An innovative approach to integrating physical activity (PA) into the management of mild-to-moderate depression (MMD)

Introduction: Physical activity (PA) has been shown to be as effective as medication or psychological therapies in reducing mild-to-moderate depression(MMD). Despite this, support for increasing PA is not routinely included in the management options offered to MMD patients. We therefore undertook a preliminary study to investigate the potential for the integration of PA into MMD management delivered within the Improving Access to Psychological Therapies (IAPT) service. The study explored: the acceptability of integrating PA into MMD management amongst IAPT staff; the extent to which IAPT already integrates PA into MMD management; infrastructure and training needs of IAPT staff related to promoting PA engagement; and, patients’ experiences of barriers and enablers to PA initiation. Methods: In-depth interviews were conducted with eight IAPT staff(Psychological Wellbeing Practitioners and Cognitive Behavioural Therapists)and twelve individuals with MMD. Transcripts were analysed using[inductive/thematic] approach. Results: The integration of PA into MMD management were seen as enhancing treatment options and having the potential to improve recovery.For IAPT practitioners barriers included uncertainty about negative consequences;lack of time; limited links to local PA providers. For individuals,many personal, social, and cultural factors affected their ability to initiate PA; including the nature of the condition, but also the wider determinants of health such as socioeconomic status, physical and social environments. Conclusion: Whilst integration of PA in MMD management is seen as appropriate and feasible by both patients and practitioners, there are many wider and condition-related factors that will influence successful implementation.