ArticleDigital health
Universal school-based e-health interventions for wellbeing, anxiety and depression: A systematic review and meta-analysis.
Article in Digital health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evaluating the evidence: a systematic review of reviews of the effectiveness and safety of digital interventions for ADHD.BMC psychiatry · 2025Pooled it
- Pedagogical health - a holistic perspective on promoting children's and students' well-being in school.International journal of qualitative studies on health and well-being · 2026Article
- Editorial: Public health strategies to improve mental health in the education sector: perspectives and applications.Frontiers in public health · 2026Article
- A mathematical analysis of math anxiety dynamics using a classical SAS model: Bridging epidemic theory and pedagogical implications.PloS one · 2026Article
- Behavioral pathways and psychosocial determinants of adolescent mental health: positioning nutrition health literacy as a candidate upstream target.Frontiers in nutrition · 2026Review
- Loneliness, problematic digital media use, and nutritional-metabolic vulnerability in adolescents from single-parent households: an integrative review of eating- and sleep-related pathways.Frontiers in nutrition · 2026Review
- Efficacy of a school-based, universal prevention programme for depression and anxiety in adolescents (OurFutures Mental Health): a two-arm cluster-randomised controlled trial.EClinicalMedicine · 2025Article
Corrections and comments
- Retracted
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Given that 'digitally native' children and young people spend much time at school, universal e-mental health interventions (ueMHIs) may have a role in supporting their wellbeing and reducing common mental health problems like anxiety and depression. However, the efficacy of school-based ueMHIs has never formally been evaluated. Methods: During this systematic review and meta-analysis, we searched online databases MEDLINE, ERIC and ACM and the grey literature for trials of school-based ueMHIs targeted at improving wellbeing or reducing anxiety or depression in students aged 5-18. Primary outcomes were changes in symptoms of wellbeing, anxiety and depression at <3 months. Secondary outcomes were changes in these symptoms at 3-12 months and >12 months. Meta-analysis was conducted using a random effects model. Quality of included studies was appraised using the Cochrane risk of bias (RoB) tool. This study was registered with PROSPERO, CRD42023421872. Findings: From 11,026 screened records, 15 papers were found and included in a systematic review. Of these, 14 papers including 8844 students were analysed in the meta-analysis. School-based ueMHIs did not significantly reduce anxiety (SMD = -0.55, 95% CI -1.68, 0.59) or depression (SMD = -0.29, 95% CI = -0.89, 0.32) at <3 months. School-based ueMHIs also did not significantly reduce anxiety (SMD = -1.03, 95% CI -3.20, 1.14) or depression (SMD = -0.47, 95% CI -1.40, 0.46) at 3-12 months. School-based ueMHIs did not significantly improve wellbeing at <3 months (SMD = 0.01, 95% CI -0.12, 0.14) and favoured control condition at 3-12 months (SMD = -0.14, 95% CI -0.23, -0.05). RoB was high across most studies and the overall quality of evidence was very low. Interpretation: Although existing school-based ueMHIs show promise for addressing pupil mental health concerns, further higher-quality evidence is needed. There is room for the development of new school-based ueMHIs for reducing pupil anxiety and depression and improving wellbeing in a scalable, clinically and cost-effective manner, whilst not causing harm.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.