2 - (SYM 39) Behavioral Activation to Increase Physical Activity in Persons with Depression

Background: Despite evidence supporting the efficacy of physical activity to improve depressive symptoms, physical activity is rarely used as a treatment option by clinicians. Several barriers exist in the provision of physical activity, including a lack of integration of physical activity support within current treatments. Furthermore, adherence to physical activity programs are often suboptimal, particularly among persons with depression.

Methods: We conducted a phased pilot study to evaluate the feasibility and acceptability of a manualized tele-behavioral activation intervention focused on supporting increased physical activity among persons with depression. In the first phase of the pilot, the tele-BA intervention was delivered to a small sample (n=15). Acceptability of the intervention was assessed through a self-report questionnaire and participant interviews. In the second phase, feasibility and acceptability of the intervention was evaluated in a larger sample (n=50) through a single-arm trial. The intervention consisted of eight weekly session, followed by two bi-weekly booster sessions. Feasibility and acceptability were assessed through recruitment and screening metrics, adherence to intervention (i.e., BA session attendance), use of self-monitoring physical activity tool (Fitbit), and completion of outcome assessments.  

Results: In Phase 1, all feasibility and acceptability metrics met pre-determined metrics. Session attendance and outcome measure completion were both 96.67%. In interviews, participants reported satisfaction with the intervention, noting the convenience of tele-delivery, and the perceived benefits on both improving physical activity and depressive symptoms. In the Phase 2 trial, session attendance was 87.8% and participants completed 84.3% of outcome assessments. In both phases, recruitment rates exceeded pre-determined feasibility metrics with an average of 2.57 participants enrolled per month.

Discussion: Results of our pilot study support the feasibility and acceptability of the tele-behavioral activation intervention. Implications for future intervention delivery will be discussed; for example, participants noted a desire for electronic tools for monitoring goals set during the BA sessions and more structured physical activity advice. A full-scale randomized controlled trial is need to assess the efficacy of the intervention in increasing physical activity and improving depressive symptoms.