Sticking with it? Factors associated with exercise adherence in people with mild to moderate depression

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Background:Exercise is an effective treatment for depression but non-adherence is common. The aim of this study was to determine the level of adherence to an exercise intervention, specifically factors associated with adherence in a depressed population.Methods:This study reports the secondary analysis from a randomized controlled trial. The 310 participants were aged 18–67 years and affected by mild to moderate depression i.e. scoring ≥10 on the Patient Health Questionnaire-9 (PHQ-9). Adherence to an exercise intervention (light, moderate, vigorous, performed three times a week for 12 weeks) was measured using pulse watches or self-reports (78.4% vs. 21.6%). Factors associated with adherence were explored using negative binomial regression models.Results:Adherers (≥12 sessions, 32.7%) exercised on average 22.9 (SD = 7.4) times, while sub-adherers (1–11 sessions, 26.9%) attended on average 4.7 (SD = 3.1) sessions. Around 40% of participants were non-adherers (0 sessions). Tobacco use and hazardous alcohol use were associated with a lower adherence while flexibility at work was associated with higher adherence.Conclusion:Tobacco use, hazardous alcohol use and flexibility at work can influence adherence to an exercise program among depressed people and should be considered when applying exercise interventions.HighlightsWe studied predictors for adherence to an exercise intervention in depressed people.Tobacco and hazardous alcohol use are associated with lower levels of adherence.Flexibility at work is associated with higher levels of adherence.These factors need to be considered when planning treatment of depression.

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