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      The Effectiveness of a Mobile Phone–Based Physical Activity Program for Treating Depression, Stress, Psychological Well-Being, and Quality of Life Among Adults: Quantitative Study

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          Abstract

          Background

          Depression is a substantial global health problem, affecting >300 million people and resulting in 12.7% of all deaths. Depression causes various physical and cognitive problems, leading to a 5-year to 10-year decrease in life expectancy compared with the general population. Physical activity is known to be an effective, evidence-based treatment for depression. However, people generally have difficulties with participating in physical activity owing to limitations in time and accessibility.

          Objective

          To address this issue, this study aimed to contribute to the development of alternative and innovative intervention methods for depression and stress management in adults. More specifically, we attempted to investigate the effectiveness of a mobile phone–based physical activity program on depression, perceived stress, psychological well-being, and quality of life among adults in South Korea.

          Methods

          Participants were recruited and randomly assigned to the mobile phone intervention or waitlist group. Self-report questionnaires were used to assess variables before and after treatment. The treatment group used the program around 3 times per week at home for 4 weeks, with each session lasting about 30 minutes. To evaluate the program’s impact, a 2 (condition) × 2 (time) repeated-measures ANOVA was conducted, considering pretreatment and posttreatment measures along with group as independent variables. For a more detailed analysis, paired-samples 2-tailed t tests were used to compare pretreatment and posttreatment measurements within each group. Independent-samples 2-tailed t tests were conducted to assess intergroup differences in pretreatment measurements.

          Results

          The study included a total of 68 adults aged between 18 and 65 years, who were recruited both through web-based and offline methods. Of these 68 individuals, 41 (60%) were randomly assigned to the treatment group and 27 (40%) to the waitlist group. The attrition rate was 10.2% after 4 weeks. The findings indicated that there is a significant main effect of time ( F 1,60=15.63; P=.003; η p 2=0.21) in participants’ depression scores, indicating that there were changes in depression level across time. No significant changes were observed in perceived stress ( P=.25), psychological well-being ( P=.35), or quality of life ( P=.07). Furthermore, depression scores significantly decreased in the treatment group (from 7.08 to 4.64; P=.03; Cohen d=0.50) but not in the waitlist group (from 6.72 to 5.08; P=.20; Cohen d=0.36). Perceived stress score of the treatment group also significantly decreased (from 2.95 to 2.72; P=.04; Cohen d=0.46) but not in the waitlist group (from 2.82 to 2.74; P=.55; Cohen d=0.15).

          Conclusions

          This study provided experimental evidence that mobile phone–based physical activity program affects depression significantly. By exploring the potential of mobile phone–based physical activity programs as a treatment option, this study sought to improve accessibility and encourage participation in physical activity, ultimately promoting better mental health outcomes for individuals with depression and stress.

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          Most cited references65

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          The PHQ-9: validity of a brief depression severity measure.

          While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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            A Global Measure of Perceived Stress

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              Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures

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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                2023
                26 June 2023
                : 11
                : e46286
                Affiliations
                [1 ] Hanyang Digital Healthcare Center Hanyang University Seoul Republic of Korea
                [2 ] Department of Cognitive Sciences School of Intelligence Hanyang University Seoul Republic of Korea
                [3 ] Graduate School of Public Policy Hanyang University Seoul Republic of Korea
                [4 ] Department of Sport, Health, and Rehabilitation College of Physical Education Kookmin University Seoul Republic of Korea
                [5 ] Division of Global Sport Industry Hankuk University of Foreign Studies Gyeonggi-do Republic of Korea
                [6 ] Department of Health & Human Performance University of Houston Houston, TX United States
                Author notes
                Corresponding Author: Ye Hoon Lee leeye22@ 123456o365.hufs.ac.kr
                Author information
                https://orcid.org/0000-0002-1177-6096
                https://orcid.org/0000-0003-4562-1620
                https://orcid.org/0000-0002-5101-9858
                https://orcid.org/0000-0003-2257-8455
                https://orcid.org/0000-0003-4611-716X
                https://orcid.org/0000-0002-3427-892X
                https://orcid.org/0009-0000-4782-6895
                https://orcid.org/0009-0006-3848-6482
                Article
                v11i1e46286
                10.2196/46286
                10337328
                37358905
                1941adc4-c1dd-48af-b09c-65dc09092dce
                ©Hyungsook Kim, Kikwang Lee, Ye Hoon Lee, Yoonjung Park, Yonghyun Park, Yeonwoo Yu, Jaeyoung Park, Sihyeon Noh. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 26.06.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 7 February 2023
                : 14 March 2023
                : 10 April 2023
                : 16 May 2023
                Categories
                Original Paper
                Original Paper

                depressive symptoms,mobile intervention,exercise,internet-based fitness,mental health

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