{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:25:39Z","timestamp":1787041539697,"version":"build-2736575974"},"reference-count":67,"publisher":"AOSIS","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Health science students\u2019 well-being and academic performance are important concerns in under-resourced universities. However, there is limited insight into mHealth interventions and institutional support for psychological stress driven by demanding curricula and socioeconomic disparities. Digital therapeutics (DTx) offer scalable technology-enabled support for stress management.\nAim:\u00a0This narrative review explores how DTx can complement or enhance existing stress management approaches for health science students in under-resourced South African universities.\nMethods:\u00a0A narrative literature search was conducted across four databases: PubMed, Scopus, Web of Science and Google Scholar. Publications were from 2020 to 2024 on DTx addressing stress among university students, in low-resource settings and theoretical foundations. PRISMA guidelines informed reporting, and thematic synthesis followed Braun and Clarke. Theoretical frameworks informed analysis of effectiveness, the digital divide and mental health service integration.\nResults:\u00a0The synthesis of nine studies, institutional reports and grey literature yielded four main themes: infrastructural and financial constraints, psychological and sociocultural barriers, facilitators and success factors and integration with university mental health services.\nConclusion:\u00a0Barriers included poor connectivity, high data costs, limited digital literacy, stigma around mental health and weak institutional support. Effective DTx adoption in low-resource settings requires overcoming barriers and strengthening policy, practice and research.\nContribution:\u00a0Digital therapeutics have the potential to play an important role in addressing mental health inequities among health science students in South Africa and similar contexts. The study contributes insights into digital health interventions to enhance support systems in higher education.<\/jats:p>","DOI":"10.4102\/hsag.v31i0.3301","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T07:47:27Z","timestamp":1787039247000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Digital therapeutics for stress in health science students at under-resourced universities: A narrative review"],"prefix":"10.4102","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1390-974X","authenticated-orcid":false,"given":"Bhekithemba","family":"Vellem","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02svzjn28","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Sisulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9158-8820","authenticated-orcid":false,"given":"Nozuko G.","family":"Mangi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02svzjn28","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Sisulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Acharya, K.R., 2022, \u2018Exploring localized usability implementation in mHealth app design for healthcare practitioners in the Global South context: A case study\u2019, Technical Communication 69(4), 44\u201363. https:\/\/doi.org\/10.55177\/tc885177","DOI":"10.55177\/tc885177"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Agyapong-Opoku, G., Agyapong, B., Obuobi-Donkor, G. & Eboreime, E., 2023, \u2018Depression and anxiety among undergraduate health science students: A scoping review of the literature\u2019, Behavioral Sciences 13(12), 1002. https:\/\/doi.org\/10.3390\/bs13121002","DOI":"10.3390\/bs13121002"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Alhassan, G.N., Ozturkcan, A. & Cavdar, S.C., 2026, \u2018Global disparities in teletherapy adoption: A cross-income analysis of mental health access\u2019, International Journal of Environmental Research and Public Health 23(2), 230. https:\/\/doi.org\/10.3390\/ijerph23020230","DOI":"10.3390\/ijerph23020230"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Alkhuzaimi, F., Rainey, D., Brown Wilson, C. & Bloomfield, J., 2025, \u2018The impact of mobile health interventions on service users\u2019 health outcomes and the role of health professions: A systematic review of systematic reviews\u2019, BMC Digital Health 3(1), 3. https:\/\/doi.org\/10.1186\/s44247-025-00003-9","DOI":"10.1186\/s44247-024-00143-3"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Almansoof, A.S., Masuadi, E., Al-Muallem, A. & Agha, S., 2024, \u2018Prevalence of psychological distress among health sciences students: A systematic review and meta-analysis\u2019, Quality & Quantity 58(4), 3747\u20133768. https:\/\/doi.org\/10.1007\/s11135-023-01744-5","DOI":"10.1007\/s11135-024-01829-6"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Alotaibi, N.B., 2025, \u2018Exploring the impact of factors on mobile learning adoption and academic performance: A study of undergraduate students in Riyadh region universities, Kingdom of Saudi Arabia\u2019, Education and Information Technologies 30(8), 11185\u201311221. https:\/\/doi.org\/10.1007\/s10639-024-13232-7","DOI":"10.1007\/s10639-024-13232-7"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Bantjes, J., Kessler, M.J., Hunt, X., Stein, D.J. & Kessler, R.C., 2023, \u2018Treatment rates and barriers to mental health service utilisation among university students in South Africa\u2019, International Journal of Mental Health Systems 17(1), 38. https:\/\/doi.org\/10.1186\/s13033-023-00605-7","DOI":"10.1186\/s13033-023-00605-7"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Barron, P., Peter, J., LeFevre, A.E., Sebidi, J., Bekker, M., Allen, R. et al., 2018, \u2018Mobile health messaging service and helpdesk for South African mothers (MomConnect): History, successes and challenges\u2019, BMJ Global Health 3(Suppl 2), e000559. https:\/\/doi.org\/10.1136\/bmjgh-2017-000559","DOI":"10.1136\/bmjgh-2017-000559"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Bidargaddi, N., Schrader, G., Klasnja, P., Licinio, J. & Murphy, S., 2020, \u2018Designing m-health interventions for precision mental health support\u2019, Translational Psychiatry 10(1), 222. https:\/\/doi.org\/10.1038\/s41398-020-00920-1","DOI":"10.1038\/s41398-020-00895-2"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Bin Abdulrahman, K.A., Alghamdi, S.A. & Abahussain, E.A., 2025, \u2018Coping with stress in the context of education in the health professions\u2019, in K.A. Bin Abdulrahman & H. Darami (eds.), Essential learning skills for health professions students, pp. 155\u2013165, Springer Nature Singapore, Singapore.","DOI":"10.1007\/978-981-96-5670-7_14"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Borghouts, J., Eikey, E., Mark, G., De Leon, C., Schueller, S.M., Schneider, M. et al., 2021, \u2018Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review\u2019, Journal of Medical Internet Research 23(3), e24387. https:\/\/doi.org\/10.2196\/24387","DOI":"10.2196\/24387"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Botes, M., 2025, \u2018Regulatory challenges of digital health: The case of mental health applications and personal data in South Africa\u2019, Frontiers in Pharmacology 16, 1498600. https:\/\/doi.org\/10.3389\/fphar.2025.1498600","DOI":"10.3389\/fphar.2025.1498600"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Braun, V. & Clarke, V., 2022, \u2018Conceptual and design thinking for thematic analysis\u2019, Qualitative Psychology 9(1), 3\u201326. https:\/\/doi.org\/10.1037\/qup000019","DOI":"10.1037\/qup0000196"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Br\u00f6cker, E., Olff, M., Suliman, S., Kidd, M., Greyvenstein, L. & Seedat, S., 2024, \u2018A counsellor-supported PTSD Coach intervention versus enhanced treatment-as-usual in a resource-constrained setting: A randomised controlled trial\u2019, Cambridge Prisms: Global Mental Health 11, e7. https:\/\/doi.org\/10.1017\/gmh.2023.92","DOI":"10.1017\/gmh.2024.34"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Chiramba, O. & Ndofirepi, E.S., 2023, \u2018Access and success in higher education: Disadvantaged students\u2019 lived experiences beyond funding hurdles at a metropolitan South African university\u2019, South African Journal of Higher Education 37(6), 56\u201375. https:\/\/doi.org\/10.20853\/37-6-6021","DOI":"10.20853\/37-6-6021"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Choudhury, A., Kuehn, A., Shamszare, H. & Shahsavar, Y., 2023, \u2018Analysis of mobile app-based mental health solutions for college students: A rapid review\u2019, Healthcare 11(2), 272. https:\/\/doi.org\/10.3390\/healthcare11020272.","DOI":"10.3390\/healthcare11020272"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Davis, F.D., 1989, \u2018Perceived usefulness, perceived ease of use, and user acceptance of information technology\u2019, MIS Quarterly 13(3), 319\u2013340. https:\/\/doi.org\/10.2307\/249008","DOI":"10.2307\/249008"},{"key":"ref17","unstructured":"Discovery Health, 2023, \u2018New Discovery Health app introduces personalised, end-to-end healthcare journey\u2019, MyNewsDesk, viewed 01 April 2026, from https:\/\/www.mynewsdesk.com\/za\/discovery-holdings-ltd\/pressreleases\/new-discovery-health-app-introduces-personalised-end-to-end-healthcare-journey-including-3-cutting-edge-first-in-south-africa-innovations-3281866."},{"key":"ref18","unstructured":"Discovery Health, 2025, Digital therapeutics for mental health, viewed 31 August 2025, from https:\/\/www.discovery.co.za\/medical-aid\/digital-therapeutics-for-mental-health."},{"key":"ref19","unstructured":"Fedhealth, 2024, Open Panda app \u2013 Mental health & wellness support, viewed 01 April 2026, from https:\/\/fed.health."},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Fichardt, A.E., Van Vuuren, C.J. & Van der Merwe, L., 2023, \u2018Psychological well-being, stressors, coping strategies and support of undergraduate healthcare students amid COVID-19\u2019, Health SA Gesondheid 28, 1\u20138. https:\/\/doi.org\/10.4102\/hsag.v28i0.2340","DOI":"10.4102\/hsag.v28i0.2340"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Gbollie, E.F., Bantjes, J., Jarvis, L., Swandevelder, S., Du Plessis, J., Shadwell, R. et al., 2023, \u2018Intention to use digital mental health solutions: A cross-sectional survey of university students\u2019 attitudes and perceptions\u2019, Digital Health 9, 1\u201319. https:\/\/doi.org\/10.1177\/20552076231216559","DOI":"10.1177\/20552076231216559"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Gerke, S., Babic, B., Evgeniou, T. & Cohen, I.G., 2020, \u2018The need for a system view to regulate artificial intelligence\/machine learning-based software as medical device\u2019, NPJ Digital Medicine 3(1), 53. https:\/\/doi.org\/10.1038\/s41746-020-0262-2.","DOI":"10.1038\/s41746-020-0262-2"},{"key":"ref23","unstructured":"Gopalan, R., Mehta, S., Krishnan, P. & Alvarez, C., 2025, \u2018Gamification in digital therapeutics: The ANTI-DA app for depression and anxiety\u2019, Frontiers in Digital Health 3, 678912. https:\/\/doi.org\/10.3389\/fdgth.2025.678912"},{"key":"ref24","unstructured":"Grand View Research, 2023, South Africa digital therapeutics market size & outlook, viewed 01 April 2026, from https:\/\/www.grandviewresearch.com\/horizon\/outlook\/digital-therapeutics-market\/south-africa."},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Henderson, R.M., Chetty, O. & Gurayah, T., 2021, \u2018Coping styles and sources of stress of undergraduate health science students: An integrative review\u2019, South African Journal of Occupational Therapy 51(2), 29\u201338. https:\/\/doi.org\/10.17159\/2310-3833\/2021\/vol51n2a5","DOI":"10.17159\/2310-3833\/2021\/vol51n2a5"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Hoffman, V., Flom, M., Mariano, T.Y., Chiauzzi, E., Williams, A., Kirvin-Quamme, A. et al., 2023, \u2018User engagement clusters of an 8-week digital mental health intervention guided by a relational agent (Woebot): Exploratory study\u2019, Journal of Medical Internet Research 25, e47198. https:\/\/doi.org\/10.2196\/47198","DOI":"10.2196\/47198"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Hunt, X., Jivan, D.C., Naslund, J.A., Breet, E. & Bantjes, J., 2023, \u2018South African university students\u2019 experiences of online group cognitive behavioural therapy: Implications for delivering digital mental health interventions to young people\u2019, Cambridge Prisms: Global Mental Health 10, e45. https:\/\/doi.org\/10.1017\/gmh.2023.39","DOI":"10.1017\/gmh.2023.39"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Jayaraj, G., Cao, X., Horwitz, A., Rozwadowski, M., Shea, S., Hanauer, S.N. et al., 2025, \u2018Trends in mental health outcomes of college students amid the pandemic (Roadmap mHealth App): Longitudinal observational study\u2019, Journal of Medical Internet Research 27, e67627. https:\/\/doi.org\/10.2196\/67627","DOI":"10.2196\/67627"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Jiang, N., Yu, X., Yang, Y., Li, G., He, C., Wang, M.P. et al., 2025, \u2018Digital therapeutics in China: Comprehensive review\u2019, Journal of Medical Internet Research 27, e70955. https:\/\/doi.org\/10.2196\/70955","DOI":"10.2196\/70955"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Julius, B., Putteeraj, M. & Somanah, M., 2024, \u2018A systematic review of university students\u2019 mental health in sub-Saharan Africa\u2019, Transformation in Higher Education 9, a316. https:\/\/doi.org\/10.4102\/the.v9i0.316","DOI":"10.4102\/the.v9i0.316"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Khatake, P., Twinkle, H. & Salgar, A., 2022, \u2018Stress among medical students and its impact on academic performance\u2019, Biomedicine 42(3), 620\u2013622. https:\/\/doi.org\/10.51248\/.v42i3.1212","DOI":"10.51248\/.v42i3.1212"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Kim, E., Jeon, H., Lee, J., Oh, H., Kim, M., Shin, J. et al., 2025, \u2018Developing and evaluating guidelines to prevent overdependence on digital therapeutics in children and adolescents: Randomized controlled trial\u2019, Journal of Medical Internet Research 27, e69248. https:\/\/doi.org\/10.2196\/69248","DOI":"10.2196\/69248"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Kim, M., Patrick, K., Nebeker, C., Godino, J., Stein, S., Klasnja, P. et al., 2024, \u2018The digital therapeutics real-world evidence framework: An approach for guiding evidence-based digital therapeutics design, development, testing and monitoring\u2019, Journal of Medical Internet Research 26, e49208. https:\/\/doi.org\/10.2196\/49208","DOI":"10.2196\/49208"},{"key":"ref34","unstructured":"Lazarus, R.S. & Folkman, S., 1984, Stress, appraisal, and coping, Springer Publishing Company, New York, NY."},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Lee, Y.K., Yoon, E.J., Kim, T.H., Kim, J.I. & Kim, J.H., 2025, \u2018Musculoskeletal digital therapeutics and digital health rehabilitation: A global paradigm shift in orthopedic care\u2019, Journal of Clinical Medicine 14(23), 8467. https:\/\/doi.org\/10.3390\/jcm14238467","DOI":"10.3390\/jcm14238467"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Lesunyane, R.A., Ramano, E.M. & Van Niekerk, K., 2025, \u2018Undergraduate students\u2019 experience regarding wellness support services at universities offering health sciences programmes\u2019, Discover Education 4(1), 540. https:\/\/doi.org\/10.1007\/s44217-025-00540-0","DOI":"10.1007\/s44217-025-00938-0"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Li, G., Zhou, X., Deng, J., Wang, J., Ai, P., Zeng, J. et al., 2025, \u2018Digital therapeutics\u2013based cardio-oncology rehabilitation for lung cancer survivors: Randomized controlled trial\u2019, JMIR mHealth and uHealth 13, e60115. https:\/\/doi.org\/10.2196\/60115","DOI":"10.2196\/60115"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Li, L., Zhang, Y. & Chen, H., 2023, \u2018Bridging the digital divide in mental health: A review of mHealth interventions in low-income settings\u2019, International Journal of Mental Health Systems 17(1), 1\u201312. https:\/\/doi.org\/10.1186\/s13033-018-0259-2","DOI":"10.1186\/s13033-018-0259-2"},{"key":"ref39","unstructured":"Liu, S., Wu, T. & Tang, S., 2025, \u2018The digital literacy paradox in higher education: Cultural attitudes, technological access, and educational equity in a global context\u2019; Scientific Culture 11(2), 84\u201396. https:\/\/doi.org\/10.5281\/zenodo.15882147"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Madonsela, S., Ware, L.J., Scott, M. & Watermeyer, J., 2023, \u2018The development and use of adolescent mobile mental health (m-mhealth) interventions in low- and middle-income countries: A scoping review\u2019, South African Journal of Psychology 53(4), 471\u2013483. https:\/\/doi.org\/10.1177\/00812463231182034.","DOI":"10.1177\/00812463231186260"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Mbunge, E., Batani, J., Gaobotse, G. & Muchemwa, B., 2022, \u2018Virtual healthcare services and digital health technologies deployed during coronavirus disease 2019 (COVID-19) pandemic in South Africa: A systematic review\u2019, Global health journal 6(2), 102\u2013113. https:\/\/doi.org\/10.1016\/j.glohj.2022.03.001","DOI":"10.1016\/j.glohj.2022.03.001"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Militello, L., Sobolev, M., Okeke, F., Adler, D.A. & Nahum-Shani, I., 2022, \u2018Digital prompts to increase engagement with the headspace app and for stress regulation among parents: Feasibility study\u2019, JMIR Formative Research 6(3), e30606. https:\/\/doi.org\/10.2196\/30606","DOI":"10.2196\/30606"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Mindu, T., Mutero, I.T., Ngcobo, W.B., Musesengwa, R. & Chimbari, M.J., 2023, \u2018Digital mental health interventions for young people in rural South Africa: Prospects and challenges for implementation\u2019, International Journal of Environmental Research and Public Health 20(2), 1453. https:\/\/doi.org\/10.3390\/ijerph20021453","DOI":"10.3390\/ijerph20021453"},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Mitchell, G., Gradidge, D. & Ntlokwana, N., 2024, \u2018Counsellors\u2019 experiences of integrating virtual interventions to provide mental health support for students\u2019, Journal of Student Affairs in Africa 12(2), 1\u201317. https:\/\/doi.org\/10.24085\/jsaa.v12i2.5449","DOI":"10.24085\/jsaa.v12i2.5449"},{"key":"ref45","doi-asserted-by":"crossref","unstructured":"Moffett, B., Pozuelo, J.R., Musenge, E., Makhanya, Z., O\u2019Mahen, H.A., Craske, M.G., Van Heerden, A., Lund, C., Orkin, K., Sodi, T., Blakemore, S.J., Tollman, S., DoBAt & Ebikolwa Consortium, Kahn, K. & Stein, A., 2025, \u2018A behavioral activation digital intervention incorporating gamification and peer mentor support for adolescent depression in rural South Africa: A pilot randomised controlled trial (the DoBAt study)\u2019, JAACAP Open 3(4), 1270\u20131283. https:\/\/doi.org\/10.1016\/j.jaacop.2025.06.009","DOI":"10.2139\/ssrn.5020643"},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"Mudau, T., Jithoo, V. & Dietrich, J., 2024, \u2018Exploring the demand, practicality, and acceptability of a mental health application intervention for students at a South African university\u2019, South African Journal of Psychology 54(2), 171\u2013184. https:\/\/doi.org\/10.1177\/00812463241249100","DOI":"10.1177\/00812463241249100"},{"key":"ref47","doi-asserted-by":"crossref","unstructured":"Musakuro, R.N. & Gie, L., 2024, \u2018University staff intentions to adopt e-health tools for digital mental health services in post-pandemic South Africa\u2019, South African Journal of Information Management 26(1), a1897. https:\/\/doi.org\/10.4102\/sajim.v26i1.1897","DOI":"10.4102\/SAJIM.v26i1.1897"},{"key":"ref48","doi-asserted-by":"crossref","unstructured":"Musakuro, R.N. & Gie, L., 2025, \u2018Strategies for sustainable adoption of e-health tools for digital mental health services\u2019, SA Journal of Human Resource Management 23, 3053. https:\/\/doi.org\/10.4102\/sajhrm.v23i0.3053","DOI":"10.4102\/sajhrm.v23i0.3053"},{"key":"ref49","doi-asserted-by":"crossref","unstructured":"Musekiwa, T., Lubinga, S. & Masiya, T., 2025, \u2018Barriers to digital inclusion in service delivery in South Africa: A systematic review\u2019, International Journal of Electronic Governance 17(2), 138\u2013160. https:\/\/doi.org\/10.1504\/IJEG.2025.148154","DOI":"10.1504\/IJEG.2025.148154"},{"key":"ref50","unstructured":"National Department of Health, 2020, National Digital Health Strategy for South Africa 2019\u20132024, viewed 27 August 2025, from https:\/\/www.health.gov.za\/wp-content\/uploads\/2020\/11\/national-digital-strategy-for-south-africa-2019-2024-b.pdf."},{"key":"ref51","doi-asserted-by":"crossref","unstructured":"Ndibalema, P., 2025, \u2018Digital literacy gaps in promoting 21st century skills among students in higher education institutions in sub-Saharan Africa: A systematic review\u2019, Cogent Education 12(1), 2452085. https:\/\/doi.org\/10.1080\/2331186X.2025.2452085","DOI":"10.1080\/2331186X.2025.2452085"},{"key":"ref52","doi-asserted-by":"crossref","unstructured":"Oliveira, C., Pereira, A., Vagos, P., N\u00f3brega, C., Gon\u00e7alves, J. & Afonso, B., 2021, \u2018Effectiveness of mobile app-based psychological interventions for college students: A systematic review of the literature\u2019, Frontiers in Psychology 12, 647606 https:\/\/doi.org\/10.3389\/fpsyg.2021.647606","DOI":"10.3389\/fpsyg.2021.647606"},{"key":"ref53","unstructured":"Ortiz, D., 2026, Pioneering digital therapeutics: Neeuro and secret mind wellness partner to transform special needs education in South Africa, viewed 30 March 2026, from https:\/\/www.neeuro.com\/our-impact\/secret-mind-wellness-in-south-african-special-needs-schools."},{"key":"ref54","doi-asserted-by":"crossref","unstructured":"Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D. et al., 2021, \u2018The PRISMA 2020 statement: An updated guideline for reporting systematic reviews\u2019, PLoS Medicine 18(3), e1003583. https:\/\/doi.org\/10.1371\/journal.pmed.1003583","DOI":"10.1371\/journal.pmed.1003583"},{"key":"ref55","doi-asserted-by":"crossref","unstructured":"Pillay, A.L. & Kriel, A.J., 2021, \u2018Mental health help-seeking among South African university students: Barriers and facilitators\u2019, South African Journal of Psychology 51(1), 23\u201334. https:\/\/doi.org\/10.1177\/0081246321992177","DOI":"10.1177\/0081246321992177"},{"key":"ref56","unstructured":"Plagerson, S. & Mthembu, S., 2019, \u2018Poverty, inequality and social exclusion in South Africa: A systematic assessment of key policies, strategies and flagship programmes\u2019, Centre for Social Development in Africa (CSDA), University of Johannesburg, Johannesburg, viewed 27 September 2025, from https:\/\/www.uj.ac.za\/wp-content\/uploads\/2021\/10\/nda-poverty-inequality-and-social-exclusion--12-2-2020.pdf."},{"key":"ref57","doi-asserted-by":"crossref","unstructured":"Santiago, I.S., De Castro e Castro, S., De Brito, A.P.A., Sanches, D., Quintanilha, L.F., Avena, K.D.M. et al., 2024, \u2018Stress and exhaustion among medical students: a prospective longitudinal study on the impact of the assessment period on medical education\u2019, BMC Medical Education 24(1), 630. https:\/\/doi.org\/10.1186\/s12909-024-05617-6","DOI":"10.1186\/s12909-024-05617-6"},{"key":"ref58","doi-asserted-by":"crossref","unstructured":"Stanford, J.A. & Just, S.A., 2025, \u2018Quantitative research on digitalized treatment options for older adults with mental illness: Scoping review\u2019, JMIR Mental Health 12, e70321. https:\/\/doi.org\/10.2196\/70321","DOI":"10.2196\/70321"},{"key":"ref59","doi-asserted-by":"crossref","unstructured":"Steyn, S. & Slabbert, M., 2025, \u2018Self-guided smartphone app (Vimbo) for the reduction of symptoms of depression and anxiety in South African adults: Pilot quantitative single-arm study\u2019, JMIR Formative Research 9, e54216. https:\/\/doi.org\/10.2196\/54216","DOI":"10.2196\/54216"},{"key":"ref60","doi-asserted-by":"crossref","unstructured":"Tricco, A.C., Lillie, E., Zarin, W., O\u2019Brien, K.K., Colquhoun, H., Levac, D. et al., 2018, \u2018PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation\u2019, Annals of Internal Medicine 169(7), 467\u2013473. https:\/\/doi.org\/10.7326\/M18-0850","DOI":"10.7326\/M18-0850"},{"key":"ref61","unstructured":"University of Cape Town, 2023, Online group cognitive behavioural therapy for South African university students with depression and anxiety: ISRCTN Trial 47089643, viewed 29 September 2025, from https:\/\/www.isrctn.com\/ISRCTN47089643."},{"key":"ref62","unstructured":"University of the Western Cape, 2023, UWC\u2019s commitment to mental health: A transformative journey, viewed 30 September 2025, from https:\/\/www.uwc.ac.za\/news-and-announcements\/news\/uwcs-commitment-to-mental-health-a-transformative-journey."},{"key":"ref63","doi-asserted-by":"crossref","unstructured":"Wang, Q., Su, M., Zhang, M. & Li, R., 2021, \u2018Integrating digital technologies and public health to fight Covid-19 pandemic: Key technologies, applications, challenges and outlook of digital healthcare\u2019, International Journal of Environmental Research and Public Health 18(11), 6053. https:\/\/doi.org\/10.3390\/ijerph18116053","DOI":"10.3390\/ijerph18116053"},{"key":"ref64","doi-asserted-by":"crossref","unstructured":"Yan, K., Balijepalli, C. & Druyts, E., 2021, \u2018The impact of digital therapeutics on current health technology assessment frameworks\u2019, Frontiers in Digital Health 3, 667016. https:\/\/doi.org\/10.3389\/fdgth.2021.667016","DOI":"10.3389\/fdgth.2021.667016"},{"key":"ref65","doi-asserted-by":"crossref","unstructured":"Yslado-M\u00e9ndez, R., Escobar-Agreda, S., Villarreal-Zegarra, D., Trejo Flores, W.M., S\u00e1nchez-Broncano, J.D., Vilela-Estrada, A.L. et al., 2025, \u2018Effectiveness, usability and satisfaction of a self-administered digital intervention for reducing depression, anxiety and stress in a university community in the Andean region of Peru: Randomized controlled trial\u2019, JMIR Formative Research 9, e71465. 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