Category: Health Psychology / Behavioral Medicine - Adult
Background: There is growing evidence for the efficacy of regular exercise for treating depression and anxiety (Cooney et al., 2014; Stonerock et al., 2015) and exercise interventions have the potential to improve access to care. However, one challenge in disseminating this intervention is adherence (Rhodes & de Bruijn, 2013). Mobile-based ecological momentary interventions (EMIs) take our treatments beyond the context of the therapy room. They have been efficacious in increasing physical activity (Heron et al., 2010) and could be used to facilitate exercise to improve mood/anxiety. Although there are many exercise mobile apps on the market, none target exercise specifically for improvement of mood or anxiety. As exercising to improve mood and anxiety provides relatively immediate benefits, producing tightly-linked contingencies important for behavior change (Lattal, 2010), an effective EMI for exercise would emphasize these benefits.
Methods: The goal of the current study is to assess the acceptability and efficacy of an EMI for exercise delivered via a mobile app called “Exercise4Mood.” This intervention was developed in accordance with the evidence-based Exercise for Mood & Anxiety protocol (Otto & Smits, 2011) and the app was tested in focus groups. In the current study, a multiple baseline design is employed first with healthy participants (n = 6) and second in patients with anxiety, depression, or traumatic stress disorders (n = 3). Physical activity is assessed using Actigraphy, heart rate, and self-report. Mood and anxiety symptoms and satisfaction with the intervention are assessed using self-report and engagement with the app is monitored.
Results: Patterns of activity across the study period in healthy participants indicated that the intervention promoted increased physical activity as compared to baseline. Participants engaged in an average of 39.6 minutes of exercise the week prior to initiating the intervention and 102.9 minutes of exercise during the last week of the intervention (t = -2.96, p < .05). Engagement with the app was high. On average participants initiated 7 of the 9 modules within the app. Within initiated modules, participants answered questions 95% of the time. All participants engaged with a module that allowed them to track their mood prior to and after exercise. Average ratings indicated a significant increase in mood from pre to post exercise (M= 0.65(0.96) to M(SD) = 1.722(0.88); t = -3.74, p< .05). The components of the intervention and app will be presented as well as findings from the patient sample.
M. Alexandra Kredlow– Graduate Student, Boston University
Josephine Lee– Graduate Student, Boston University
Elijah Patten– Research Assistant, Boston University
Sarah Oppenheimer– Research Assistant, Boston University
Michael Otto– Professor, Boston University, Boston
Michael W. Otto, PhD, is Professor in the Department of Psychological and Brain Sciences at Boston University. He has had a major career focus on developing and validating new psychosocial treatments for anxiety, mood, psychotic, and substance use disorders, with a particular focus on treatment refractory populations. This includes a translational research agenda investigating brain-behavior relationships in therapeutic learning. His focus on hard-to-treat conditions and principles underlying behavior-change failures led him to an additional focus on health behavior promotion, including investigations of addictive behaviors, medication adherence, sleep, and exercise. Across these health behaviors, he has been concerned with cognitive, attention, and affective factors that derail adaptive behaviors, and the factors that can rescue these processes. He also investigates exercise as an intervention for affective and addictive disorders, as well as for cognitive enhancement. He has over 400 publications spanning his research interests, and was identified as a “top producer” in the clinical empirical literature, and an ISI Highly Cited Researcher. He is a Past President of the Association of Behavioral and Cognitive Therapies, and is currently President of Division 12 of the American Psychological Association.