Cultural adaptations of a group exercise intervention for diverse outpatients in an urban community to improve exercise engagement and mood outcomes.

Abstract

Background: Exercise is an accessible intervention that can improve mental and physical health. However, few people meet exercise recommendations, particularly those with anxiety or depressive symptoms. Individuals living in marginalized communities may have more barriers to exercise engagement. Affect-based interventions highlight the immediate mood benefits of exercise. They may perform better than standard health-based prescriptions at improving exercise engagement and mental health outcomes. Including important cultural adaptations may improve the efficacy of affect-based interventions for racially and economically marginalized communities.

Purpose: This pilot study aimed to establish feasibility, acceptability, and preliminary effectiveness of a culturally adapted affect-based intervention with culturally diverse outpatients with mood or anxiety symptoms and primary diagnoses ranging in severity.

Method: Twenty adult outpatients engaged in a 3-week Exercise for Mood group with culturally informed adaptations to reduce structural barriers, increase accessibility, and increase intervention engagement. Feasibility, acceptability, exercise, mood, and quality of life were examined.

Results: The intervention was deemed feasible (80% attended all sessions) and highly acceptable (average credibility ratings from 7.39 to 8.17 of 9). Total and moderate/vigorous exercise minutes improved over time (P = 0.015, P = 0.007; d = 0.33-0.42). Some changes in stress and ability to tolerate distress occurred (d = 0.64-0.82), but there were no noticeable improvements in depression and quality of life.

Conclusion: Cultural adaptations to an affect-based intervention were effective at retaining participants and increasing exercise in an at-risk, culturally diverse population. Preliminary results suggest potential for improvement in distress intolerance and stress, which may importantly target mental and physical health.