Behavioral activation versus physical activity via the internet: A randomized controlled trial

Nyström, Markus; Stenling, Andreas; Sjöström, Emma; Neely, Gregory; Lindner, Philip; Hassmén, Peter; Andersson, Gerhard; Martell, Christopher R.; Carlbring, Per

doi:10.1016/j.jad.2017.03.018

Cited by 39 publications

(33 citation statements)

References 65 publications

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“…Exploratory analysis revealed a decrease in symptoms of depression and anxiety in favor of the intervention group at 2 months postrandomization, a similar reduction to that found in previous studies promoting PA for depression [ 23 , 29 - 31 , 45 ] and anxiety [ 13 ]. However, other studies did not find such an effect [ 54 , 62 , 63 ], possibly due to low power and the use of active control conditions [ 7 ].…”

Section: Discussionsupporting

confidence: 83%

“…The achieved recruitment rates resembled those found in other studies of Web-based interventions promoting PA for depression [ 29 - 31 , 45 , 54 ]. Other studies report between 26% and 46% of people approached being subsequently randomized [ 29 - 31 , 45 , 54 ]. Mailey et al [ 54 ] recruited students registered with mental health counseling services but did not have an inclusion criterion for the level of depressive symptoms, possibly contributing to their higher recruitment rate (46%).…”

Section: Discussionsupporting

confidence: 81%

“…Conversely, a systematic review of Web-based psychological treatments for depression reported drop-out rates of 74% for unsupported, 38.4% for administratively supported, and 28% for therapist-supported treatments [ 38 ]. Some individual trials of Web-based PA interventions for depression have reported lower attrition rates than ours (8%-12%) [ 29 , 54 ]. However, both of these trials provided therapist support, whereas our study only provided administrative support.…”

Section: Discussionmentioning

confidence: 57%

“…Minutes per week of MVPA were estimated using Web-based self-completion of the International PA Questionnaire-Short Form (IPAQ-SF) at baseline and at 2-months postrandomization. The IPAQ-SF is a validated measure of PA [ 44 ] and has been used in previous behavioral trials promoting PA for depression [ 29 , 45 ] as well as being the most frequently used measure in Web-based studies for PA [ 46 ].…”

Section: Methodsmentioning

confidence: 99%

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Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults With Depression (The eMotion Study): Pilot Randomized Controlled Trial

Lambert¹,

Greaves²,

Farrand³

et al. 2018

J Med Internet Res

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BackgroundPhysical activity is a potentially effective treatment for depression and depressive relapse. However, promoting physical activity in people with depression is challenging. Interventions informed by theory and evidence are therefore needed to support people with depression to become more physically active. eMotion is a Web-based intervention combining behavioral activation and physical activity promotion for people in the community with symptoms of depression.ObjectiveThe objectives were to assess the feasibility and acceptability of delivering eMotion to people in the community with symptoms of depression and to explore outcomes.MethodsParticipants with elevated depressive symptoms were recruited from the community through various methods (eg, social media) and randomized to eMotion or a waiting list control group for 8 weeks. eMotion is an administratively supported weekly modular program that helps people use key behavior change techniques (eg, graded tasks, action planning, and self-monitoring) to re-engage in routine, pleasurable, and necessary activities, with a focus on physical activities. Feasibility data were collected that included the following: recruitment and trial retention rates; fidelity of intervention delivery, receipt, and enactment; and acceptability of the intervention and data collection procedures. Data were collected for the primary (depression) and secondary outcomes (eg, anxiety, physical activity, fidelity, and client satisfaction) at baseline and 2 months postrandomization using self-reported Web-based questionnaires and accelerometers. Delivery fidelity (logins, modules accessed, time spent) was tracked using Web usage statistics. Exploratory analyses were conducted on the primary and secondary outcomes.ResultsOf the 183 people who contacted the research team, 62 were recruited and randomized. The mean baseline score was 14.6 (SD 3.2) on the 8-item Patient Health Questionnaire depression scale (PHQ-8). Of those randomized, 52 participants provided accelerometer-recorded physical activity data at baseline that showed a median of 35.8 (interquartile range [IQR] 0.0-98.6) minutes of moderate-to-vigorous physical activity (MVPA) recorded in at least 10-minute bouts per week, with only 13% (7/52) people achieving guideline levels (150 minutes of MVPA per week). In total, 81% (50/62) of participants provided follow-up data for the primary outcome (PHQ-8), but only 39% (24/62) provided follow-up accelerometer data. Within the intervention group, the median number of logins, modules accessed, and total minutes spent on eMotion was 3 (IQR 2.0-8.0), 3 (IQR 2.0-5.0), and 41.3 (IQR 18.9-90.4), respectively. Acceptability was mixed. Exploratory data analysis showed that PHQ-8 levels were lower for the intervention group than for the control group at 2 months postrandomization (adjusted mean difference −3.6, 95% CI −6.1 to −1.1).ConclusionsIt was feasible to deliver eMotion in UK communities to inactive populations. eMotion has the potential to be effective and is ready for testing in a ...

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 57%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults With Depression (The eMotion Study): Pilot Randomized Controlled Trial

Lambert¹,

Greaves²,

Farrand³

et al. 2018

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Although the two trials did not follow the exact same manual, Jacobson and Gortner (2000) deemphasized the differences between the two treatments when they stated that they Bkept the same set of treatment options, but created a behavior analytic theoretical framework^which guided therapist selection of interventions and was also taught to patients. Moreover, there is no evidence that BA with a focus on behavioral chain analysis is more effective than BA following a different rationale (Nyström et al 2017). The Jacobson et al (1996) and Dimidjian et al (2006) studies were designed and conducted by similar teams, which suggests that the trials are more comparable than randomized controlled trials usually are.…”

Section: Discussionmentioning

confidence: 99%

Is Behavioral Activation (BA) More Effective than Cognitive Therapy (CT) in Severe Depression? A Reanalysis of a Landmark Trial

Lorenzo‐Luaces

Dobson

2019

J Cogn Ther

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A landmark study (Jacobson et al., JCCP, 64:295-304, 1996) suggested that behavioral activation (BA) is as effective as cognitive therapy (CT) in the treatment of major depression. A conceptual replication supported the efficacy of BA and suggested BA is more effective than CT for severe depression (Dimidjian et al., JCCP, 74:658-670, 2006), though these findings have never been replicated. Outcome data from the participants in the BA and CT condition of the Jacobson et al. (JCCP, 64:295-304, 1996) trial were analyzed with the same analytic approach used by Dimidjian et al. (JCCP, 74:658-670, 2006). The sample was stratified on the Hamilton Rating Scale for Depression (HRSD) as higher-severity (HRSD ≥ 20) and lower-severity (HRSD ≤ 19). Treatment differences in change over time on the HRSD, Beck Depression Inventory (BDI), as well as response (≥ 50% change) and remission on each scale, were examined. Tests of moderation with severity as a categorical or continuous variable were conducted, and we explored the effect of severity by treatment on relapse. The results of Dimidjian et al. (JCCP, 74:658-670, Dimidjian et al. 2006) were not replicated. Tests of moderation with severity as a continuously measured variable (with the BDI or HRSD) also failed to find that BA was more effective than CT for more severe depression. No differences by severity emerged over the follow-up period. BA and CT may be roughly equivalent in the treatment of mild, moderate, and severe depression.

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The Potential and Challenges of Virtual Reality as an Adjunctive Treatment of Depression Patients

Kim,

Kim

2024

Advances in Experimental Medicine and Biology

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Behavioral activation versus physical activity via the internet: A randomized controlled trial

Cited by 39 publications

References 65 publications

Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults With Depression (The eMotion Study): Pilot Randomized Controlled Trial

Web-Based Intervention Using Behavioral Activation and Physical Activity for Adults With Depression (The eMotion Study): Pilot Randomized Controlled Trial

Is Behavioral Activation (BA) More Effective than Cognitive Therapy (CT) in Severe Depression? A Reanalysis of a Landmark Trial

The Potential and Challenges of Virtual Reality as an Adjunctive Treatment of Depression Patients

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