Conclusions: This study suggests that the sleep of chronic users of sleep medications is no better than that of drug-free patients complaining of insomnia. It is disturbing that 42% of the patients treated pharmacologically for insomnia also suffers from sleep apnoea. We suggest careful sleep assessment as a prerequisite for long-term prescription of sleep medications. Four unhealthy behaviors are especially prevalent. in industrialized cultures: eating a high-fat diet, consuming few fruits and vegetables, extensive television viewing, and low moderatevigorous physical activity. Public health guidelines advise correcting all of these unhealthy behaviors, but little guidance is available about the best approach. To address that question, we conducted a head-to-head comparative effectiveness randomized clinical trial (n=200) of four diet and activity interventions, all of which entailed guideline-recommended behavior change. In each condition, participants modified one diet and one activity behavior, while effects on all four behaviors were evaluated as an aggregated healthy lifestyle score. Results indicated that the conventional intervention practice of increasing physical activity and decreasing fat intake produced the least improvement in overall healthy lifestyle. Conversely, a novel approach suggested by behavioral economic theory (increase fruits/ vegetables and decrease recreational screen time) maximized acrossthe-board healthy lifestyle change. To fulfill its full potential, however, comparative effectiveness research needs to extend beyond determining only what works best for the average patient. In the present study, for example, traditional dieting (decrease fat, increase physical activity) minimized overall healthy lifestyle change for females but maximized it for males, suggesting that gender-tailored guidance might be needed. Comparative effectiveness research holds potential to undergird personalized, evidence-based behavioral medicine. The aim is for intervention decisions to be guided by evidence that conveys what works best for particular types of individuals or communities and in different settings and circumstances. Depression is a very common and disabling condition. Prevalence rates of major depressive disorder (MDD) have been estimated to be a high as 25%, with point prevalence rates estimated at up to 45% for patients with minor depression (mDD) or elevated depressive symptoms. Moreover, depression in cardiac patients has been associated with greater than a 2-fold increase in risk for adverse clinical events, including death. Although effective treatments for depression are available, the optimal ways to manage depression in cardiac patients are not known. This presentation will briefly review the prior randomized clinical trials for treating depression using cognitive behavioral therapy (CBT) and pharmacotherapy. Recent studies of exercise in treating depression also will be reviewed, and data examining the comparative efficacy of exercise, medication and CBT will be examined. The added physical and mental health benefits of exercise training in treating depression in cardiac patients will be highlighted and directions for future research in the area will be discussed. Older people are the least active segment of the population. This contributes to their high level of disease (including cardiovascular disease), disability and healthcare usage. Practical and effective interventions are needed to increase activity in this population. A brief behavioural change intervention consisting of goal setting, planning, self monitoring delivered with or without a pedometer was compared with no treatment in a 3 arm prospective study of 204 sedentary community dwelling women aged ≥70 years (average age 77 years). The primary outcome was daily activity counts assessed by accelerometer over 7 days prior to treatment, at 3 months and at 6 months. Secondary outcomes included lower limb function, health related quality of life, anxiety, depression and falls. 179 women completed the trial with most dropouts from the behaviour change alone condition (15/68). Over the first 3 months activity increased reliably more in the intervention groups than the control (which did not change). Pedometers did not add to the effects of the behaviour change techniques. The increase in activity was not maintained at the 6 month assessment. The secondary outcomes were not affected by the intervention. The psychological and behavioural processes mediating the change in activity, and the failure to sustain it, will be discussed. Heart failure (HF) affects millions of individuals and is increasing in prevalence each year as the population ages. Approximately one third of HF patients experience clinical depression symptoms, which are further associated with elevated risk of cardiovascular hospitalization and mortality. However, depression treatments such as cognitive-behavioral therapy (CBT) do not decrease morbidity/mortality in patients with coronary heart disease. This is not surprising since recent evidence suggests somatic but not cognitive/affective depressive symptoms have a greater association with cardiovascular-related mortality and events. Somatic symptoms such as fatigue and sleep disturbances are common among HF patients that may lead to physical inactivity and create a spiraling decline in physical and cardiac function. Indeed, physical inactivity is associated with reduced quality of life and greater morbidity and mortality in HF. Meanwhile, Tai Chi practice is observed to increase vigor, and reduce tension, anger and fatigue. Tai Chi emphasizes a holistic approach, both mind and body. It is a meditative exercise originating from China, and with its moderate intensity and relative ease of performance it is well-suited even for those with significant physical impairments. The present study consists of HF patients (n=29 completers; 43-83 years old; mean age=72.9, SD=5.1) that had Tai chi training (n=19) twice per week for 12 weeks or were in a waitlist control group (n = 10). At baseline and after the 12-week intervention period, patients completed the Beck Depression Index (BDI), subcategorized into somatic (BDI-s) and cognitive (BDI-c) symptoms, and the Multidimensional Fatigue Symptom Inventory -Short Form (MFSI-SF). All subjects also were measured pre-and post-intervention period for physical function, in a 6-min walk task. Compared to controls, HF patients in the Tai Qigong is a traditional Chinese energy medicine practice combining breathing, movement, and meditation. Qigong therapy is becoming a popular adjunctive treatment for type 2 diabetes. Previous studies have suggested benefits of Qigong practice for this disease; however, its effectiveness has never been rigorously evaluated in adults diagnosed with type 2 diabetes. We conducted a randomized, controlled 3-arm clinical trial in comparing 12weeks of Qigong, Progressive Resistance Training (PRT), or usual care in 32 adults with type 2 diabetes. Outcome measures included fasting glucose, hemoglobin A1c, insulin, C-peptide, BMI, HOMA-IR, Perceived Stress Scale (PSS) and Beck's depression Index (BDI) before, during and at the end of the interventions. We found that body weight increased in the usual care group, but S272 Int.J. Behav. Med. (2010) 17(Suppl 1):S1-S329 decreased in both Qigong and PRT groups. Additionally, the Qigong group showed significant reductions in fasting glucose (P=0.003) and PSS (P=0.045) and also demonstrated trends for improved insulin resistance, as measured by the HOMA-IR Index. In contrast, the PRT group showed a significant reduction in depression scores with an increase in fasting glucose and insulin resistance, which also increased in the usual care group (NS). In this presentation, I will discuss three key themes in conducting comparative efficacy clinical trials: 1) understanding the different schools of Qigong; 2) choosing the best control group for Qigong intervention; and 3) choosing an appropriate patient population with type 2 diabetes for Qigong intervention. Complementary therapies are popular and frequently used by patients with CVD. Survey data indicate that herbal therapies and mind-body therapies are most commonly used. One such treatment option is qigong. Several reviews have claimed that qigong has therapeutic effects on blood pressure in patients with hypertension. However, these reviews are non-systematic and therefore open to bias. To systematically assess the clinical evidence of qigong for hypertension. Databases were searched up to December 2009. All randomized clinical trials testing qigong in patients with hypertension of any origin and assessing clinically relevant outcomes were considered. Trials using any type of control intervention were included. The selection of studies, data extraction and quality assessment were performed independently by at least two reviewers. Methodological quality was evaluated using the Jadad score. 12 RCTs could be included. Seven of these RCTs tested qigong in combination with antihypertensive drugs compared with antihypertensive drugs alone. The meta-analysis of four trials reporting adequate data suggested beneficial effects in favour of qigong (weighted mean difference, systolic blood pressure (mmHg) -12.06, 95% confidence interval (CI) -17.12 to -7.00; diastolic blood pressure -8.46, 95% CI -12.55 to -4.37). Qigong alone was compared with waiting list control in 2 RCTs and was found to significantly reduce systolic blood pressure (weighted mean difference (mmHg) -18.46, 95% CI -23.07 to -13.86). In further three RCTs comparisons made were: qigong combined with antihypertensive drugs versus muscle relaxation combined with antihypertensive drugs; qigong as a sole treatment versus exercise and/or antihypertensive drugs, all reported positive results in at least some of the relevant outcome measures. The methodological quality of the original studies was low. There is some encouraging evidence to suggest that qigong is effective for lowering systolic blood pressure. However, the conclusiveness of these findings is limited. Rigorously designed trials seem warranted to confirm these results. After-school activities provide valuable opportunities for health promotion activities that do not interfere with the regular school day, especially in minority populations with higher rates of obesity and type 2 diabetes. The current study is an evaluation of an after-school health education and physical activity program conducted in 8 elementary schools along the U.S.-Mexico border in El Paso, Texas.