Abstract
Purpose
This meta-analysis aimed to determine the effect of interventions targeting multiple
modifiable health behaviors (i.e., physical activity/sedentary behaviors, nutrition/diet,
sleep, substance use) on depression and anxiety in young people.
Methods
A search of electronic databases from inception until May 2020 was conducted. Randomized
controlled trials (RCTs) that explicitly targeted at least two modifiable health behaviors,
measured anxiety or depression at baseline and after intervention using a validated
instrument, and included participants with an average age between 12 and 25 years
were included. The effect of interventions was synthesized using random effects meta-analysis.
Results
A total of 14 RCTs reporting on depression and six RCTs reporting on anxiety were
included in the quantitative synthesis. Results showed that although interventions
targeting multiple modifiable health behaviors did not produce significant reductions
in symptoms of depression ( = -.16, 95% confidence interval [CI] = [-.34, .02], 95% prediction interval [PI] =
[-.80, .48], very low certainty evidence) or anxiety ( = -.55, 95% CI = [-1.36, .26], 95% PI = [-3.48, 2.83], very low certainty evidence)
across all young people, there was a significant difference in the effect of interventions
on depression based on intervention type (Q = 8.37, df = 2, p = .012). Specifically, interventions targeting multiple modifiable health behaviors
delivered to groups of young people with an elevated risk of depression had a favorable
effect ( = -.28, 95% CI = [-.52, -.05], 95% PI = [-1.04, .47]) on symptoms of depression compared
with controls.
Conclusions
Although not universally effective, this meta-analysis establishes the potential efficacy
of targeted interventions aiming to improve multiple modifiable health behaviors to
address depression in young people at elevated risk of depression. More research is
needed to understand the effect of such interventions on symptoms of anxiety in young
people.
Keywords
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Article info
Publication history
Published online: September 24, 2021
Accepted:
August 4,
2021
Received:
May 16,
2021
Footnotes
Conflicts of interest: J.F. has received honoraria/consultancy fees from Atheneum, ParachuteBH, and Nirakara, independent of this work. F.N.J. has received industry support for research from Meat and Livestock Australia, Woolworths Limited, the A2 Milk Company, and Be Fit Foods; philanthropic support from the Fernwood Foundation, Wilson Foundation, the JTM Foundation, the Serp Hills Foundation, the Roberts Family Foundation, and the Waterloo Foundation; and travel support and speakers honoraria from Sanofi-Synthelabo, Janssen Cilag, Servier, Pfizer, Network Nutrition, Angelini Farmaceutica, Eli Lilly, and Metagenics. F.N.J. has written two books for commercial publication.
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