{
  "abstract": "Introduction: Physical activity interventions for adolescents with depression often show limited effectiveness due to insufficient developmental tailoring, limited autonomy support, and poor contextual feasibility. BRIDGES (Brussels Resilience and Inclusion for Depression – Guidance, Exercise, and Support) is a theory-informed and co-designed physical activity intervention integrating the COM-B model, self-determination theory and motivational interviewing to support autonomous and competence-enhancing engagement. This pilot randomized controlled trial uses a hybrid type 2 implementation–effectiveness design to examine feasibility, acceptability, implementation processes and obtain preliminary estimates of clinical effectiveness to inform a future larger-scale trial. Methods and analysis: Sixty physically inactive adolescents aged 12–19 years with depression will be recruited from an outpatient mental health service in Brussels, Belgium. Participants will be randomized in waves using covariate-adaptive minimization with a biased-coin component (p=0.85), balancing baseline depression severity, physical activity level, gender and age. The intervention consists of 18 individualized physiotherapist-led counselling sessions delivered over 12 weeks, including structured support to facilitate transition to community-based physical activity. Primary feasibility, acceptability, implementation outcomes will be assessed using quantitative measures and semi-structured interviews with adolescents, caregivers and community partners, guided by the Practical, Robust Implementation and Sustainability Model (PRISM) and the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Preliminary effectiveness outcomes are changes in physical activity measured using the Physical Activity Vital Sign (PAVS) and depressive symptoms measured using the Patient Health Questionnaire-9 modified for Adolescents (PHQ-A). Preliminary effectiveness will be analysed using linear mixed-effects models following an intention-to-treat approach to estimate cluster-level parameters for a future fully powered Hybrid Type 2 trial. Secondary outcomes include social support, exercise self-efficacy, cardiorespiratory fitness and waist-to-height ratio. Qualitative data will be analysed using the Qualitative Analysis Guide of Leuven. Trial registration: ClinicalTrials.gov NCT07422909",
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  "affiliations": [
    "Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium",
    "AREA+, Psychiatric Units for Adolescents, Epsylon ASBL Psychiatric Network, Brussels, Belgium",
    "UCLouvain, Louvain-la-Neuve, Institute of Neuroscience, Belgium",
    "University Psychiatric Center KU Leuven, Leuven, Belgium",
    "UCLouvain, Bruxelles-Woluwe, Institute Health and Society, Belgium",
    "Leuven Brain Institute, Leuven, Belgium"
  ],
  "article_type": "Study Protocol",
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  "author_total": 11,
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      "name": "Arnaud Philippot",
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      "name": "Irène Ibanez"
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      "name": "Marine Coppens"
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      "name": "Coralie Eeckhout"
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      "name": "Catherine Cescutti"
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      "name": "Alexandre Beine"
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      "name": "Esther Meers",
      "orcid": "0009-0004-0626-6317"
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    {
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        3
      ],
      "name": "Tine Van Damme"
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    {
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      ],
      "name": "Marc Francaux"
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    {
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        4
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      "name": "Vincent Dubois"
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    {
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        5
      ],
      "name": "Davy Vancampfort",
      "orcid": "0000-0002-4592-8625"
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  "bibtex": "https://research.draconitic.com/paper/9cwsztn7wswqa.bib",
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  "doi": "10.1371/journal.pone.0360292",
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  "published": "2026-10-27",
  "publisher": "Public Library of Science",
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  "title": "Bridging the gap: Implementing BRIDGES (Brussels Resilience and Inclusion for Depression - Guidance, Exercise and Support) to shape adolescent outpatient mental health care. A pilot randomized controlled study protocol",
  "title_text": "Bridging the gap: Implementing BRIDGES (Brussels Resilience and Inclusion for Depression - Guidance, Exercise and Support) to shape adolescent outpatient mental health care. A pilot randomized controlled study protocol",
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