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A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions

Lowri Wilkie, Zoe Fisher Orcid Logo, Antonia Geidel, Isabel Goodall, Shannon Kamil, Elen Davies Orcid Logo, Andrew Kemp Orcid Logo

Nature Human Behaviour

Swansea University Authors: Lowri Wilkie, Zoe Fisher Orcid Logo, Antonia Geidel, Isabel Goodall, Shannon Kamil, Elen Davies Orcid Logo, Andrew Kemp Orcid Logo

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DOI (Published version): 10.1038/s41562-025-02369-1

Abstract

Improving population well-being is increasingly recognized as a global priority, yet evidence on the comparative effectiveness of well-being-focused interventions in adults is fragmented. Here we conduct a preregistered systematic review and network meta-analysis (PROSPERO CRD42023403480) of randomi...

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Published in: Nature Human Behaviour
ISSN: 2397-3374
Published: Springer Nature 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa70747
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spelling 2026-01-20T12:02:13.2254824 v2 70747 2025-10-21 A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions c2dd53e9f6c691a340f6170b24b032a2 Lowri Wilkie Lowri Wilkie true false b7d5965d35de6f683716c6eb1e82ff81 0000-0001-8150-2499 Zoe Fisher Zoe Fisher true false 2bccc09ba02d08eaf745387d6bef6feb Antonia Geidel Antonia Geidel true false 9f78abe7432f9dd62def271064beb483 Isabel Goodall Isabel Goodall true false 3cd3fcbe071961a9ee65c5f3eba2d25f Shannon Kamil Shannon Kamil true false 737fc3272d41df1a9106958a4a273e3a 0000-0002-3621-5308 Elen Davies Elen Davies true false dfd05900f0e2409d3f67dca227c59a93 0000-0003-1146-3791 Andrew Kemp Andrew Kemp true false 2025-10-21 PSYS Improving population well-being is increasingly recognized as a global priority, yet evidence on the comparative effectiveness of well-being-focused interventions in adults is fragmented. Here we conduct a preregistered systematic review and network meta-analysis (PROSPERO CRD42023403480) of randomized controlled trials evaluating well-being interventions in adults without diagnosed conditions. Searches of MEDLINE, PsycINFO, CENTRAL and Scopus (to March 2023) identified 183 trials (n = 22,811). Interventions included mindfulness-based, compassion-based, acceptance and commitment therapy and positive psychology interventions, as well as exercise, yoga, educational, nature-based programmes and combined exercise-psychological approaches. Risk of bias was assessed using RoB 2, and data were synthesized using random-effects network meta-analysis. Most interventions improved well-being compared with inactive controls. Combined exercise-psychological interventions produced the largest effect (standardized mean difference of 0.73, 95% confidence interval 0.27 to 1.20). Mindfulness, compassion, single positive psychology, yoga and exercise interventions demonstrated moderate, consistent effects (standardized mean difference of 0.41–0.49), with no significant differences between interventions. Nature-based interventions were not significantly more effective than controls, but evidence was limited by conceptual and methodological heterogeneity. Risk of bias was frequently moderate to high, and funnel plot asymmetry suggested potential publication bias. However, multiple sensitivity analyses (including grey literature, excluding studies with high risk of bias and small studies) supported the robustness of overall conclusions. Most comparisons (71%) were rated as moderate in certainty of evidence using CINEMA. These findings provide an integrated synthesis of the well-being intervention literature and highlight priority areas for future interdisciplinary, methodologically robust research. No external funding was received. Journal Article Nature Human Behaviour 0 Springer Nature 2397-3374 2 1 2026 2026-01-02 10.1038/s41562-025-02369-1 COLLEGE NANME Psychology School COLLEGE CODE PSYS Swansea University SU Library paid the OA fee (TA Institutional Deal) Swansea University 2026-01-20T12:02:13.2254824 2025-10-21T17:21:18.5161215 Faculty of Medicine, Health and Life Sciences School of Psychology Lowri Wilkie 1 Zoe Fisher 0000-0001-8150-2499 2 Antonia Geidel 3 Isabel Goodall 4 Shannon Kamil 5 Elen Davies 0000-0002-3621-5308 6 Andrew Kemp 0000-0003-1146-3791 7 70747__35894__10b5ce7e665d4423a1afd78c5855b548.pdf s41562-025-02369-1 (1).pdf 2026-01-02T10:35:34.6630939 Output 2957764 application/pdf Version of Record true © The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
spellingShingle A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
Lowri Wilkie
Zoe Fisher
Antonia Geidel
Isabel Goodall
Shannon Kamil
Elen Davies
Andrew Kemp
title_short A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
title_full A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
title_fullStr A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
title_full_unstemmed A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
title_sort A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions
author_id_str_mv c2dd53e9f6c691a340f6170b24b032a2
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9f78abe7432f9dd62def271064beb483
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dfd05900f0e2409d3f67dca227c59a93
author_id_fullname_str_mv c2dd53e9f6c691a340f6170b24b032a2_***_Lowri Wilkie
b7d5965d35de6f683716c6eb1e82ff81_***_Zoe Fisher
2bccc09ba02d08eaf745387d6bef6feb_***_Antonia Geidel
9f78abe7432f9dd62def271064beb483_***_Isabel Goodall
3cd3fcbe071961a9ee65c5f3eba2d25f_***_Shannon Kamil
737fc3272d41df1a9106958a4a273e3a_***_Elen Davies
dfd05900f0e2409d3f67dca227c59a93_***_Andrew Kemp
author Lowri Wilkie
Zoe Fisher
Antonia Geidel
Isabel Goodall
Shannon Kamil
Elen Davies
Andrew Kemp
author2 Lowri Wilkie
Zoe Fisher
Antonia Geidel
Isabel Goodall
Shannon Kamil
Elen Davies
Andrew Kemp
format Journal article
container_title Nature Human Behaviour
container_volume 0
publishDate 2026
institution Swansea University
issn 2397-3374
doi_str_mv 10.1038/s41562-025-02369-1
publisher Springer Nature
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
document_store_str 1
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description Improving population well-being is increasingly recognized as a global priority, yet evidence on the comparative effectiveness of well-being-focused interventions in adults is fragmented. Here we conduct a preregistered systematic review and network meta-analysis (PROSPERO CRD42023403480) of randomized controlled trials evaluating well-being interventions in adults without diagnosed conditions. Searches of MEDLINE, PsycINFO, CENTRAL and Scopus (to March 2023) identified 183 trials (n = 22,811). Interventions included mindfulness-based, compassion-based, acceptance and commitment therapy and positive psychology interventions, as well as exercise, yoga, educational, nature-based programmes and combined exercise-psychological approaches. Risk of bias was assessed using RoB 2, and data were synthesized using random-effects network meta-analysis. Most interventions improved well-being compared with inactive controls. Combined exercise-psychological interventions produced the largest effect (standardized mean difference of 0.73, 95% confidence interval 0.27 to 1.20). Mindfulness, compassion, single positive psychology, yoga and exercise interventions demonstrated moderate, consistent effects (standardized mean difference of 0.41–0.49), with no significant differences between interventions. Nature-based interventions were not significantly more effective than controls, but evidence was limited by conceptual and methodological heterogeneity. Risk of bias was frequently moderate to high, and funnel plot asymmetry suggested potential publication bias. However, multiple sensitivity analyses (including grey literature, excluding studies with high risk of bias and small studies) supported the robustness of overall conclusions. Most comparisons (71%) were rated as moderate in certainty of evidence using CINEMA. These findings provide an integrated synthesis of the well-being intervention literature and highlight priority areas for future interdisciplinary, methodologically robust research. No external funding was received.
published_date 2026-01-02T05:33:38Z
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