Effectiveness of Interventions for Internet, Smartphone, and Gaming Addictions: Umbrella Review and Meta-Meta-Analysis

针对互联网、智能手机和游戏成瘾的干预措施的有效性:伞状综述和荟萃分析

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Abstract

BACKGROUND: Digital addiction, including internet, smartphone, and gaming addiction, has emerged as a significant global health concern. Although a wide range of interventions has been evaluated, the fragmented and siloed nature of existing meta-analyses limits a clear understanding of the comparative effectiveness of different interventions across addiction subtypes. OBJECTIVE: This umbrella review and meta-meta-analysis aimed to estimate the overall effectiveness of interventions for digital addiction and examine differential effects according to addiction subtype, intervention modality, study design, and control condition. METHODS: A systematic search of 5 electronic databases (PubMed, Web of Science, Scopus, APA PsycInfo, and the Cochrane Library) was conducted from inception to June 24, 2025. Eligible studies were systematic reviews with meta-analyses evaluating interventions for internet, smartphone, or gaming addiction. Random-effects models were applied to synthesize standardized mean differences (SMDs). Methodological quality and certainty of evidence were assessed using A Measurement Tool to Assess Systematic Reviews 2 and the Grading of Recommendations Assessment, Development, and Evaluation framework. RESULTS: A total of 29 meta-analyses, comprising 52 effect sizes and 66,530 participants, were included (I2=95.13%). Overall, interventions demonstrated a large and statistically significant effect in reducing digital addiction symptoms (SMD=-1.44, 95% CI -1.67 to -1.21; P=.003). Subgroup analyses indicated that the largest effects were observed for internet addiction (SMD=-1.70, 95% CI -1.99 to -1.42), followed by gaming addiction (SMD=-0.82, 95% CI -1.09 to -0.56) and smartphone addiction (SMD=-0.80, 95% CI -1.39 to -0.21). Exercise-based interventions, particularly those integrated with psychological approaches, showed large effect sizes (SMD=-3.14, 95% CI -4.30 to -1.97); however, this finding was based on a very limited number of effect sizes and should be interpreted cautiously. In addition, randomized controlled trials yielded larger effects than mixed study designs, and no-intervention controls were associated with larger effect sizes than mixed control conditions. The certainty of evidence was generally low. CONCLUSIONS: Interventions for digital addiction are effective, although their magnitude of benefit varies by addiction subtype and intervention modality. These findings support the use of tailored and multimodal intervention strategies while highlighting the need for more rigorous, high-quality, and balanced evidence across different forms of digital addiction.

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