Abstract
BackgroundPrevalence of depression is increasing in young people, and there is a need to develop and evaluate behavioural interventions which may provide benefits equal to or greater than talking therapies or pharmacological alternatives. Exercise could be beneficial for young people living with depression, but robust, large-scale trials of effectiveness and the impact of exercise intensity are lacking. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery.MethodsThe design is a three-arm cluster randomised controlled feasibility trial with embedded process evaluation. Participants will be help-seeking young people, aged 13–17 years experiencing mild to moderate low mood or depression, referred from three counties in England. The intervention will be delivered by registered exercise professionals, supported by mental health support workers, twice a week for 12 weeks. The three arms will be high-intensity exercise, low-intensity exercise, and a social activity control. All arms will receive a ‘healthy living’ behaviour change session prior to each exercise session and the two exercise groups are energy matched. The outcomes are referral, recruitment, and retention rates; attendance at exercise sessions; adherence to and ability to reach intensity during exercise sessions; proportions of missing data; adverse events, all measured at baseline, 3, and 6 months; resource use; and reach and representativeness.DiscussionUK National Health Service (NHS) policy is to provide young people with advice about using exercise to help depression but there is no evidence-based exercise intervention to either complement or as an alternative to medication or talking therapies. UK National Institute for Health and Care Excellence (NICE) guidelines suggest that exercise can be an effective treatment, but the evidence base is relatively weak. This feasibility trial will provide evidence about whether it is feasible to recruit and retain young people to a full RCT to assess the effectiveness and cost-effectiveness of an exercise intervention for depression.Trial registrationISRCTN, ISRCTN66452702. Registered 9 April 2020.
Highlights
The prevalence of depression amongst young people is high worldwide and recorded rates have increased significantly since the 1980s [1,2,3]
Evidence suggests that there are significant disparities in mental health experiences amongst specific groups of young people. Those identifying as lesbian, gay, bisexual, and transgender (LGBT) report experiencing depression and anxiety, suicidality, and self-harm at considerably higher rates than heterosexual young people of a similar age, influenced by factors such as bullying and perceived stigma [14, 15]
The intervention will be delivered by registered exercise professionals (REP), employed by local physical activity providers (e.g. Watford FC Community and Sports Trust, Active Luton, Norwich City FC Community Sports Foundation), in local community venues
Summary
Background and rationale The prevalence of depression amongst young people is high worldwide and recorded rates have increased significantly since the 1980s [1,2,3]. By 13–15 years, more girls are diagnosed with depression compared to boys [11] The reasons for this trend are not fully understood but may be related to hormonal changes during puberty, or the tendency for greater internalisation of emotion in girls [4]. These findings are supported by a recent large-scale survey in England (aged 11–15) which found poorer emotional health and wellbeing amongst adolescent girls compared to boys [12, 13]. This study aims to test whether a randomised controlled trial (RCT) of an intervention targeting young people living with depression is feasible by determining whether it is possible to recruit and retain young people, develop and deliver the intervention as planned, and evaluate training and delivery
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