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Computerized Psychological Interventions in Veterans and Service Members: Systematic Review of Randomized Controlled Trials

Authors
  • Pearson, Rahel1
  • Carl, Emily2
  • Creech, Suzannah K1, 3
  • 1 Central Texas Veterans Affairs Healthcare System, Waco, TX , (United States)
  • 2 University of Texas, Austin, TX , (United States)
  • 3 Dell Medical School of the University of Texas, Austin, TX , (United States)
Type
Published Article
Journal
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Publication Date
Jun 03, 2022
Volume
24
Issue
6
Identifiers
DOI: 10.2196/30065
PMID: 35657663
PMCID: PMC9206197
Source
PubMed Central
Keywords
Disciplines
  • Review
License
Unknown
External links

Abstract

Background Computerized psychological interventions can overcome logistical and psychosocial barriers to the use of mental health care in the Veterans Affairs and Department of Defense settings. Objective In this systematic review, we aim to outline the existing literature, with the goal of describing: the scope and quality of the available literature, intervention characteristics, study methods, study efficacy, and study limitations and potential directions for future research. Methods Systematic searches of two databases (PsycINFO and PubMed) using PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines were conducted from inception until November 15, 2020. The following inclusion criteria were used: the study was published in an English language peer-reviewed journal, participants were randomly allocated to a computerized psychological intervention or a control group (non–computerized psychological intervention active treatment or nonactive control group), an intervention in at least one treatment arm was primarily delivered through the computer or internet with or without additional support, participants were veterans or service members, and the study used validated measures to examine the effect of treatment on psychological outcomes. Results This review included 23 studies that met the predefined inclusion criteria. Most studies were at a high risk of bias. Targeted outcomes, participant characteristics, type of support delivered, adherence, and participant satisfaction were described. Most of the examined interventions (19/24, 79%) yielded positive results. Study limitations included participant characteristics limiting study inference, high rates of attrition, and an overreliance on self-reported outcomes. Conclusions Relatively few high-quality studies were identified, and more rigorous investigations are needed. Several recommendations for future research are discussed, including the adoption of methods that minimize attrition, optimize use, and allow for personalization of treatment.

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