Effects and moderators of a 16-week intervention on contextual physical activity in adults with moderate to severe depressive symptoms: short and long-term results of a randomized clinical trial
- 1Physical Education Department, Federal University of Santa Catarina
- 2CHEO Research Institute
- 3Postgraduate Program in Public Health, State University of Ceará
Abstract
Background Depression is associated with reduced physical activity (PA), and evidence on the long-term effects of interventions and their potential moderators remains limited. Thus, this study aimed to evaluate the short- (post-intervention) and long-term (six-month follow-up) effects of a PA-promoting intervention on contextual PA and to explore potential moderators in adults with depressive symptoms. Methods A randomized, controlled, and assessor-blinded clinical trial was conducted with adults presenting depressive symptoms. The intervention lasted 16 weeks, with two sessions per week. Strategies were grounded in Self-Determination Theory and aimed to increase participants’ awareness of their lifestyle, primarily focusing on PA and its relationship with depression. Activities included lectures, group discussions, interactive activities with family and friends, and PA practices in different contexts. Intensity-specific PA was assessed using wrist-worn accelerometers, and contextual PA (by type and domain) was self-reported. Generalized estimating equations were used to assess intervention effects. Potential moderators (sex and age) were examined in exploratory analyses using three-way interaction terms. Results A total of 78 individuals (76.9% women, mean age 37.5 ± 10.2) were equally randomized into control (CG) and intervention (IG) groups. No significant group-by-time interactions were identified in the intention-to-treat analyses. However, per-protocol analysis suggested that the intervention increased leisure-time PA compared to controls (p = 0.004), with short-term increases (between-group changes of 119.6 min/week) and maintenance at follow-up (83.6 min/week). Exploratory moderator analyses indicated potential differences in intervention effects according to sex and age. Conclusion Although no significant effects were identified in the intention-to-treat analyses, per-protocol findings suggested potential increases in leisure-time PA among participants with higher adherence. Exploratory findings indicate possible variation according to sex and age, but these results should be interpreted with caution and considered hypothesis-generating. Overall, the findings highlight the importance of strategies to improve adherence in PA interventions targeting adults with depressive symptoms. Trial registration Brazilian Registry of Clinical Trials (ReBEC) RBR7466htj, April, 17 2023. Retrospectively registered.
Related
- Effects of a Web-Based Debiasing Intervention on Brazilian Psychologists’ Accuracy on Major Depressive Disorder Diagnostic Tasks: A Randomized Training Intervention
- m-Health intervention for physical activity among patients with type 2 diabetes mellitus in India: a randomized controlled trial
- Structured physical activity, yoga, and music-based interventions for depressive symptoms in adolescents: a systematic review and meta-analysis of randomized controlled trials
- Effects of a combined diet and physical activity intervention (the ALAPAGE program) on dietary diversity and lower-limb muscle strength in community-dwelling older people: a pragmatic randomized controlled trial.
- Differential roles of confidence and competence in the association between understanding and enjoyment of physical activity: developmental and demographic moderators in children and adolescents
BibTeX
@article{bertuol2026effects,
title = {{Effects and moderators of a 16-week intervention on contextual physical activity in adults with moderate to severe depressive symptoms: short and long-term results of a randomized clinical trial}},
author = {Cecília Bertuol and Kelly Samara Silva and Marcus Vinicius Veber Lopes and Deborah Kazimoto Alves and Caroline Soares da Silva and Marcelo Baggio do Amaral and Anne Ribeiro Streb and Giovani Firpo Del Duca},
journal = {International Journal of Behavioral Nutrition and Physical Activity},
year = {2026},
month = jul,
doi = {10.1186/s12966-026-01950-9},
url = {https://doi.org/10.1186/s12966-026-01950-9},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects and moderators of a 16-week intervention on contextual physical activity in adults with moderate to severe depressive symptoms: short and long-term results of a randomized clinical trial
AU - Cecília Bertuol
AU - Kelly Samara Silva
AU - Marcus Vinicius Veber Lopes
AU - Deborah Kazimoto Alves
AU - Caroline Soares da Silva
AU - Marcelo Baggio do Amaral
AU - Anne Ribeiro Streb
AU - Giovani Firpo Del Duca
PY - 2026
DA - 2026/07/01
JO - International Journal of Behavioral Nutrition and Physical Activity
DO - 10.1186/s12966-026-01950-9
UR - https://doi.org/10.1186/s12966-026-01950-9
AB - Background Depression is associated with reduced physical activity (PA), and evidence on the long-term effects of interventions and their potential moderators remains limited. Thus, this study aimed to evaluate the short- (post-intervention) and long-term (six-month follow-up) effects of a PA-promoting intervention on contextual PA and to explore potential moderators in adults with depressive symptoms. Methods A randomized, controlled, and assessor-blinded clinical trial was conducted with adults presenting depressive symptoms. The intervention lasted 16 weeks, with two sessions per week. Strategies were grounded in Self-Determination Theory and aimed to increase participants’ awareness of their lifestyle, primarily focusing on PA and its relationship with depression. Activities included lectures, group discussions, interactive activities with family and friends, and PA practices in different contexts. Intensity-specific PA was assessed using wrist-worn accelerometers, and contextual PA (by type and domain) was self-reported. Generalized estimating equations were used to assess intervention effects. Potential moderators (sex and age) were examined in exploratory analyses using three-way interaction terms. Results A total of 78 individuals (76.9% women, mean age 37.5 ± 10.2) were equally randomized into control (CG) and intervention (IG) groups. No significant group-by-time interactions were identified in the intention-to-treat analyses. However, per-protocol analysis suggested that the intervention increased leisure-time PA compared to controls (p = 0.004), with short-term increases (between-group changes of 119.6 min/week) and maintenance at follow-up (83.6 min/week). Exploratory moderator analyses indicated potential differences in intervention effects according to sex and age. Conclusion Although no significant effects were identified in the intention-to-treat analyses, per-protocol findings suggested potential increases in leisure-time PA among participants with higher adherence. Exploratory findings indicate possible variation according to sex and age, but these results should be interpreted with caution and considered hypothesis-generating. Overall, the findings highlight the importance of strategies to improve adherence in PA interventions targeting adults with depressive symptoms. Trial registration Brazilian Registry of Clinical Trials (ReBEC) RBR7466htj, April, 17 2023. Retrospectively registered.
SN - 1479-5868
ER -