The experience of a physical activity counseling intervention among people with major depression within the PACINPAT trial – A reflexive thematic analysis

Abstract

IntroductionPhysical activity can be an effective complementary treatment for major depression, yet among afflicted people, physical inactivity is prevalent. The aim of the “Physical Activity Counseling in In-Patients with Major Depression” (PACINPAT) trial was to promote a more physically active lifestyle by implementing a theory-based in-person and remote counseling intervention. It is not only important to establish whether this approach works, but also how, when and why it works. Hence, the aim of this study was to explore how participants receiving a theory-based physical activity counseling intervention experienced the intervention. MethodsSemi-structured interviews were conducted with 12 participants who were recruited purposively after completing the intervention and data assessments within the PACINPAT randomized controlled trial being conducted in four Swiss psychiatric clinics. The interviews were analyzed according to the six steps of reflexive thematic analysis. FindingsTwelve initially physically inactive adults described managing life with depression as “balancing pressures” which strongly influenced their well-being and physical activity behaviors. This became visible in the varying experiences to the intervention: (1) Expansive: increasing well-being with maintained physical activity; (2) Adoptive: fragile well-being with relationship-dependent physical activity; (3) Stagnant: declining well-being with shift away from physical activity; and (4) Confirmatory: unchanged well-being with unaffected physical activity. ConclusionParticipants with major depression who took part in the same physical activity counseling intervention experienced it in four distinguishable ways, which were noticeably linked with their level of self-management. Identifying these experience patterns is promising, because it could lead to refining the intervention to improve effectiveness for individuals. Further investigation is required to validate these suggested experience patterns. Trial registrationSRCTN, ISRCTN10469580, registered on 3rd September 2018.