The Effectiveness of Internet-Guided Self-help Interventions to Promote Physical Activity Among Individuals With Depression: Systematic Review

Abstract

Background Depression is a prevalent and debilitating mental disorder and a leading cause of disability worldwide. Physical activity (PA) interventions have been shown to alleviate depressive symptoms. However, not all patients have access to PA programing tailored for depression. Internet-guided self-help (IGSH) interventions may be an effective option for increasing PA among people with depression who cannot or prefer not to access supervised exercise treatment. Objective We aimed to evaluate the effectiveness of IGSH interventions in increasing PA and alleviating depressive symptoms in people with depression. Methods A systematic literature search was conducted for randomized controlled trials and quasiexperimental studies using 9 electronic databases. The review was registered in PROSPERO (2020 CRD42020221713). Results A total of 4 randomized controlled trials (430 participants) met the inclusion criteria. Of these, 3 were web-based and 1 was app-based. Three studies found IGSH interventions to have medium to large effects on decreasing depressive symptoms but not on increasing PA compared with waitlist or usual care. One study showed increased self-reported PA but no significant difference in depressive symptoms in the intervention group compared with the control group. Goal setting was the most common behavior change technique used in the interventions. Dropout rates within the intervention groups were relatively low (0%-19%). Conclusions Our findings suggested that IGSH PA interventions are feasible and have the potential to reduce depressive symptoms in people with depression. More well-designed and tailored interventions with different combinations of behavior change techniques, particularly those targeting the emotion domain, are needed to assess the overall effectiveness and feasibility of using IGSH interventions to increase PA among people with depression. Trial Registration PROSPERO CRD42020221713; https://tinyurl.com/ysaua5bu