I Can Be More Resilient! A Systematic Review and Meta-Analysis of Interventions to Promote Resilience During the COVID-19 Pandemic

Background: The COVID-19 pandemic threatens mental health, making the enhancement of individual resiliency against this adversity a matter of urgency. This study aimed to synthesize existing evidence on resilience interventions during the COVID-19 pandemic, estimate intervention effectiveness, and identify potential moderators of between-study heterogeneity. Methods: Nine English and three Chinese electronic databases were searched for intervention studies with resilience as the primary or secondary outcome conducted during the COVID-19 pandemic. Meta-analysis with the random-effects model was conducted to pool the effect sizes of the included randomized controlled trials (RCTs) and non-RCTs with a control group, and a qualitative review synthesized the results of the included studies without control groups. Subgroup analysis and meta-regression were used to examine study heterogeneity. Outcomes: A total of 33 studies including 8 RCTs, 11 non-RCTs with control groups, and 14 single-armed studies with 3159 intervention participants and 1199 control participants were identified in this systematic review. Meta-analysis of 17 studies showed that interventions conducted during the COVID-19 pandemic, regardless of their theoretical background, improved the resilience level, with a medium to large pooled effect size (Hedges’g = 0·77, 95% CI 0·46–1·07, p < 0·0001). Moderation analyses showed that culture, population type, intervention format, delivery mode, and resilience measurements were the sources of study heterogeneity. Specifically, interventions applied to Eastern people, children, and adolescents; in group formats; and in-person showed larger intervention effects than their counterparts. Moreover, 13 of the 16 studies in the descriptive analysis showed significant improvements in resilience after completion of the interventions.Interpretation: Interventions were effective at building resilience in individuals during the COVID-19 pandemic. It is suggested that resilience enhancement programs consider the moderators identified in this study to optimize intervention benefits.Funding Information: This study was supported by the National Natural Science Foundation of China (Project No. 32171086) and the Research Grants Council of the Hong Kong Special Administrative Region, P. R. China (CityU 11606221). Declaration of Interests: We declare no competing interests.