Digitalization of Intervention Delivery and Its Impact on the Effects of Interventions for Mental Well-being in Higher Education Students: Systematic Review and Meta-Analysis Protocol (Preprint)

BACKGROUND Delivery of interventions within student mental health services has undergone considerable digital transformation in recent years. Traditional face-to-face meetings are being substituted with autonomous digital tools with evident advantages in terms of accessibility and scalability. Despite an increasing array of digital options, there is also a growing recognition that digital tools offer limited effectiveness without some degree of human support. For example, for mental well-being, completely digitally delivered interventions show approximately half the effect sizes of interventions delivered in a traditional format. Blended forms of delivery that use both digital advantages and recognized effects of human contact are therefore promising. Hitherto, the effects of blended delivery have not been evaluated for mental well-being. Hence, investigating how digitalization in intervention delivery impacts intervention effects on mental well-being is important. This is especially relevant among emerging adults enrolled in higher education, going through a critical, transformative life phase. OBJECTIVE This systematic review and meta-analysis will primarily aim to investigate differences in effect due to the degree of digitalization in the mode of delivery of interventions on mental well-being among higher education students. METHODS This work will adhere to the Cochrane Collaboration methodology, and results will be reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic literature search will be conducted across 9 databases (Scopus, MEDLINE, PubMed, PsycINFO, ERIC, CINAHL, Web of Science, Cochrane, and International Clinical Trials Registry Platform). The population, intervention, comparator, and outcome framework will inform both the search strategy and eligibility criteria. For inclusion, studies should be randomized controlled trials investigating the effect of individually delivered interventions on positive affect or life satisfaction among mentally healthy higher education students aged 18 to 29 years. Studies will be independently screened, and data will be extracted, including the standardized mean difference as the effect measure. Risk of bias assessment will be conducted using the Cochrane Risk of Bias 2 instrument. The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis will be applied, and study biases will be analyzed by funnel-plot assessment and Egger test. Finally, certainty of evidence for positive affect and life satisfaction will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results will be presented in a summary of findings table. RESULTS The search was finalized in March 2026, generating 6603 records after duplicate removal. Study selection and data extraction were conducted during April 2026, resulting in 41 eligible studies. Risk of bias assessment, data analysis, and manuscript preparation are planned before submission for peer review in August 2026. CONCLUSIONS The principal findings of this study will highlight differences in effect due to the mode of delivery of interventions on mental well-being among higher education students. This will be relevant for the management of student mental health promotion services. CLINICALTRIAL PROSPERO CRD420251131950; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251131950 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/88458

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