Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Scientific reports
Satisfaction with telepsychiatry and mental health stigma among health sciences students in Egyptian universities
Health sciences students have a higher incidence of mental health disorders; however, stigma and barriers have complicated help-seeking. Telepsychiatry may be a solution, but acceptance, satisfaction, and stigma in this population, especially in Egypt, remain unclear. This study aimed to evaluate the levels of satisfaction regarding telepsychiatry, stigma perceived with respect to mental illness, among health sciences students towards mental health services. It also aims to assess sociodemographic factors associated with these outcomes. This was a questionnaire-based cross-sectional study conducted among 799 students from various universities in Egypt. It was conducted between August and November 2025, and the questionnaire involved sociodemographic data, the telepsychiatry satisfaction scale (21 items), and the STIG-9 stigma scale. Data were analyzed using descriptive statistics, chi-square and t-tests, and linear regression, with significance set at p < 0.05. Overall, participants had a mean age of 21.4 years, while 66.8% of participants were female. In total, 24.0% agreed, and 18.4% strongly agreed to being satisfied with telepsychiatry, with a mean total satisfaction score of 67.84/105. The mean STIG‑9 stigma score was 14.44/27. Linear regression identified sociodemographic variables independently associated with satisfaction and stigma; higher stigma was also positively associated with higher satisfaction. In this cohort of Egyptian health sciences students with prior telepsychiatry experience, satisfaction with telepsychiatry was positively associated with perceived stigma. These findings suggest that addressing socio-cultural stigma may support the acceptability of telepsychiatry and improve engagement with digital mental health services in similar student populations.
13 July 2026
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Effects of a guided digital intervention on sleep and mental health outcomes in university students - a randomized controlled trial
STUDY OBJECTIVES: To evaluate the effectiveness of a guided digital intervention targeting sleep and circadian rhythms in university students. METHODS: We randomized 195 university students with self-reported insomnia (Insomnia Severity Index ≥10) from nine Dutch Universities to receive either the 5-week guided digital cognitive-behavioral therapy for insomnia "i-Sleep & BioClock", or digital sleep psychoeducation and sleep monitoring. Online assessments were at baseline, 3 (mid-treatment), 6 (post-treatment), and 18 (follow-up) weeks. The primary outcome was insomnia severity at 6 weeks. Secondary outcomes were symptoms of depression and anxiety; functioning; quality of life (QoL); academic performance; and sleep and light exposure diary outcomes. RESULTS: From Nov 1st 2023 until Sept 5th 2024, we randomly assigned 96 students (age 23.8 ± 3.8, 75.4% female) to the intervention and 99 to the control condition, stratified by university and gender. Fifty-one percent completed the post-treatment assessment, and 30% the follow-up. 31% were intervention completers. Linear mixed models showed no significant time x treatment interaction for insomnia severity ("i-Sleep & BioClock": baseline ISI M = 16.8, SD = 4.0; post-treatment ISI M = 10.2, SD = 3.9; Digital psychoeducation: baseline ISI M = 16.5, SD = 3.6; post-treatment ISI M = 11.1, SD = 4.2). The difference in change between groups was -1.17 points (95% CI -2.72 to 0.38), p=.14, Cohen's d = -0.31. Most secondary outcomes showed no significant time x treatment effects. CONCLUSIONS: "i-Sleep & BioClock" was not more effective than online psychoeducation on most outcomes, possibly due to active elements present in both conditions or low adherence. Future research should identify factors for early disengagement and investigate which intervention components drive improvements in sleep. CLINICAL TRIAL: Effectiveness of a Guided Self-help Intervention for Improving Sleep in University Students, https://clinicaltrials.gov/study/NCT06023693, prospectively registered at ClinicalTrials.gov on August 3rd, 2023.
14 May 2026
Read appraisal →Journal of medical Internet research
A Gamified Mobile Health Intervention to Promote Physical Activity, Executive Function, and Mental Health in College Students: Randomized Controlled Trial
BACKGROUND: College students commonly experience suboptimal health conditions, including insufficient physical activity (PA), excessive body weight, and declining physical fitness. Traditional interventions face low adherence, while gamified mobile health (mHealth) programs may improve engagement and outcomes. OBJECTIVE: This study aimed to evaluate the feasibility and effectiveness of a novel gamified, incentive-based mHealth intervention on primary outcomes (PA and adherence) and secondary outcomes (physical fitness, body composition, executive function [EF], and mental health). METHODS: A 2-arm parallel-group randomized controlled trial (RCT) was conducted in 2025 at Yantai University with 160 college students (18-25 years; BMI 18.5-30.0) who were randomized 1:1 (computer-generated, sex-stratified blocks of 4; concealed allocation) to the intervention group (IG) or control group (CG; n=80 each); major exclusions were contraindications to exercise, severe physical/mental illness, recent PA interventions, or psychotropic medication use. Both used the same fitness watch-app system and identical PA targets (≥150 min moderate-to-vigorous physical activity [MVPA] per week or ≥900 metabolic equivalent-minutes [MET-min] per week); IG additionally received team-based gamification (competition, points/leaderboards, feedback, and rewards), while CG received monitoring only. PA and adherence were monitored throughout the 8-week intervention; other outcomes were assessed at baseline and 8 weeks (fitness, body composition, EF, and mental health). Open-label with blinded outcome assessors/analysts; intention-to-treat (ITT) with multiple imputation. RESULTS: At 8 weeks, data were available for 154 participants (IG 78; CG 76); all 160 were analyzed per ITT. Compared to the CG, the IG demonstrated significantly higher mean levels in all primary PA outcomes over 8 weeks (daily steps: mean 10,356, SD 1245 versus 8242, SD 1087; Δ=2114; d=1.81, 95% CI 1.44-2.18; P<.001; daily MVPA: mean 71, SD 15 versus 43, SD 12 min; Δ=28 min; d=2.06, 95% CI 1.68-2.45; P<.001; and weekly MET-min: mean 1650, SD 310 versus 1340, SD 285; Δ=310; d=1.04, 95% CI 0.71-1.37; P<.001). Adherence was also higher in the IG (both P<.001). Key secondary outcomes, including skeletal muscle mass (Δ +0.54 kg), body fat percentage (Δ -0.46 percentage points), 800/1000 m run time (Δ -6.5 s), and depressive symptoms (Δ -2.0 points), significantly favored the IG (all P<.001). No serious adverse events occurred. CONCLUSIONS: This RCT demonstrated that integrating gamification into an mHealth platform significantly enhanced PA, intervention adherence, and selected health outcomes among college students. The key innovation lies in the trial design, which held the technology platform and activity goals constant across groups, thereby allowing a clearer estimate of the incremental contribution of gamification. Unlike many existing studies, this approach reduces confounding from co-occurring intervention components in between-group comparisons. It therefore provides more comparable and methodologically robust evidence on the specific efficacy of gamification in mHealth interventions. For real-world implementation, this model leverages the existing smartphone and wearable ecosystem, offering a low-cost, scalable strategy for university health-promotion programs.
8 Apr 2026
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