4 - (SYM 68) Exercise for Mood: Cultural Adaptations of a Group Exercise Intervention for an Urban and Diverse Community Outpatient Setting

Background: Mood and anxiety disorders are common and impairing; but many do not respond or have access to traditional interventions. This study adapted an Exercise for Mood group intervention to increase feasibility, acceptability, and efficacy for a culturally diverse urban community of outpatients with moderate to severe anxiety and depressive symptoms.

Methods: 20 low-active patients (Mean age=48.0(11.7), 90% female, 24% white, 65% Hispanic; 87.5% with ≥1 medical comorbidity) experiencing anxiety and/or depressive symptoms participated in 3 weekly 1-hour sessions of an Exercise for Mood group. The intervention included motivational principles for exercise and was adapted for the Bronx population which faces substantial poverty, disparities in health care, and exposure to community violence.  Adaptations included tailoring exercise options (e.g., free neighborhood activities) and creating culturally responsive examples and handouts.  Participants completed weekly measures of exercise (International Physical Activity Questionnaire; measured in metabolic equivalents [METS]), depression (CES-D), distress intolerance (Distress Intolerance Index; DII), perceived stress (Perceived Stress Scale; PSS), and quality of life (QLESQ) as well as a 1-month follow-up.

Results: Depression (28.2[10.3]) and DII (24.9[6.5]) were high at baseline. 75% of participants completed all sessions. Participants rated the intervention as highly credible with mean ratings of 7.39 (logical) and 7.61 (success at reducing symptoms) of 9. 72% expected symptoms would improve by ≥50%. Mean METs of exercise increased over time (Week 1: 2550.3±3589.5; Week 3 (post-intervention): 3510.3±3567.9; F/U: 3782.2±4490.8) with significant change from Week 1 to Week 3 (mean change[MC]=1035.7, p=.03, d=0.34). At follow-up, mean DII (Week 1: 24.9±1.5; F/U: 18.6±2.8; MC =5.5; p=.03, d=0.75) and PSS (Week 1: 23.1±1.1; F/U: 19.8±2.3; MC=-4.3, p=.03, d=0.49) were lower than baseline. No significant changes occurred for CES-D or QLESQ.

Conclusions: The intervention demonstrated strong feasibility and acceptability across participants with diverse ethnic/racial backgrounds in an urban setting. These pilot data suggest that a brief, adapted intervention focusing on mood benefits of exercise may help to increase overall activity and improve stress and resilience. This may be especially useful for populations at risk for health problems (e.g., higher obesity rates) and with chronic exposure to stress as exercise may help to improve both physical and mental health.