Let's Move: Promotion of Physical Activity in the Treatment of Depression

Monday, 9 November 2015

Josephine A. Igwacho, BSN, RN-BC, BSN
College of Nursing, BSN-DNP, PMHNP, East Tennessee State University, Johnson City, TN, USA

Over the years, the prevalence of chronic diseases (resulting from poor lifestyle behaviors) and especially mental health disorders, such as depression, substance misuse disorders, suicide, and violence are continually on the rise, with depression projected to be the leading cause of disability in the U.S. by 2020 (CDC, 2012). A significant amount of the U.S. health care expenditure is being spent on depression and other mental health disorders. Yet, the efficacy of antidepressants continues to be modest, at best, with poor treatment response and remission rates. According to Gaynes, Lux, and Gartlehner (2012), approximately 70% of patients do not respond to their initial antidepressants while 50% remain resistant to multiple medications. Multiple studies have shown that treatment outcomes are much improved when antidepressants are augmented with other alternative treatment modalities and better self-care management, such as physical activity (Donaghy & Taylor, 2010; Mota-Pereira et al., 2011). Physical activity is one of the most modifiable risk factor against multiple chronic diseases However, many Americans do not meet the recommended guidelines for physical activity (McPhail & Schippers, 2012). 

In order to curb the increasing prevalence of multiple chronic conditions, which result from physical inactivity and other poor lifestyle behaviors, and transform health globally, the status quo must be improved.  The management of chronic diseases must continue to move beyond the heavy focus on medical treatments where patients are passive recipients to models that incorporate integrative and self-care management. Recently, more focus has been on interprofessional collaboration as well as health promotion and preventive services. In this modern era of information technology, patients are increasingly empowered to take the lead in their health care. My scholarly project is centered on the promotion of physical activity as an adjunct treatment in the management of depression and, therefore, in line with this paradigm shift in health care.

The purpose of my project is to encourage physical activity counseling and prescription in the treatment of depression. The specific objectives are to encourage physical activity counseling and the incorporation of physical activity in treatment plans. This system change project is currently being implemented at a community health center in North East Tennessee, using a descriptive pretest posttest design. A presentation for the healthcare providers to encourage physical activity counseling and prescription, coupled with a PowerPoint streaming video for patients in the waiting room, physical activity pyramid poster in patient examination rooms and print brochures for patients have all been implemented. These interventions will provide visual cues and reminders to promote physical activity counseling. Data will be collected two months before and after the interventions using a questionnaire as well as a review of the electronic health record, assessing providers’ perceptions and practices about physical activity counseling and prescription. Data will be analyzed using descriptive statistics and independent t-test. The primary outcome of this project will be an increase in physical activity counseling. It is hoped that providers will not only increase physical activity counseling, but also incorporate it into patients’ plans of care. Further recommendations will be made based on the project outcomes.