ExTRA - Exercise Therapy to Reduce Anxiety Pilot Study

ExTRA will develop and pilot an 8-week self-directed web-based exercise intervention to reduce anxiety in middle-aged and older people with clinically significant anxiety. Participants will undertake the program independently in the community and receive strategies/prompts/encouragement/reminders to their email tailored to activity level measured by a wearable activity monitor (e.g. Fitbit), and rating scale responses – this process will be pre-determined so that it can become an automated or semi-automated process in future research. It will aim to be cost-effective and scalable to increase access. Feasibility and acceptability will be investigated with 20-30 participants. It will target mid-life onwards (40-79 years of age) to maximise impact given the higher risk of chronic disease in this age group. Participants will be orientated to the use of the web-based intervention platform and wearable activity monitor (WAM). The platform will provide education about national physical activity guideline recommendations and provide information resources to assist participants to work towards meeting them; or to maintain or increase beyond if appropriate. The format of the platform includes text, diagrams and links to videos and other useful resource websites. It will also include a dashboard containing their WAM data and links to behaviour change strategies. There will also be templates for goal setting and a weekly planner on the platform. The time involved using the web-based platform is estimated to be around 30 minutes at the beginning of the program and then around 10 minutes per week to be done any time at the participant's discretion. The physical activity undertaken will generally be 150 minutes of moderate intensity aerobic physical activity, with walking being the default activity, although participants can continue or increase an activity type that they are already engaged in such as cycling, swimming or sport. It will be designed with consumer input, including from within the project team. It will link to evidence-based resources including those developed by the team for previous intervention studies such as EXCEL (registration number ACTRN12621001152819). Participants will receive tailored behaviour change strategies, prompts, encouragement and reminders to participants via email and the platform. Tailored strategies will be based on both PA level through WAM data integration with the platform and participant responses to measures including the barriers self-efficacy scale. These emails will be 1-2 short paragraphs including a summary of their WAM data as well as links to selected strategies and will be sent once per week. The strategies used in the program will be informed by previous qualitative research findings led by the research team. Acceptability and usability is being measured via number of log ins and pages clicked which will provide indirect data about fidelity of the intervention.