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Animal-Assisted Interventions Improve Mental, But Not Cognitive or Physiological Health Outcomes of Higher Education Students: a Systematic Review and Meta-analysis.

ABSTRACT: Due to the high burden of mental health issues among students at higher education institutions world-wide, animal-assisted interventions (AAIs) are being used to relieve student stress. The objective of this study was to systematically review of the effects of AAIs on the mental, physiological, and cognitive outcomes of higher education students. Randomized controlled trials using any unfamiliar animal as the sole intervention tool were included in this review. Study quality was assessed using the Cochrane Risk-of-Bias tool. Where possible, effect sizes (Hedges' g) were pooled for individual outcomes using random-effects meta-analyses. Albatross plots were used to supplement the data synthesis. Of 2.494 identified studies, 35 were included. Almost all studies used dogs as the intervention animal. The quality of most included studies was rated as moderate. Studies showed an overall reduction of acute anxiety and stress. For other mental outcomes, studies showed smaller, but nonetheless beneficial effects. Studies showed no clear effect on physiological or cognitive outcomes. Strong methodological heterogeneity between studies limited the ability to draw clear conclusions.

Supplementary information

The online version contains supplementary material available at 10.1007/s11469-022-00945-4.

SUBMITTER: Huber A

PROVIDER: S-EPMC9666958 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Animal-Assisted Interventions Improve Mental, But Not Cognitive or Physiological Health Outcomes of Higher Education Students: a Systematic Review and Meta-analysis.

Huber Annalena A Klug Stefanie J SJ Abraham Annette A Westenberg Erica E Schmidt Veronika V Winkler Andrea S AS

International journal of mental health and addiction 20221115

Due to the high burden of mental health issues among students at higher education institutions world-wide, animal-assisted interventions (AAIs) are being used to relieve student stress. The objective of this study was to systematically review of the effects of AAIs on the mental, physiological, and cognitive outcomes of higher education students. Randomized controlled trials using any unfamiliar animal as the sole intervention tool were included in this review. Study quality was assessed using t ...[more]

PMID: 36406903

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Project description:BackgroundDigital mental health interventions have been posited as a way of reducing the burden on mental health services in higher education institutions. However, low adherence and high attrition rates present a challenge that limits the effectiveness of these interventions. User-centered design has been proposed as a suitable approach in improving the adherence of users to these interventions.ObjectiveThe objective of this scoping review was to examine digital mental health interventions that have been designed specifically for students in higher education. It aimed to summarize the published literature on digital mental health interventions which take a user-centered approach in developing interventions for students in higher education.MethodsA scoping review of peer-reviewed research papers from the following electronic databases was conducted: Embase, ACM digital library, Web of Science, IEEE Explore, SCOPUS, EBSCO Host (including APA PyscInfo, CINAHL PLUS, APA PsycArticles, Medline), PubMed and Google Scholar. Databases were searched from inception until 13 Jan and 14 Jan 2021. Of the 755 articles that were identified, 57 articles were selected for full review. 34 articles were excluded for not matching the inclusion criteria.Results23 studies were included in this review. The included interventions targeted various areas of mental health including depression, anxiety, overall wellbeing, and mental health awareness. The interventions were commonly delivered through mobile apps, web-based apps, and desktop apps. In addition, we explore design methodologies applied in the development of the interventions: we note significant stakeholder engagement in the studies, the inclusion of multiple stakeholder types (students, health care professionals, university staff, and young people in the general population), and limited use of design frameworks. Finally, in exploring user engagement, attrition rates and user acceptance, we find that most of the studies have not progressed enough (i.e., at pilot/prototype stages of development) to determine the impact of design methodologies on the success of these interventions.ConclusionOur review revealed a need for further research on the impact of user-centered design practices on the success of digital mental health interventions in this population. Further, we provide recommendations that researchers/designers in this field of research should take into consideration when designing online mental health interventions for students in higher education. Some of the recommendations include: add personalization; improve user interfaces; take adequate steps to ensure anonymity/privacy/security; include peer engagement; and include access to mental health professionals.

Project description:BackgroundSymptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics.Material and methodsA systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995-2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges' g) used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3-6 months, 7-12 months, and 13-18 months of post-intervention follow-up.ResultsAbout 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7-12 months post-intervention (standardized mean difference (Hedges' g) effect size (ES) = -0.28 (95% CI [-0.49, -0.08])). Further, sustainability of symptom-reductions were evident for depression with intervention effect lasting up to 13-18 months (ES = -0.30 (95% CI [-0.51, -0.08])), for anxiety up to 7-12 months (ES = -0.27 (95% CI [-0.54, -0.01])), and for stress up to 3-6 months (ES = -0.30 (95% CI [-0.58, -0.03])). The effects of interventions to enhance positive mental health were sustained up to 3-6 months for the combined positive mental health outcomes (ES = 0.32 (95% CI [0.05, 0.59])). For enhanced active coping, sustainability up to 3-6 months was observed with a medium and significant effect (ES = 0.75 (95% CI [0.19, 1.30])).DiscussionThe evidence suggests long-term effect sustainability for mental ill health preventive interventions, especially for interventions to reduce the symptoms of depression and symptoms of anxiety. Interventions to promote positive mental health offer promising, but shorter-lasting effects. Future research should focus on mental health organizational interventions to examine their potential for students in tertiary education.

Project description:BackgroundAnimal-assisted interventions and robotic animal interventions are becoming increasingly popular to support the care of people with dementia and may have the potential to improve a range of psychosocial outcomes. This review aims to identify, describe, and compare animal-assisted and robotic animal interventions delivered to people with dementia, their characteristics, effectiveness, and the proposed mechanisms underlying any potential impact.MethodsA systematic literature search was conducted in MEDLINE, AMED, EMBASE, PsycINFO, OVID Nursing, PubMed, CINAHL and Web of Science. Random-effects meta-analyses of randomised controlled trials (RCTs) were conducted to summarise studies that evaluated common outcomes (agitation, depression, quality of life). A narrative approach was used to synthesise other findings.ResultsFifty-one studies were included: 18 RCTs; 12 non-randomised trials, 13 cohort studies, 7 qualitative studies and one mixed-methods study. Meta-analyses were conducted for a small number of RCTs, with effectiveness of animal-assisted interventions demonstrated for agitation. Narrative findings suggested animal-assisted and robotic animal interventions may be promising in improving depression, agitation, and quality of life. Three potential mechanisms of action were identified for both animal-assisted and robotic animal interventions, namely enhancing social connections, providing engaging and meaningful activities, and the affect-generating aspect of the human-animal bond. A fourth mechanism was identified for animal-assisted interventions only: promoting physical activity. Robotic animals appear to have a place in complex human-animal relationships, but a greater understanding of robotic animal interventions is required to harness the benefits that may be derived from their use.ConclusionDelivering these interventions appear promising in improving psychosocial outcomes for people with dementia. As most included studies had methodological limitations, these findings are preliminary, but contribute to the body of evidence providing an understanding in terms of intervention characteristics and mechanisms of action. When developing intervention guidance, attention should be given to potential mechanisms and fundamental characteristics such as session content, delivery format and facilitator role.

Dataset Information

Animal-Assisted Interventions Improve Mental, But Not Cognitive or Physiological Health Outcomes of Higher Education Students: a Systematic Review and Meta-analysis.

Supplementary information

Publications

Animal-Assisted Interventions Improve Mental, But Not Cognitive or Physiological Health Outcomes of Higher Education Students: a Systematic Review and Meta-analysis.

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