caution due to the substantial number of military service personnel studies. Future trials, considering individually tailored scenarios in virtual environments to cover a wider range of trauma types, are required to investigate its evidence on treating PTSD.

BACKGROUND: Apathy is common in people with cognitive impairment. It leads to different consequences, such as more severe cognitive deficits, rapid functional decline, and decreased quality of life. Virtual reality (VR) interventions are increasingly being used to manage apathy in individuals with cognitive impairment. However, reports of VR interventions are scattered across studies, which has hindered the development and use of the interventions. OBJECTIVE: This study aimed to systematically review existing evidence on the use of VR interventions for managing apathy in people with cognitive impairment with regard to the effectiveness, contents, and implementation of the interventions. METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. The PubMed, Embase, CINAHL, and PsycINFO databases were systematically searched for experimental studies published up to March 13, 2022, that reported the effects of VR interventions on apathy in older adults with cognitive impairment. Hand searching and citation chasing were conducted. The results of the included studies were synthesized by using a narrative synthesis. Their quality was appraised by using the Effective Public Health Practice Project quality assessment tool. However, because the VR interventions varied in duration, content, and implementation across studies, a meta-analysis was not conducted. RESULTS: A total of 22 studies were identified from the databases, of which 6 (27%) met the inclusion criteria. Of these 6 studies, 2 (33%) were randomized controlled trials, 1 (17%) was a controlled clinical trial, and 3 (50%) were quasi-experimental studies. Individual studies showed significant improvement in apathy and yielded within-group medium to large effect sizes. The level of immersion ranged from low to high. Minor adverse effects were reported. The VR content mostly included natural scenes, followed by city views and game-based activities. A background soundtrack was often used with natural scenes. Most (5/6, 83%) of the studies were conducted in a residential care setting and were implemented by health care professionals or researchers. Safety precautions were taken in most (5/6, 83%) of the studies. CONCLUSIONS: Although preliminary evidence shows that VR interventions may be effective and feasible for alleviating apathy in people with cognitive impairment, the methodological limitations in the included studies make it difficult to reach a firm conclusion on these points. The implementation of the interventions was highlighted and discussed. More rigorous studies are encouraged.

With over 80 million people forcibly displaced worldwide, providing safe, healthy, and supportive places for refugees has become an imperative for national governments, aid organizations, and host communities. While much has been written about the needs of these displaced people, organizations and practitioners tend to focus on essential material needs, medical care, and food and water provisioning. Yet a growing body of evidence points to the potential role of social capital - the bonding, bridging, and linking social ties that connect us to one another - as a critical resource for these refugees. We have little data about social capital interventions at individual and community levels to assist with mental health for this vulnerable population, and even less methodical evidence about such interventions' impact. This systematic review analyzes nearly 400 articles to find patterns in the literature on how social-capital-based interventions can improve the mental health of refugees. Within the studies of interventions that met our filtering criteria, the reinforcement or creation of social capital, especially bridging and linking types, serves as a crucial resource to help this vulnerable group. Specifically, our review showed that community and multilevel social capital interventions are key to curbing mental health symptoms among refugees. Given this scanty evidence base among a group so vulnerable to mental health problems, this review serves as an explicit invitation for researchers to further examine social capital interventions among refugees.

PURPOSE OF THE REVIEW: The prevalence of mental and substance use disorders is three to five times higher than that of the general population. Psychosocial interventions are effective in identifying and managing mental health and substance use disorders. This article aims to review the randomized control studies which have used nonpharmacological interventions alone or in combination with pharmacological interventions for managing mental and substance use disorders in prison/correctional settings. COLLECTION AND ANALYSIS OF DATA: Studies included were randomized control trials and pilot randomized studies that assessed the impact of psychosocial interventions for prisoners with mental disorders and substance use disorders. A comprehensive search for articles was done by the primary author (Sreekanth Nair Thekkumkara) in the following databases: PubMed, ProQuest, PsychArticles, and Google Scholar (search engine), for the period June 1, 2000, to December 31, 2020. RESULTS AND CONCLUSIONS: The 21 studies included in the review had a sample size of 34 to 759. The settings of all the interventions were the prison and different types of psychosocial interventions were provided across the studies. The average duration of intervention ranged between 10 min and 120 min with the frequency of one to six sessions per week for 1 to 36 months. All the 21 Randomized Control Trials (RCTs) were nonIndian studies. Overall, the results of the included studies showed significant improvement postintervention (motivational intervention, interpersonal therapy, cognitive behavior therapy, positive psychology intervention, music therapy, and acceptance and commitment therapy) on primary outcome measures such as symptom severity of depression, anxiety, and substance abuse prisoners. Positive effects were observed on secondary outcome measures such as motivation, aggression, follow up rates, and recidivism. A limited number of studies have focused on evaluating psychosocial interventions in prison settings. Most of the interventions were tested in prisoners with substance use disorder alone or in those with dual diagnoses and in high-income countries.

Internalizing problems (e.g., depression, anxiety) and substance use are common among young people and often co-occur. However, youths face myriad barriers to access needed treatment, and existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than both simultaneously. Brief interventions that target both problems may, therefore, be an efficient and accessible resource for alleviating youth difficulties; however, this possibility has been insufficiently evaluated. This systematic review evaluated the intervention characteristics and quality of six studies spanning 2015 to 2019 that examined intervention effects on internalizing and substance use outcomes. Based on independent calculations and author reports (respectively), 3-4 interventions significantly reduced youth internalizing symptoms; 3-5 reduced youth substance use; and 2-3 reduced symptoms in both domains. All six interventions identified substance use as a primary target. Four interventions were administered by interventionists to youths in inpatient, outpatient, primary care, or school settings. The remaining two studies delivered content through voicemail messages or an online design. Interventions ranged from ~ 15 to 240 min. Results highlight the sparsity and heterogeneity of youth-focused brief interventions that have evaluated program effects on both internalizing problems and substance use outcomes, suggesting a clear need for integrated supports that are also designed for accessibility. Future investigations of brief youth-focused interventions should assess program effects on both internalizing and substance use outcomes; examine mechanisms driving the varied efficacy of identified interventions; and create, refine, and test interventions with potential to address co-occurring internalizing problems and substance use in young people.

INTRODUCTION: Depression is the leading cause of disability in the world. Despite the prevalence of depression, a small proportion of individuals seek mental health services. A cost-effective method for increasing access to mental health services is the implementation of telemental-health programs. This review aims to summarize the state of the field on the efficacy and effectiveness of videoconferencing psychotherapy (VCP) for the treatment of depression. MATERIALS AND METHODS: Systematic literature searches were performed using PsychINFO, PubMed, and EMBASE. Specific inclusion criteria were used to identify controlled and uncontrolled studies evaluating VCP for the treatment of depression. Data extraction included study assessment quality, research design, sample size, intervention details, outcome results, intervention effect size, and statistical differences between VCP and in-person (IP) therapy. RESULTS: Of the 1,424 abstracts screened, 92 articles were critically reviewed. Thirty-three articles were included in the review, with 14 randomized controlled studies, 4 controlled nonrandomized studies, and 15 uncontrolled studies. Sample size ranged from 1 to 243 participants. Twenty-one studies reported statistically significant reductions in depressive symptoms following VCP, and the median effect size for studies ranged from medium to the very large range. Most controlled studies reported no statistical differences between VCP and IP groups receiving the same intervention. CONCLUSIONS: VCP for the treatment of depression is a promising method for delivering mental health services. More rigorous research is needed to evaluate VCP on depression in various contexts and participants.

In the present systematic review, we summarize the feasibility, usability, efficacy, and effectiveness of mental health-related apps created by the Veterans Affairs (VA) or the Department of Defense (DoD). Twenty-two articles were identified, reporting on 8 of the 20 VA/DoD mental health self-management and treatment companion apps. Review inclusion criteria were studies that reported original data on the usability, acceptability, feasibility, efficacy, and effectiveness, or attitudes toward the app. We collected data from each article regarding type of study, sample size, participant population, follow-up period, measures/assessments, and summary of findings. The apps have been tested with patients seeking treatment, patients with elevated mental health symptoms, and clinicians. The strongest area of support for the apps is regarding evidence of their feasibility and acceptability. Research support for efficacy and effectiveness of the apps is scarce with exceptions for two apps (PTSD Coach, Virtual Hope Box). Until more evidence accumulates, clinicians should use their judgment and be careful not to overstate the potential benefits of the apps.

In the present systematic review, we summarize the feasibility, usability, efficacy, and effectiveness of mental health-related apps created by the Veterans Affairs (VA) or the Department of Defense (DoD). Twenty-two articles were identified, reporting on 8 of the 20 VA/DoD mental health self-management and treatment companion apps. Review inclusion criteria were studies that reported original data on the usability, acceptability, feasibility, efficacy, and effectiveness, or attitudes toward the app. We collected data from each article regarding type of study, sample size, participant population, follow-up period, measures/assessments, and summary of findings. The apps have been tested with patients seeking treatment, patients with elevated mental health symptoms, and clinicians. The strongest area of support for the apps is regarding evidence of their feasibility and acceptability. Research support for efficacy and effectiveness of the apps is scarce with exceptions for two apps (PTSD Coach, Virtual Hope Box). Until more evidence accumulates, clinicians should use their judgment and be careful not to overstate the potential benefits of the apps.

BACKGROUND: This study examined the state of the art relevant for clinical practice on symptom manifestation of depression or depression-related idioms of distress, the treatment effectiveness and obstacles and facilitators for therapeutic success in Turkish and Moroccan immigrant populations with depression in Europe. METHODS: We conducted a systematic search in PsycINFO, MEDLINE, Science Direct, Web of Knowledge, and Cochrane databases (1970- 31 July 2017). Peer-reviewed studies, with adult populations, and an instrument assessing depressive symptoms met inclusion criteria and were evaluated following quality guidelines. RESULTS: We included 13 studies on symptom manifestation, 6 on treatment effectiveness, and 17 on obstacles and facilitators, published between 2000 and 2017, from Germany, the Netherlands, Austria and Sweden (n Turkish individuals=11,533; n Moroccan individuals=5278; n native individuals=303,212). Both ethnic groups more often reported combined mood and somatic symptoms (and anxiety in the case of Turkish groups) than natives, and had higher levels of symptoms. There was no report on effectiveness of pharmacotherapy and there was weak evidence of the effectiveness of examined psychological treatments for depression in Turkish groups. No treatment has been examined in Moroccan groups. Salient obstacles to therapeutic success were socioeconomic problems, higher level of psychological symptoms at baseline, and negative attitudes towards psychotherapy. Possible facilitators were interventions attuned to social, cultural and individual needs. Results were most representative of first generation, low SES Turkish immigrant patients, and Moroccan-Dutch members of the general populations. CONCLUSION: Turkish and Moroccan immigrants with depression presented a comorbid symptom profile with more intertwined depressive and somatic complaints. There were indications that the available therapies are insufficient for Turkish groups, but the current evidence is scarce and heterogeneous, and RCTs suffer from methodological limitations.

Smoking in pregnancy remains a global public health issue due to foetal health risks and potential maternal complications. The aims of this systematic review and meta-analysis were to explore: (1) whether digital interventions for pregnancy smoking cessation are effective, (2) the impact of intervention platform on smoking cessation, (3) the associations between specific Behaviour Change Techniques (BCTs) delivered within interventions and smoking cessation, and (4) the association between the total number of BCTs delivered and smoking cessation. Systematic searches of nine databases resulted in the inclusion of 12 published articles (n = 2970). The primary meta-analysis produced a sample-weighted odds ratio (OR) of 1.44 (95% CI 1.04-2.00, p=0.03) in favour of digital interventions compared with comparison groups. Computer-based (OR=3.06, 95% CI 1.28 - 7.33) and text-message interventions (OR=1.59, 95% CI 1.07 - 2.38) were the most effective digital platform. Moderator analyses revealed seven BCTs associated with smoking cessation: information about antecedents; action planning; problem solving; goal setting (behaviour); review behaviour goals; social support (unspecified); and pros and cons. A meta-regression suggested that interventions using larger numbers of BCTs produced the greatest effects. This paper highlights the potential for digital interventions to improve rates of smoking cessation in pregnancy.

A number of technologies to help self-manage attention deficit hyperactivity disorder (ADHD) in children and young people (YP) have been developed. This review will assess the level of evidence for the use of such technologies. The review was undertaken in accordance with the general principles recommended in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. 7545 studies were screened. Fourteen studies of technology that aim to self-manage difficulties associated with ADHD in children and YP were included. Primary outcome measures were measures that assessed difficulties related to ADHD. Databases searched were MEDLINE, Web of Science (Core collection), CINAHL, the Cochrane Library, ProQuest ASSIA, PsycINFO and Scopus. The methodological quality of the studies was assessed. This review highlights the potential for the use of technology in paediatric ADHD management. However, it also demonstrates that current research lacks robustness; using small sample sizes, non-validated outcome measures and little psychoeducation component. Future research is required to investigate the value of technology in supporting children and YP with ADHD and a focus psychoeducation is needed.