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The Effect of Interventions That Target Multiple Modifiable Health Behaviors on Symptoms of Anxiety and Depression in Young People: A Meta-Analysis of Randomized Controlled Trials

  • Matthew Bourke
    Correspondence
    Address correspondence to: Matthew Bourke, Institute for Health and SPort, Victoria University, PO Box 14428, Melbourne, Victoria, Australia.
    Affiliations
    Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
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  • Rhiannon K. Patten
    Affiliations
    Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
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  • Sarah Dash
    Affiliations
    Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia

    Deakin University, IMPACT – The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
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  • Michaela Pascoe
    Affiliations
    Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
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  • Melinda Craike
    Affiliations
    Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia

    Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Victoria, Australia
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  • Joseph Firth
    Affiliations
    Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom

    NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
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  • Alan Bailey
    Affiliations
    Centre for Youth Mental Health and Orygen, University of Melbourne, Melbourne, Victoria, Australia
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  • Felice Jacka
    Affiliations
    Deakin University, IMPACT – The Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia

    Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia

    Black Dog Institute, Sydney, New South Wales, Australia

    College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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  • Alexandra G. Parker
    Affiliations
    Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia

    Centre for Youth Mental Health and Orygen, University of Melbourne, Melbourne, Victoria, Australia
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Published:September 24, 2021DOI:https://doi.org/10.1016/j.jadohealth.2021.08.005

      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 ( g ¯  = -.16, 95% confidence interval [CI] = [-.34, .02], 95% prediction interval [PI] = [-.80, .48], very low certainty evidence) or anxiety ( g ¯  = -.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 ( g ¯  = -.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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