{
  "schema_version": 1,
  "id": "wellbeing-multiple-pathways-boundary-2026",
  "canonical_url": "https://brali-lifeos.github.io/evidence/wellbeing-multiple-pathways-boundary-2026/",
  "json_url": "https://brali-lifeos.github.io/evidence/wellbeing-multiple-pathways-boundary-2026/index.json",
  "decision": "support-existing",
  "decision_label": "Supports existing guidance",
  "reviewed_at": "2026-09-05",
  "reviewed_by": "Brali Evidence Reviewer",
  "source": {
    "title": "A systematic review and network meta-analysis of randomized controlled trials of well-being-focused interventions",
    "url": "https://www.nature.com/articles/s41562-025-02369-1",
    "type": "systematic-review-network-meta-analysis",
    "doi": "10.1038/s41562-025-02369-1",
    "citation_text": "Wilkie L, Fisher Z, Geidel A, et al. Nature Human Behaviour. 2026;10:715-726.",
    "study_design": "Preregistered systematic review and random-effects network meta-analysis (PROSPERO CRD42023403480) of randomized controlled trials. Searches of MEDLINE, PsycINFO, CENTRAL and Scopus through March 2023 identified 183 trials used in the final network meta-analysis. Risk of bias was assessed with RoB 2, network confidence with CINeMA, and sensitivity analyses excluded high-risk and small studies, restricted outcomes, and added grey literature.",
    "population": "22,811 adults without diagnosed conditions. Mean participant age was 38.3 years with a reported range of 18-82. Studies were conducted in universities, workplaces, communities and online settings; 79% were conducted in Western countries. Demographic reporting was incomplete across many trials.",
    "intervention_or_exposure": "Structured well-being interventions including mindfulness-based, compassion-based, positive-psychology, exercise, yoga, ACT, educational, nature-based and some combined psychological-plus-exercise programmes, compared directly or indirectly through a connected randomized-trial network.",
    "outcomes": [
      "Validated well-being outcomes",
      "Relative intervention effects versus control",
      "Network treatment rankings",
      "Risk of bias",
      "Certainty of network comparisons",
      "Sensitivity analyses"
    ]
  },
  "supported_claim": "For general adult well-being, Brali can reasonably offer more than one small practice rather than pretending there is a single best technique. In this network meta-analysis, several established approaches—including mindfulness, exercise, yoga, compassion-based and positive-psychology interventions—showed moderate benefits versus inactive controls, while many head-to-head differences were not statistically clear. This supports the existing short-meditation protocol as one optional practice and supports a broader Brali rule: choose a feasible evidence-informed route, test it, and keep the one that is useful in the user's context.",
  "unsupported_or_overstated_claims": [
    "Mindfulness is the single best well-being intervention for everyone.",
    "A five-minute meditation is an evidence-established dose.",
    "Exercise-plus-psychological interventions are definitively superior; that node contained only three studies and two were high risk of bias.",
    "These interventions treat depression, anxiety or another diagnosed mental-health condition; clinical samples were excluded.",
    "Nature-based practices do not work; the nature node was small, heterogeneous and weakly connected to the network.",
    "Treatment rankings prove one intervention should be preferred clinically or personally over another.",
    "Immediate post-intervention gains prove durable long-term improvement.",
    "The pooled effect sizes predict how much one individual will benefit."
  ],
  "limitations": [
    "The literature search ended in March 2023 even though the synthesis was published in 2026, so it is a current synthesis of an older evidence window rather than a review of trials through 2025-2026.",
    "Only 12 of 183 studies were rated low risk of bias overall; 110 (60%) were rated high risk.",
    "Only 33% of studies used intention-to-treat analysis.",
    "Funnel-plot asymmetry and Egger tests suggested publication bias, although sensitivity analyses did not materially change the overall pattern.",
    "Many trials reported only immediate post-intervention outcomes, leaving long-term durability poorly characterized.",
    "Many network comparisons relied on indirect evidence rather than direct head-to-head trials.",
    "Seventy-nine percent of studies were conducted in Western countries and demographic reporting was incomplete.",
    "Broad intervention nodes combined programmes that can differ materially in content, dose and delivery, so the review cannot identify the active ingredient or an optimal protocol duration."
  ],
  "target_hack_ids": [
    "5-minute-meditation-habit-tracker"
  ],
  "target_protocol_ids": [
    "brali:5-minute-meditation-habit-tracker"
  ],
  "risk_flags": [
    "mental-health"
  ],
  "notes": "Editorial role: strengthen the short-meditation page without turning it into a sales pitch for meditation. The useful lesson is pluralism: structured mindfulness is a defensible option, but exercise, yoga, compassion and positive-psychology approaches also have evidence. Brali should explain the mechanism/action clearly, invite a small experiment, and make switching practices normal when one approach is unhelpful."
}