Evidence map›Paper›PMID 42343534›Full record

ReviewBJPsych open2026

Effectiveness of lay workers delivering behavioural activation for people with depression: systematic review and meta-analysis.

Shwikar Othman, Lauren Blekkenhorst, Asangaedem Akpan, Irene Ngune, Nilufeur McKay, Alison Kennedy, Elizabeth Armstrong, Michael Hunter, Kevin Murray, Mathew Coleman and 4 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BJPsych open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Shwikar OthmanSchool of Nursing and Midwifery, https://ror.org/05jhnwe22Edith Cowan University, Perth, Western Australia, Australia.ORCID https://orcid.org/0000-0003-3283-9305
Lauren BlekkenhorstNutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.
Asangaedem AkpanDepartment of Geriatric Medicine, Bunbury Regional Hospital, Bunbury, Western Australia, Australia.
Irene NguneSchool of Nursing and Midwifery, https://ror.org/05jhnwe22Edith Cowan University, Perth, Western Australia, Australia.
Nilufeur McKaySchool of Nursing and Midwifery, https://ror.org/05jhnwe22Edith Cowan University, Perth, Western Australia, Australia.
Alison KennedyDeakin University, Melbourne, Victoria, Australia.
Elizabeth ArmstrongDepartment of Rural Health South West, Edith Cowan University, South West Campus, Bunbury, Western Australia, Australia.
Michael HunterBusselton Health Study Centre, Busselton Population Medical Research Institute (BPMRI), Busselton, Western Australia, Australia.
Kevin MurraySchool of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.
Mathew ColemanAlbany Regional Hospital, Albany, Western Australia, Australia.
Richard GrayHealthy People, Families and Communities, LaTrobe University, Melbourne, Victoria, Australia.
Emma JonesRural Clinical School, University of Western Australia, Geraldton, Western Australia, Australia.
Christopher LeeConnell School of Nursing, Boston College, Massachusetts, USA.
Martin JonesSchool of Nursing and Midwifery, Edith Cowan University, South West Campus, Bunbury, Western Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBehavioural activation is effective for depression, but its effectiveness in treating adults with depression when delivered by lay workers remains unclear.

aimsTo examine the effectiveness of behavioural activation delivered by lay workers, compared with any control group, in reducing depressive symptoms in adults.

methodThis systematic review searched six databases from inception to January 2025, for randomised controlled trials (RCTs) comparing behavioural activation and any control conditions for individuals with depression when delivered by lay workers. Additional searches were conducted in the international trial registries and reference lists (PROSPERO registration CRD42024625620). Risk of bias was assessed using the Cochrane Collaboration's Risk-of-Bias 2 tool. Random effects meta-analysis was conducted using the Metafor package in R.

resultsOf 9614 initial studies, six RCTs met the inclusion criteria and were included. A total of 1118 participants in the intervention groups and 1596 in the control groups. The findings demonstrated a small but statistically significant effect in reducing depressive symptoms in favour of the intervention group (standardised mean difference: -0.28, 95% CI -0.46 to -0.09;

conclusionsEvidence from this review and meta-analysis suggests that behavioural activation, when delivered by trained lay workers, may offer an effective approach for reducing depressive symptoms in adults, particularly in settings with limited access to specialist mental healthcare professionals. However, high risk of bias and heterogeneity of the included studies means that these findings should be interpreted with caution.

Indexed as

Behavioural activationdepressioneffectivenesslay workersmeta-analysis

Identifiers

PMID42343534
PMCPMC13312275

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.