{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:59:10Z","timestamp":1792076350952,"version":"4.4.0"},"reference-count":99,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec020\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>Stepped Care Models (SCM) and other approaches for organizing the delivery of services and resources by individual mental health (MH) needs are being increasingly implemented in post-secondary institutions. However, no consensus definitions exist of what constitutes a SCM for post-secondary students (PSS), and there is little guidance for evaluation of these complex, multicomponent interventions. The purpose of this research is to identify and characterize MH and substance use interventions for PSS that apply a SCM, stepped approach (i.e., stepped care \u201clite\u201d), and\/or organize delivery of resources\/services based on individual MH needs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec021\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A rapid scoping review of peer-reviewed research articles was conducted using OVID MEDLINE\u00ae, OVID Embase, EBSCO CINAHL, OVID PsycINFO\u00ae, and ERIC. Eligible studies included multicomponent interventions for improving MH or substance use among PSS applying a SCM, stepped approach or another way of organizing resources\/services offered according to individual MH needs. Results: 5757 abstracts were reviewed, resulting in full text examination of 172 studies. Data were extracted from 68 eligible studies comprising 50 interventions (SCMs: n\u2009=\u20097, stepped care \u201clite\u201d: n\u2009=\u200913; organized delivery matched to MH needs: n\u2009=\u200930). Almost all involved a website\/app and symptom tracking was often included within the intervention. Most addressed either alcohol use, depression, anxiety and eating disorders. A variety of evaluation models were applied, but approaches were not generally geared to look at individual-level outcomes in a manner that captured the overall effect of the SCM or outcomes related to the specific \u201cdose\u201d of the intervention received. Most outcomes focused on MH symptoms, satisfaction, and utilization; student-related outcomes such as academic success were rarely used. Student co-design was not often described.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec022\">\n<jats:title>Conclusions\/Implications<\/jats:title>\n<jats:p>Despite increasing implementation of SCMs in post-secondary settings, few studies on the model have been published. Drawing on strengths and shortcomings of studies identified, recommendations for future work in this area are presented.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319473","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T18:44:57Z","timestamp":1742928297000},"page":"e0319473","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Stepped care, stepped care \u201clite\u201d &amp; matching intervention components to individual mental health needs: A rapid scoping review of mental health and substance use interventions for post-secondary students"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2538-582X","authenticated-orcid":true,"given":"Sarah","family":"Brennenstuhl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Agard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Cleverley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"pone.0319473.ref001","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1017\/S2045796020000281","article-title":"A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018","volume":"29","author":"K Wiens","year":"2020","journal-title":"Epidemiol Psychiatr Sci"},{"issue":"1","key":"pone.0319473.ref002","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1176\/appi.ps.201800332","article-title":"Increased Rates of Mental Health Service Utilization by U.S. College Students: 10-Year Population-Level Trends (2007-2017)","volume":"70","author":"SK Lipson","year":"2019","journal-title":"Psychiatr Serv"},{"issue":"1","key":"pone.0319473.ref003","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1186\/s12889-021-10622-1","article-title":"Cross-sectional trend analysis of the NCHA II survey data on Canadian post-secondary student mental health and wellbeing from 2013 to 2019","volume":"21","author":"B Linden","year":"2021","journal-title":"BMC Public Health"},{"issue":"4","key":"pone.0319473.ref004","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1037\/ser0000130","article-title":"Are we in crisis? National mental health and treatment trends in college counseling centers","volume":"14","author":"H Xiao","year":"2017","journal-title":"Psychol Serv"},{"key":"pone.0319473.ref005","doi-asserted-by":"crossref","first-page":"777251","DOI":"10.3389\/fpsyt.2021.777251","article-title":"Post-secondary Student Mental Health During COVID-19: A Meta-Analysis","volume":"12","author":"J Zhu","year":"2021","journal-title":"Front Psychiatry"},{"issue":"3","key":"pone.0319473.ref006","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s11469-018-0015-5","article-title":"An Overview of Post-Secondary Mental Health on Campuses in Ontario: Challenges and Successes","volume":"17","author":"P Ng","year":"2018","journal-title":"Int J Ment Health Addiction"},{"issue":"11","key":"pone.0319473.ref007","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/S2215-0366(19)30275-5","article-title":"Mental health care for university students: a way forward?","volume":"6","author":"A Duffy","year":"2019","journal-title":"Lancet Psychiatry"},{"issue":"4","key":"pone.0319473.ref008","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1037\/ser0000158","article-title":"Meeting the mental health needs of today\u2019s college student: Reinventing services through Stepped Care 2.0","volume":"14","author":"PA Cornish","year":"2017","journal-title":"Psychol Serv"},{"issue":"4","key":"pone.0319473.ref009","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/eip.13180","article-title":"Scoping review of stepped care interventions for mental health and substance use service delivery to youth and young adults","volume":"16","author":"M Berger","year":"2022","journal-title":"Early Interv Psychiatry"},{"issue":"3","key":"pone.0319473.ref010","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1521\/jsyt.2020.39.3.21","article-title":"Open-Access Single-Session Therapy in the Context of Stepped Care 2.0","volume":"39","author":"PA Cornish","year":"2020","journal-title":"Journal of Systemic Therapies"},{"issue":"2","key":"pone.0319473.ref011","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1177\/07067437221128168","article-title":"A Descriptive Overview of Mental Health Services Offered in Post-Secondary Educational Institutions Across Canada","volume":"68","author":"A Read","year":"2023","journal-title":"Can J Psychiatry"},{"issue":"3","key":"pone.0319473.ref012","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1037\/ser0000564","article-title":"Adapting stepped care: Changes to service delivery format in the context of high demand","volume":"19","author":"RJ Bailey","year":"2022","journal-title":"Psychol Serv"},{"key":"pone.0319473.ref013","unstructured":"Provincial budget reports: Ontario and Quebec. University Affairs. Accessed: May 09, 2024. [Online]. Available: https:\/\/universityaffairs.ca\/news\/news-article\/provincial-budget-reports-ontario-and-quebec\/"},{"key":"pone.0319473.ref014"},{"key":"pone.0319473.ref015","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/978-3-031-45206-2_9","article-title":"Stepped Care, a Closer Look: Reviewing Evidence and Evaluating Outcomes.","volume-title":"Stepped Care 2.0: The Power of Conundrums","author":"A Salmon","year":"2023"},{"key":"pone.0319473.ref016","doi-asserted-by":"crossref","first-page":"106320","DOI":"10.1016\/j.cct.2021.106320","article-title":"Harnessing mobile technology to reduce mental health disorders in college populations: A randomized controlled trial study protocol","volume":"103","author":"EE Fitzsimmons-Craft","year":"2021","journal-title":"Contemp Clin Trials"},{"issue":"9","key":"pone.0319473.ref017","doi-asserted-by":"crossref","first-page":"e40637","DOI":"10.2196\/40637","article-title":"Internet-Delivered Cognitive Behavioral Therapy for 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people: A scoping review and critical ecological analysis","volume":"297","author":"JE Williams","year":"2022","journal-title":"Soc Sci Med"},{"key":"pone.0319473.ref023","author":"M Mancini"},{"key":"pone.0319473.ref024","doi-asserted-by":"crossref","first-page":"29281","DOI":"10.1038\/srep29281","article-title":"The Efficacy and Cost-Effectiveness of Stepped Care Prevention and Treatment for Depressive and\/or Anxiety Disorders: A Systematic Review and Meta-Analysis","volume":"6","author":"FY-Y Ho","year":"2016","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0319473.ref025","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1108\/IJPSM-07-2015-0125","article-title":"Contextualizing co-production of health care: a systematic literature review","volume":"29","author":"R Palumbo","year":"2016","journal-title":"Int J Public Sect 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Levin","year":"2018","journal-title":"Mindfulness"},{"issue":"3","key":"pone.0319473.ref045","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1080\/07448481.2020.1763366","article-title":"Utilizing ACT daily as a self-guided app for clients waiting for services at a college counseling center: A pilot study","volume":"70","author":"JA Haeger","year":"2022","journal-title":"J Am Coll Health"},{"issue":"3","key":"pone.0319473.ref046","doi-asserted-by":"crossref","first-page":"e20036","DOI":"10.2196\/20036","article-title":"Transdiagnostic Internet Intervention for Indonesian University Students With Depression and Anxiety: Evaluation of Feasibility and Acceptability","volume":"8","author":"M Rahmadiana","year":"2021","journal-title":"JMIR Ment Health"},{"key":"pone.0319473.ref047","doi-asserted-by":"crossref","first-page":"104028","DOI":"10.1016\/j.brat.2021.104028","article-title":"Guided internet-based transdiagnostic individually tailored Cognitive Behavioral Therapy for symptoms of depression and\/or anxiety in college students: A randomized controlled trial","volume":"150","author":"E Karyotaki","year":"2022","journal-title":"Behav Res Ther"},{"issue":"12","key":"pone.0319473.ref048","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1037\/ccp0000846","article-title":"Internet-delivered cognitive behavior therapy versus treatment as usual for anxiety and depression among Latin American university students: A randomized clinical trial","volume":"91","author":"C Benjet","year":"2023","journal-title":"J Consult Clin Psychol"},{"issue":"5","key":"pone.0319473.ref049","doi-asserted-by":"crossref","first-page":"e37292","DOI":"10.2196\/37292","article-title":"A Group-Facilitated, Internet-Based Intervention to Promote Mental Health and Well-Being in a Vulnerable Population of University Students: Randomized Controlled Trial of the Be Well Plan Program","volume":"9","author":"DB Fassnacht","year":"2022","journal-title":"JMIR Ment Health"},{"issue":"3","key":"pone.0319473.ref050","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1080\/03069880902957049","article-title":"ES[S]PRIT \u2013 an Internet-based programme for the prevention and early intervention of eating disorders in college students","volume":"37","author":"S Bauer","year":"2009","journal-title":"British Journal of Guidance & Counselling"},{"issue":"6","key":"pone.0319473.ref051","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1037\/a0029902","article-title":"Addressing alcohol use and problems in mandated college students: a randomized clinical trial using stepped care","volume":"80","author":"B Borsari","year":"2012","journal-title":"J Consult Clin Psychol"},{"key":"pone.0319473.ref052","doi-asserted-by":"crossref","first-page":"74","DOI":"10.2174\/1745017901107010074","article-title":"E-health for individualized prevention of eating disorders","volume":"7","author":"K Lindenberg","year":"2011","journal-title":"Clin Pract 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Benton","year":"2016","journal-title":"Professional Psychology: Research and Practice"},{"key":"pone.0319473.ref056","doi-asserted-by":"crossref","first-page":"100493","DOI":"10.1016\/j.invent.2021.100493","article-title":"Uptake and effectiveness of a self-guided mobile app platform for college student mental health","volume":"27","author":"EG Lattie","year":"2021","journal-title":"Internet Interv"},{"issue":"2","key":"pone.0319473.ref057","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1037\/ser0000264","article-title":"State-wide university implementation of an online platform for eating disorders screening and intervention","volume":"16","author":"EE Fitzsimmons-Craft","year":"2019","journal-title":"Psychol Serv"},{"issue":"6","key":"pone.0319473.ref058","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.chb.2010.04.020","article-title":"Development and usability of an online CBT program for symptoms of moderate depression, anxiety, and stress in 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high-risk drinking prevention web site for college students","volume":"53","author":"E Chiauzzi","year":"2005","journal-title":"J Am Coll Health"},{"issue":"3","key":"pone.0319473.ref062","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1093\/alcalc\/ags133","article-title":"The effectiveness of the \u201cwhat do you drink\u201d web-based brief alcohol intervention in reducing heavy drinking among students: a two-arm parallel group randomized controlled trial","volume":"48","author":"CV Voogt","year":"2013","journal-title":"Alcohol Alcohol"},{"issue":"2","key":"pone.0319473.ref063","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1037\/ser0000310","article-title":"Real-time demonstration of a mHealth app designed to reduce college students hazardous drinking","volume":"16","author":"DM Kazemi","year":"2019","journal-title":"Psychol Serv"},{"key":"pone.0319473.ref064","article-title":"Mobile phone brief intervention applications for risky alcohol use among university 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Behav"},{"issue":"3","key":"pone.0319473.ref073","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1001\/jamainternmed.2015.8260","article-title":"Effectiveness of Short Message Service Text-Based Smoking Cessation Intervention Among University Students: A Randomized Clinical Trial","volume":"176","author":"U M\u00fcssener","year":"2016","journal-title":"JAMA Intern Med"},{"issue":"2","key":"pone.0319473.ref074","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3200\/JACH.53.2.71-78","article-title":"College smoking-cessation using cell phone text messaging","volume":"53","author":"JL Obermayer","year":"2004","journal-title":"J Am Coll Health"},{"issue":"4","key":"pone.0319473.ref075","doi-asserted-by":"crossref","first-page":"534","DOI":"10.15288\/jsad.2007.68.534","article-title":"Using wireless handheld computers and tailored text messaging to reduce negative consequences of drinking alcohol","volume":"68","author":"JA Weitzel","year":"2007","journal-title":"J Stud Alcohol Drugs"},{"issue":"4","key":"pone.0319473.ref076","doi-asserted-by":"crossref","first-page":"70","DOI":"10.5993\/AJHB.42.4.7","article-title":"Developing Text Messages to Reduce Community College Student Alcohol Use","volume":"42","author":"MA Lewis","year":"2018","journal-title":"Am J Health Behav"},{"issue":"4","key":"pone.0319473.ref077","doi-asserted-by":"crossref","first-page":"405","DOI":"10.2190\/DE.41.4.e","article-title":"Efficacy of a web-based, tailored, alcohol prevention\/intervention program for college students: 3-month follow-up","volume":"41","author":"CR Bingham","year":"2011","journal-title":"J Drug Educ"},{"issue":"2","key":"pone.0319473.ref078","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1037\/a0039800","article-title":"Mandated college students\u2019 response to sequentially administered alcohol interventions in a randomized clinical trial using stepped care","volume":"84","author":"B Borsari","year":"2016","journal-title":"J Consult Clin 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Biotechnol"},{"issue":"3","key":"pone.0319473.ref082","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1007\/s40501-019-00178-8","article-title":"Recent Developments in Digital Mental Health Interventions for College and University Students","volume":"6","author":"TD Becker","year":"2019","journal-title":"Curr Treat Options Psych"},{"issue":"6","key":"pone.0319473.ref083","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1080\/07448481.2020.1825225","article-title":"College student engagement with mental health apps: analysis of barriers to sustained use","volume":"70","author":"J Melcher","year":"2022","journal-title":"J Am Coll Health"},{"key":"pone.0319473.ref084","doi-asserted-by":"crossref","first-page":"20552076231210658","DOI":"10.1177\/20552076231210658","article-title":"Willing and unwilling digital cyborg assemblages: University students talk about mental health apps","volume":"9","author":"R Van Der Poll","year":"2023","journal-title":"Digit 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Res"},{"key":"pone.0319473.ref088","volume-title":"National Standard for the Psychological Health and Safety of Post-Secondary Students \u2013 Phase I: Scoping Literature Review","author":"B Linden","year":"2018"},{"key":"pone.0319473.ref089","author":"S. C. Government of Canada"},{"key":"pone.0319473.ref090","doi-asserted-by":"crossref","first-page":"52","DOI":"10.47678\/cjhe.vi0.188815","article-title":"Mental Health Status and Help-Seeking Strategies of Canadian International Students","author":"D De Moissac","year":"2020","journal-title":"CJHE"},{"key":"pone.0319473.ref091"},{"key":"pone.0319473.ref092","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.3389\/fpsyg.2020.01226","article-title":"Mental Health and Well-Being of University Students: A Bibliometric Mapping of the Literature","volume":"11","author":"D Hern\u00e1ndez-Torrano","year":"2020","journal-title":"Front Psychol"},{"issue":"1","key":"pone.0319473.ref093","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1186\/s12889-023-15452-x","article-title":"Mental health challenges, treatment experiences, and care needs of post-secondary students: a cross-sectional mixed-methods study","volume":"23","author":"E Moghimi","year":"2023","journal-title":"BMC Public Health"},{"key":"pone.0319473.ref094","author":"C Sabiston"},{"issue":"2","key":"pone.0319473.ref095","doi-asserted-by":"crossref","first-page":"e014080","DOI":"10.1136\/bmjopen-2016-014080","article-title":"Integrated collaborative care teams to enhance service delivery to youth with mental health and substance use challenges: protocol for a pragmatic randomised controlled trial","volume":"7","author":"JL Henderson","year":"2017","journal-title":"BMJ Open"},{"key":"pone.0319473.ref096","doi-asserted-by":"crossref","first-page":"1188690","DOI":"10.3389\/fpubh.2023.1188690","article-title":"Mental health trajectories in university students across the COVID-19 pandemic: findings from the Student Wellbeing at Northern England Universities prospective cohort study","volume":"11","author":"LW Paton","year":"2023","journal-title":"Front Public Health"},{"key":"pone.0319473.ref097"},{"key":"pone.0319473.ref098","article-title":"Frameworks used to engage post-secondary students in campus mental health research: A scoping review","author":"K Cleverley","year":"2024","journal-title":"Health Expect"},{"issue":"17","key":"pone.0319473.ref099","doi-asserted-by":"crossref","first-page":"10663","DOI":"10.3390\/ijerph191710663","article-title":"Cultural Differences in Patients\u2019 Preferences for Paternalism: Comparing Mexican and American Patients\u2019 Preferences for and Experiences with Physician Paternalism and Patient Autonomy","volume":"19","author":"GA Thompson","year":"2022","journal-title":"Int J Environ Res Public Health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T18:48:25Z","timestamp":1742928505000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319473"}},"subtitle":[],"editor":[{"given":"Hamufare","family":"Mugauri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":99,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0319473","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,25]]}}}