Healthy hearts healthy minds: A randomized trial of online interventions to improve physical activity

Louisa G Sylvia; Alexandra K Gold; Marina Rakhilin; Selen Amado; Madelaine Faulkner Modrow; Evan A Albury; Nevita George; Amy T Peters; Caitlin A Selvaggi; Nora Horick; Dustin J Rabideau; Heidi Dohse; Roberta E Tovey; Jon A Turner; David W Schopfer; Mark J Pletcher; Doug Katz; Thilo Deckersbach; Andrew A Nierenberg

doi:10.1016/j.jpsychores.2022.111110

Healthy hearts healthy minds: A randomized trial of online interventions to improve physical activity

J Psychosom Res. 2023 Jan:164:111110. doi: 10.1016/j.jpsychores.2022.111110. Epub 2022 Dec 1.

Authors

Louisa G Sylvia¹, Alexandra K Gold², Marina Rakhilin³, Selen Amado³, Madelaine Faulkner Modrow⁴, Evan A Albury³, Nevita George³, Amy T Peters³, Caitlin A Selvaggi⁵, Nora Horick⁵, Dustin J Rabideau⁶, Heidi Dohse³, Roberta E Tovey³, Jon A Turner⁷, David W Schopfer⁸, Mark J Pletcher⁴, Doug Katz³, Thilo Deckersbach⁹, Andrew A Nierenberg²

Affiliations

¹ Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: LSYLVIA2@mgh.harvard.edu.
² Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
³ Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA.
⁴ University of California San Francisco, San Francisco, CA, USA.
⁵ Biostatistics, Massachusetts General Hospital, Boston, MA, USA.
⁶ Harvard Medical School, Boston, MA, USA; Biostatistics, Massachusetts General Hospital, Boston, MA, USA.
⁷ Department of Information, Operations, and Management Sciences, Stern School of Business, New York University, New York, New York, USA.
⁸ National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
⁹ University of Applied Sciences, Diploma Hochschule, Germany.

PMID: 36525851
DOI: 10.1016/j.jpsychores.2022.111110

Abstract

Introduction: Depressed individuals are more likely to die from cardiovascular disease (CVD) than those without depression. People with CVD have higher rates of depression than those without and have higher mortality rates if they have comorbid depression. While physical activity (PA) improves both, few people engage in enough. We compared self-guided internet-based cognitive behavior therapy (CBT) + Fitbit or mindfulness-based cognitive therapy (MBCT) + Fitbit, with Fitbit only to increase daily steps for participants with depression who have low PA.

Methods: Adult participants (N = 340) were recruited from two online patient-powered research networks and randomized to one of three study interventions for 8 weeks with an additional 8 weeks of follow-up. Using linear mixed effects models, we evaluated the effect of the intervention on average daily steps (NCT03373110).

Results: Average daily steps increased 2.8 steps per day in MBCT+Fitbit, 2.9 steps/day in CBT + Fitbit, but decreased 8.2 steps/day in Fitbit Only. These changes were not statistically different between the MBCT+Fitbit and CBT + Fitbit groups, but were different from Fitbit Only across the initial 8-week period. Group differences were not maintained across follow-up. Exploratory analyses identified comorbid anxiety disorders, self-reported PA, and employment status as moderators.

Discussion: Changes in daily steps over both 8- and 16-week periods-regardless of intervention group-were minimal. The results emphasize the limits of using self-guided web-based psychotherapy with an activity tracker to increase PA in participants with a history of depression and low PA.

Keywords: Depression; Health eHeart; MoodNetwork; Physical activity.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety
Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / therapy
Exercise
Humans
Internet-Based Intervention*
Mindfulness*

Associated data

ClinicalTrials.gov/NCT03373110