Systematic Review of Digital Interventions for Stress Management inAdults

Background Stress is an inevitable part of everyday life. Proper management of stress is crucial in maintaining health of individuals. There are several program that help to manage stress. With the development of new technologies such programs are adapted in digital form. Studies on these digital programs show different results. There is need to review the literature to find out the effective interventions. The Objective of this review is to search systematically, assess and present literature on effectiveness of available digital interventions for stress management in adult population worldwide for the last five years. Methods MEDLINE, Embase, PsycINFO and CENTRAL databases have been systematically searched for the Randomized Controlled Trials (RCT) and Non-randomized Studies (NRS). The population of healthy individuals aged 18 years and above eligible for the review. The intervention is any stress management program or strategies that is delivered digitally, i.e. on digital device (computer, mobile phone etc.) online or offline mode. Cochrane Collaboration tool was used for assessing the risk of bias in RCT and NRS. Results Thirty eight relevant studies were included into the review which were based on the Cognitive Behavioral Therapy (CBT), Mindfulness, framework, combination of frameworks as well as other frameworks. Included studies on digital CBT interventions do not show its effectiveness on reducing stress in healthy populations. The majority of studies on Online Mindfulness-based stress management show a decrease in stress level with a small to a large effect size (d=0,23, d=1,57) in healthy adults. Most of the studies on digital intervention based on several frameworks and other strategies also show positive results in decreasing stress in healthy population. Conclusion Digital CBT Interventions alone are not effective in managing the stress. Online Mindfulnessbased Interventions are likely to be effective in stress management in adult population. Digital stress management intervention that are based on several strategies and other frameworks are also showing promising results. The recommended framework for developing the tool for stress management is combination of cognitive behavioral and mindfulness intervention