{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:44:39Z","timestamp":1792215879384,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mental health challenges are prevalent among university students, many of whom face barriers to accessing traditional psychological services. Smartphone\u2010delivered mental health applications offer a scalable intervention option, but evidence regarding their effectiveness and engagement remains limited. This systematic review and multilevel meta\u2010analysis examined clinical and engagement outcomes of app\u2010based mental health interventions in university students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Medline, PsycINFO, CINAHL, ProQuest Dissertations &amp; Theses Global and Scopus were searched from inception to 27 October 2025 (initial search: 2 April 2025). Randomised controlled trials were synthesised using multilevel meta\u2010analysis and non\u2010randomised designs were narratively synthesised. Risk of bias was assessed using the Cochrane Risk of Bias tool. Outcomes included depression, anxiety, stress, well\u2010being, disordered eating and body image, alongside attrition and adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u2009122 studies were included. Interventions produced significant effects across all outcomes: anxiety (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.22, 95% CI [0.14, 0.30]), depression (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.25, 95% CI [0.16, 0.33]), stress (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.28, 95% CI [0.19, 0.38]), well\u2010being (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.47, 95% CI [0.16, 0.78]), disordered eating (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.29, 95% CI [0.06, 0.52]) and body image (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.27, 95% CI [0.06, 0.48]). Substantial heterogeneity was observed for most outcomes. Attrition was moderate (17.0%, 95% CI [13.5, 21.2]) and adherence varied (70.0%, 95% CI [54.0, 82.0]). Personalization significantly moderated depression outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>App\u2010based interventions demonstrate small\u2010to\u2010moderate benefits for university student mental health, though heterogeneity and engagement challenges limit impact. Future research should prioritise personalised, transdiagnostic approaches and standardised engagement reporting, with greater focus on eating\u2010 and appearance\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eip.70207","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T01:12:34Z","timestamp":1785201154000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the Effectiveness, Adherence and Attrition of Smartphone\u2010Based Mental Health Interventions in University Students: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8369-1086","authenticated-orcid":false,"given":"Maya","family":"Jabs","sequence":"first","affiliation":[{"name":"Flinders University Institute for Mental Health and Wellbeing and Blackbird Initiative Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7311-5727","authenticated-orcid":false,"given":"Matthew","family":"Thompson","sequence":"additional","affiliation":[{"name":"Flinders University Institute for Mental Health and Wellbeing and Blackbird Initiative Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4475-7139","authenticated-orcid":false,"given":"Jake","family":"Linardon","sequence":"additional","affiliation":[{"name":"SEED Lifespan Strategic Research Centre, Faculty of Health, School of Psychology Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7186-7264","authenticated-orcid":false,"given":"Mariel","family":"Messer","sequence":"additional","affiliation":[{"name":"SEED Lifespan Strategic Research Centre, Faculty of Health, School of Psychology Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4402-770X","authenticated-orcid":false,"given":"Tracey D.","family":"Wade","sequence":"additional","affiliation":[{"name":"Flinders University Institute for Mental Health and Wellbeing and Blackbird Initiative Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000362"},{"key":"e_1_2_11_3_1","volume-title":"Dissertation Abstracts International: Section B: The Sciences and Engineering, 81 (12\u2010B)","author":"Bosso K. 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