{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:03:21Z","timestamp":1790877801710,"version":"4.1.0"},"reference-count":61,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosdigitalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Digit Health"],"abstract":"<jats:p>\n                    To synthesise the efficacy of digital third-wave process-based interventions (e.g., ACT, Mindfulness, Compassion) for improving wellbeing and ameliorating mental health symptoms in adults. A prospectively registered systematic review (OSF:\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.17605\/OSF.IO\/5RMU2\" xlink:type=\"simple\">10.17605\/OSF.IO\/5RMU2<\/jats:ext-link>\n                    ) and random-effects meta-analysis of randomised controlled trials (RCTs) was conducted across six databases through January 2026. Certainty of evidence was assessed using the GRADE framework. Interventions (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u2009147;\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200926,391) yielded small-to-moderate immediate post-intervention improvements in wellbeing (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200946,\n                    <jats:italic>g<\/jats:italic>\n                    \u2009=\u20090.36), depression (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u2009110,\n                    <jats:italic>g<\/jats:italic>\n                    \u2009=\u20090.44), anxiety (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200993,\n                    <jats:italic>g<\/jats:italic>\n                    \u2009=\u20090.40), stress (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200966,\n                    <jats:italic>g<\/jats:italic>\n                    \u2009=\u20090.46), quality of life (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200932,\n                    <jats:italic>g<\/jats:italic>\n                    \u2009=\u20090.30), and psychological flexibility (\n                    <jats:italic>k<\/jats:italic>\n                    \u2009=\u200951,\n                    <jats:italic>g<\/jats:italic>\n                    \u2009=\u20090.41). Heterogeneity was substantial across most outcomes (\n                    <jats:italic>I2<\/jats:italic>\n                    \u2009&gt;\u200975%). Benefits were observed across healthy (61 trials;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200915,770), mental health (41 trials;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20096,130), and medical samples (46 trials;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094,491), with population type not significantly moderating immediate post-intervention effects. Comparator type significantly moderated several analyses, with smaller effects against active than inactive controls. Guidance did not significantly moderate immediate post-intervention effects, although it predicted larger short-term depression effects (\n                    <jats:italic>QM<\/jats:italic>\n                    \u2009=\u20094.17,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.048). At short-term follow-up, effects remained statistically supported across all outcomes, while only depression, anxiety, and stress remained statistically supported at medium-term follow-up. GRADE certainty was moderate for most immediate post-intervention outcomes and low for quality of life. Digital third-wave interventions produced small-to-moderate average benefits across symptom-focused, wellbeing-focused, and process outcomes. Effects were smaller against active comparators, indicating that pooled benefits should be interpreted in relation to comparator intensity. Future research should prioritise rigorous active controls, longer follow-up, and direct tests of whether changes in psychological flexibility mediate improvements in symptoms and wellbeing.\n                  <\/jats:p>","DOI":"10.1371\/journal.pdig.0001764","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:27:21Z","timestamp":1790875641000},"page":"e0001764","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impacts of digital third-wave interventions for adults on wellbeing and mental health outcomes: A systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1371","volume":"5","author":[{"given":"Tom C.","family":"Gordon","sequence":"first","affiliation":[{"name":"Swansea University","place":["Swansea, United Kingdom"],"department":["Department of Public Health"]},{"name":"Swansea University","place":["Swansea, United Kingdom"],"department":["School of Psychology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H.","family":"Kemp","sequence":"additional","affiliation":[{"name":"Swansea University","place":["Swansea, United Kingdom"],"department":["School of Psychology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1347-2800","authenticated-orcid":true,"given":"Josh","family":"Hope-Bell","sequence":"additional","affiliation":[{"name":"Cardiff University","place":["Cardiff, United Kingdom"],"department":["Division of Psychological Medicine and Clinical Neurosciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2143-1198","authenticated-orcid":true,"given":"Darren J.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Swansea University","place":["Swansea, United Kingdom"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"issue":"2","key":"pdig.0001764.ref001","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S2215-0366(21)00395-3","article-title":"Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"9","author":"Collaborators G. 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