An online intervention for increasing physical activity in individuals with mood disorders at risk for cardiovascular disease: Design considerations.

BACKGROUND: Physical activity can mitigate the risk of cardiovascular diseases, but the presence of mood disorders makes it challenging to follow or develop a regular exercise habit. We conducted an online comparative effectiveness study (Healthy Hearts Healthy Minds) to evaluate whether an online psychosocial intervention adjunctive to an activity monitor (Fitbit) can improve adherence to physical activity among individuals with mood disorders who have or are at-risk for cardiovascular disease (CVD). METHODS: In this paper, we explore design considerations (including both procedural challenges and achievements) of relevance to our study. RESULTS: Challenges of this study included navigating a complex IRB review process, integrating two study platforms, automating study procedures, and optimizing participant engagement. Achievements of this study included building trust with collaborators, leveraging existing online communities, generating daily data reports, and conducting patient-centered research. LIMITATIONS: These design considerations are based on a single online comparative effectiveness study, and other online intervention studies may be presented with other unique challenges that are specific to their study format or aims. Consistent with some of the generalizability challenges facing other online studies, participants in this study were overall highly educated (most had at least a college degree). CONCLUSIONS: We successfully conducted a large-scale virtual online intervention to increase physical activity of participants with comorbid mood and cardiovascular disorders by overcoming substantial operational and technical challenges. We hope that this exploration of design considerations in the context of our online study can inform upcoming online intervention studies.

Examining the Feasibility and Acceptability of an Online Yoga Class for Mood Disorders: A MoodNetwork Study.

BACKGROUND: Despite ongoing advances in the treatment of mood disorders, a substantial proportion of people diagnosed with major depression or bipolar disorder remain symptomatic over time. Yoga, which has been shown to reduce stress and depressive symptoms, as well as to improve overall quality of life, shows promise as an adjunctive treatment. However, dissemination of yoga for clinical populations remains challenging. The purpose of this pilot study was to test the feasibility and acceptability of an online yoga intervention for individuals with mood disorders. METHODS: In total, 56 adults who reported being diagnosed with a mood disorder (bipolar disorder, major depressive disorder, cyclothymia, or schizoaffective disorder) were recruited from MoodNetwork, an online community of individuals with mood disorders. A feedback survey and a measure of positive and negative affect were administered before and after a 30-minute online Hatha yoga class. RESULTS: In total, 44 individuals (78.6%) completed all components of the yoga class. The mean score on a 10-point Likert scale rating how much participants liked the online yoga class was 7.24 (SD=2.40). Most participants (67.9%) reported that they would be "somewhat likely" or "very likely" to participate in an online yoga program again. There was a statistically significant decrease in negative affect after completing the class (t=-6.05; P<0.001), but positive affect did not change (P>0.10). DISCUSSION: These preliminary data support the utility of online yoga tailored specifically for people with mood disorders as a possible adjunctive intervention that warrants further investigation.