Title: The H.E.A.L.T.H. Project: Help Enabling Active Lifestyles Toward Health in young people with depression.
Funder: Department of Health (England)

Abstract: Background Systematic reviews suggest exercise is helpful in depression, but there is a lack of well-designed studies that include young people seeking help with this. When testing the effect of exercise on mental health outcomes researchers often use interventions based on national guidelines of exercise levels thought to produce health benefits. But, this research team’s previous work in depression suggests that an intervention matched to peoples’ preferred exercise levels may produce better outcomes and that motivational coaching and psychosocial support enables ongoing exercise participation. We propose to evaluate whether doing an enabling exercise programme tailored to their exercise preferences improves mental health outcomes and exercise compliance in young people with depression. Aims The aims of the proposed study are to: 1. Compare mental health outcomes in depressed young people receiving an exercise intervention tailored to their preferred exertion level and designed to enable ongoing participation, with mental health outcomes for depressed young people in a waiting list control group. 2. Explore young people’s experiences of exercise in the treatment of their mental health difficulties. 3. Investigate the attrition rate for the tailored exercise intervention group. 4. Investigate longevity of changes in exercise habit with a six month follow up. 5. Conduct an economic evaluation of the tailored exercise intervention. Plan of Investigation A pragmatic randomised controlled trial (PRCT) and an associated qualitative study is proposed. 158 depressed young people attending CAMHS in Nottinghamshire will be randomly allocated into a group receiving 12x 60 minute exercise sessions, or a waiting list control group. The intervention group will also receive psychosocial support and motivational coaching throughout each session to facilitate ongoing participation and enduring change. The primary outcome measure is the Children's Depression Inventory, alongside measures of self-esteem, self-efficacy, physical fitness, cost-effectiveness, ongoing treatment, compliance, service outcomes. 20 participants will also be invited to attend one of 3 focus groups of 45 minutes duration. Participants will be followed up 6 months afterwards. Potential Impact The proposed study may stimulate wider debate about therapeutic use of exercise across the mental health sector and beyond, and has the potential to amend practice locally, bringing benefits to local people. Broad inclusion criteria will give a better indication of how useful the results are to the wider public health community as the participants will be representative of those whom clinicians see on a regular basis. There is potential for services to save money and use resources more effectively with reduced attrition than exercise on script. Our intervention is designed to offer an improvement to mainstream exercise on prescription with better accessability, better adherence, better outcomes and enduring change in exercise habit with few, if any, adverse effects.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MENTAL HEALTH