Interventions to promote resilience in children and adolescents: A systematic review and meta-analysis of randomized controlled trials

Abstract

Background

Stressors can significantly threaten the physical and mental health of children and adolescents. While it has been demonstrated that fostering resilience to cope effectively with stressors benefits children and adolescents, research on the efficacy of interventions to promote resilience remains limited.

Objective

This study aimed to synthesize evidence from randomized controlled trials on the efficacy of interventions to promote resilience in enhancing child and adolescent stress coping abilities.

Design

A systematic review and meta-analysis of randomized controlled trials.

Methods

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020. Eligible randomized controlled trials were identified through searches of the PubMed, Embase, Web of Science, Scopus, EBSCOhost, and APA PsycINFO electronic databases. Additionally, Google Scholar and the reference lists of studies with similar designs were manually searched. Two independent researchers evaluated the risk of bias in the included trials using the revised Cochrane risk-of-bias tool for randomized trials. A narrative synthesis of the included trials was conducted, with a focus on the adequacy of intervention reporting, implementation parameters, and resilience factors of interventions.

Results

The review included 68 randomized controlled trials involving 16,623 participants, among which 30 were included in the meta-analyses. Four types of interventions to promote resilience were identified, with three showing small to moderate effects in improving stress coping abilities in children and adolescents and one not demonstrating any efficacy in this regard. The certainty of evidence for resilience ranged from moderate to very low based on Grading of Recommendations, Assessment, Development, and Evaluations ratings.

Conclusions

The review's findings support the positive effects of established interventions—specifically resilience-based, mindfulness-based, and sport-based approaches—in enhancing child and adolescent stress coping abilities. Interventions to promote resilience may represent a promising complementary approach to help children and adolescents cope effectively with stressors. However, future research must establish their clinical effectiveness, particularly among those with mental health conditions.