Depression, Inactive People
Conditions
Keywords
Depression, Physical Activity, Adolescents, Community-level, Outpatient, Physiotherapy, Inactive, psychiatry
Brief summary
Together with teenagers, we have developed a new approach: BRIDGES, which stands for "In Brussels, Resilience and Inclusion for Depression through Guidance, Exercise, and Support." BRIDGES aims to help young people with depression get moving again in their daily lives, at their own pace and in ways that are good for them.
Detailed description
Even though physical activity is recognized for its mental and physical health benefits, we find that adolescents going through a difficult psychological period often engage in very little of it. Current physical activity offerings do not always take into account their specific needs, preferences, or daily realities. That is why we have co-created a new approach with adolescents: BRIDGES, which stands for "In Brussels, Resilience and Inclusion for Depression through Guidance, Exercise, and Support." This project includes 18 30-minute sessions over 3 months with a physical therapist specializing in mental health, including individual follow-ups with advice and discussions, as well as putting you in touch with sports clubs or associations of your choice. The goal is to help you get moving again in your daily life, at your own pace and in a way that makes you feel good. This study has a waiting list control group, so young people can either participate immediately or wait 6 months to participate.
Interventions
BEHAVIORALThe BRIDGES (In Brussels, Resilience and Inclusion for Depression through Guidance, Exercise and Support) intervention
Described above
Sponsors
Université Catholique de Louvain
KU Leuven
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Person in charge of randomisation Stastitician in charge of analysis
Intervention model description
This study will use a hybrid type 2 effectiveness-implementation randomized controlled trial design, allowing simultaneous evaluation of the BRIDGES intervention's impact on adolescents and the processes supporting its uptake in routine outpatient care. Implementation will be guided by the Practical, Robust Implementation and Sustainability Model (PRISM) and the RE-AIM framework, which together provide a structured approach to assess how the intervention is delivered, adopted, and sustained across outpatient and community-based settings. This dual perspective enables a comprehensive understanding of both the intervention's effects and the factors influencing its successful integration into real-world clinical practice.
Eligibility
Sex/Gender
ALL
Age
12 Years to 19 Years
Healthy volunteers
No
Inclusion criteria
* All adolescents aged 12 to 19 with a diagnosis of depression who are receiving outpatient care through AREA+ * voluntary participation and accepting the randomisation * being admitted at AREA+ * being able to stay focused for 30 minutes * having a good knowledge of French * physically inactive defined as not meeting the PA guidelines from World Health Organisation (28) following the corresponding age (i.e. at least 420 min of moderate to vigorous physical activity (MVPA) /week for those aged 12-17 and at least 150 min of MVPA /week for those aged 18 and 19 years * living in Brussels
Exclusion criteria
* intellectual disability (defined as an intelligence quotient \< 70) * participants with serious medical problems or medical precautions prohibiting higher-intensity exercise (e.g., severe metabolic disorders, oncologic disease, unstable diabetes) according to the recommendations of the American College of Sports Medicine.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Depressive symptoms | Throughout the entire study, during approximately 15 months | Patient Health Questionnaire-9 modified for Adolescents (PHQ-A) The PHQ-A is a brief instrument modified to adolescents used to assess the severity of depression (41). It contains 9 items that are on a scale from 0 to 3, with the total score ranging from 0 to 27. |
| Physical activity levels | Throughout the entire study, during approximately 15 months | Physical Activity Vital Sign (PAVS) The PAVS is a screening tool used to assess patients' physical activity levels (37). It consists of two questions: (a) on average, how many days per week do you engage in moderate to vigorous physical activity, and (b) on those days, how many minutes do you typically spend participating in moderate to vigorous physical activity? The product of these responses (days × minutes) provides an estimate of the patient's average weekly minutes of physical activity in moderate to vigorous physical activity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Depressive symptoms (larger evaluation) | Throughout the entire study, during approximately 15 months | Beck Depression Index (BDI II) The BDI-II captures specific behavioral manifestations of depression. It is a 21-item self-report inventory, with each item scored from 0 to 3 based on four statements reflecting symptom severity, yielding a total score ranging from 0 to 63. |
| Multidimensional Scale of Perceived Social Support (MSPSS) | Throughout the entire study, during approximately 15 months | The Multidimensional Scale of Perceived Social Support (MSPSS) is a widely used self-report instrument designed to assess an individual's perception of social support from different sources (49). The scale comprises 12 items, each rated on a 7-point Likert scale ranging from a score of 7 to 84. |
| Adapted Exercise self-efficacy (SEE) | Throughout the entire study, during approximately 15 months | Exercise self-efficacy (SEE) is a key determinant of intention formation and engagement in physical activity. In the original SEE, respondents rate their confidence in exercising three times per week for 20 minutes. For the present study, the scale was adapted so that the target behavior reflects an individualized exercise goal defined by each adolescent, that is, the type of physical activity they wish to perform. |
| Astrand Rhyming test (ART) | Throughout the entire study, during approximately 15 months | Astrand Rhyming test (ART) ART is a single-stage cycle ergometer test, to measure the CRF fitness levels (assessed as an estimation of VO2 max) |
| Waist-to-height ratio (WHtR) | Throughout the entire study, during approximately 15 months | Waist-to-height ratio (WHtR) WHtR is calculated as waist circumference (cm) divided by height (cm). Waist circumference will be measured in standing position, midway between the lowest border of the rib cage and the superior border of the iliac crest, at the end of a normal expiration. |
| Motivational interviewing fidelity | Throughout the entire study, during approximately 15 months | Fidelity to motivational interviewing (MI) will be assessed using a combination of observer- and participant-reported measures. First, adherence to MI principles will be evaluated using the Independent Tape Rater Scale (ITRS), which is recommended for effectiveness studies |
| Client Perception of Motivational Interviewing | Throughout the entire study, during approximately 15 months | the Client Perception of Motivational Interviewing (CPMI) scale captures participants' experiences of MI-consistent communication during sessions. This combined approach enables assessment of both the technical and relational components of MI fidelity while remaining feasible within the constraints of a pilot implementation study. |
| The Health Care Climate Questionnaire | Throughout the entire study, during approximately 15 months | Adolescents will complete the Health Care Climate Questionnaire (HCCQ) (61) to evaluate perceived autonomy support provided by the physiotherapist. In addition, brief post-session feedback forms will invite participants to rate the extent to which they felt understood, empowered, and supported in setting their own goals-key indicators of SDT-congruent delivery. |
| Logbook | Throughout the entire study, during approximately 15 months | the physiotherapist will fill out a logbook with their participation describing their presence, the context, the mechanisms at work, and clinical observations on the adolescents and their participation in physical activities |
Countries
Belgium
Contacts
PRINCIPAL_INVESTIGATORArnaud Philippot, PhD
UCLouvain and KU Leuven
STUDY_DIRECTORMarc Francaux, PhD
Université Catholique de Louvain
Outcome results
None listed