Developing a Fitbit-supported lifestyle physical activity intervention for depressed alcohol dependent women

Abstract

Purpose Women in alcohol treatment are more likely to relapse when in unpleasant, negative emotional states. Given the demonstrated benefits of exercise for decreasing depression, negative affect, and urges to drink, helping women engage in a lifestyle physical activity (LPA) intervention in early recovery may provide them a tool they can utilize “in the moment” in order to cope with negative emotional states and alcohol craving when relapse risk is highest. New digital fitness technologies (e.g., Fitbit activity monitor with web and mobile applications) may facilitate increases in physical activity (PA) through goal setting and self-monitoring. Method We piloted a 12-week LPA+Fitbit intervention focused on strategically using bouts of PA to cope with affect and alcohol cravings to prevent relapse in 20 depressed women (mean age=39.5 years) in alcohol treatment. Results Participants wore their Fitbit on 73% of days during the intervention period. An average of 9,174 steps/day were taken on the days the Fitbit was worn. Participants completed 4.7 of the 6 scheduled phone PA counseling sessions (78%). Among women who completed the intervention (n=15), 44% remained abstinent throughout the entire course of treatment. On average, women were abstinent on 95% of days during the 12-week intervention. Participants reported an increase in using PA to cope with either negative affect or urges to drink from baseline to end of treatment (p<.05). Further, participants reported high satisfaction with the LPA+Fitbit intervention and with the Fitbit tracker. Conclusions Further research is needed to evaluate the LPA+Fitbit intervention in a more rigorous randomized controlled trial. If the LPA+Fitbit intervention proves to be helpful during early recovery, this simple, low-cost and easily transported intervention can provide a much-needed alternate coping strategy to help reduce relapse risk among women in alcohol treatment.

Changes in coping, autonomous motivation, and beliefs about exercise among women in early recovery from alcohol participating in a lifestyle physical activity intervention

“…At baseline, participants reported heavy alcohol use, consuming alcohol 52.6% or the prior 90 days with an average of 10.11 (SD=6.36) drinks per drinking day. Overall results from the parent open trial (Abrantes et al, 2017) found that women significantly increased physical activity (Cohen’s d z = 0.87) and rates of alcohol abstinence (Cohen’s d z =1.08) over the course of the 12-week intervention.…”

“…Women with a DSM-5 moderate to severe other substance use disorder, history of psychotic disorder, current suicidality/homicidality, current mania, current pregnancy, or physical or mental problems that would preclude them from engaging in physical activity were excluded from the study. See main outcome paper from the pilot project (Abrantes et al, 2017) for details on eligibility. A total of 20 women were recruited.…”

“…Potentially eligible participants were approached and given information about the study. Women who were interested were briefly screened (5–10 minutes) and, if they met physical activity and depression criteria, were scheduled for a more comprehensive baseline assessment, fitness test, and medical clearance (see Abrantes et al, 2017) for a more detailed description of procedures). Eligible and interested participants were then scheduled for an in-person orientation with a counselor.…”

“…In contrast, regular physical activity engagement reduces depression (Kvam et al, 2016) and acute bouts of physical activity has been shown to reduce alcohol craving (Ussher et al, 2004) and reduce negative affect (Bartholomew et al, 2005; Petruzzello et al, 1991). Indeed, we have examined a lifestyle physical activity intervention focused on guiding depressed alcohol dependent women to use bouts of physical activity specifically as a coping strategy to manage negative mood and alcohol cravings (Abrantes et al, 2017). As women begin to use an adaptive coping strategy such as physical activity, it is possible that, in turn, they may increase other adaptive coping strategies such as reaching out for support from others or gaining acceptance, particularly as confidence in the ability to utilize the coping skills effectively strengthens.…”

A novel mobile biobehavioral regulation system for personalized trauma recovery support

“…For example, "lifestyle physical activity" devices provide real-time support to women who are suffering from depression and addiction. Fitness trackers have been used to help individuals cope with mental Patient Experience Journal, Volume 6, Issue 2 -2019 illness/substance abuse, resulting in improved affect and reported high satisfaction with the devices 15 . Other researchers are examining the use of wearables to help engage in "digital phenotyping," collecting information about patients from their smartphones, to determine who is at risk of harm to notify supports when intervention might be necessary 16 .…”