Open Collections

Abstract

Depression has remained a global mental health concern for decades. Physical activity (PA) interventions have been shown to alleviate depressive symptoms; however, access to PA programs tailored specifically for individuals with depression remains limited. This dissertation focused on the development of an evidence-based, app-based PA behaviour change intervention (MoodMover) for individuals with depression, following a systematic and phased approach. The development process integrated the Obesity-Related Behavioural Intervention Trials (ORBIT) model and the Integrate, Design, Assess, and Share (IDEAS) framework, and was grounded in the Multi-Process Action Control (M-PAC) framework. Study 1 involved a systematic review of internet-based self-help (IGSH) interventions that incorporated PA promotion for depression. The review highlighted the need for well-designed, theory-driven PA apps targeting depression and contributed to six recommendations for the future development and evaluation of IGSH PA interventions. Study 2 was a secondary data analysis examining the moderating role of mental health status within an adapted M-PAC framework. Findings suggested that mental health status only partially moderated the relationships in the model, supporting the appropriateness of the M-PAC framework for understanding PA behaviour among adults with poor mental health. Nevertheless, further prospective research is needed to test the full model. Study 3 described the formative development of MoodMover, including needs assessment, intervention planning, development, and usability testing, presented following the IDEAS framework. Both qualitative and quantitative usability testing results indicated good usability and strong interest in using an enhanced version of the app. These findings informed Study 4, a single-arm, pre-post proof-of-concept and feasibility study that fits within Phases IIa and IIb of the ORBIT model. Proof-of-concept results from Study 4 were generally encouraging and demonstrated the potential of MoodMover to promote PA among individuals with depression. However, usability and feasibility outcomes indicated that further refinements are needed before progressing to a larger-scale efficacy trial. Collectively, the studies in this dissertation contributed to the development of the first app-based, PA-focused behaviour change intervention specifically designed for individuals with depression. While further refinement and evaluation are necessary, MoodMover shows promise as a scalable and accessible adjunctive treatment for depression through the promotion of PA.