Title: Mind Fit: Evaluation of a Community-Based Wellness Program for Adolescents Experiencing Depression and/or Anxiety
Thesis Supervisor: Dr. Guy Faulkner
Committee Members: Dr. Erica Lau, Dr. Peter Crocker
Chair: Dr Moss Norman
Abstract: Exercise, a subset of physical activity, is a promising treatment for mild-to-moderate depression and anxiety in adolescents (teens). Mind Fit is an 8-week, group-based, early-intervention wellness program that combines physical activity with mental health discussions for teens (13- to 18-years-old) experiencing mild-to-moderate symptoms of depression and/or anxiety in British Columbia, Canada. The purposes of this thesis were to: 1) conduct an outcome evaluation to assess short-term and 3-month effects of Mind Fit on targeted health outcomes; 2) conduct a process evaluation to examine the facilitators and barriers related to program implementation and success; and 3) assess the effects of site-specific level of program implementation on targeted outcomes over a 2-year period.
To assess key outcomes, measures of depression (PHQ-9), anxiety (GAD-7), overall wellness (ORS), physical activity (GLEQ/COMPASS), and motivation were assessed at baseline, post-program, and 3-month follow-up using self-reported surveys. Overall, 184 teens participated in the evaluation across 10 sites. The following outcomes significantly improved from baseline to post-program (Time 1) and baseline to 3-month follow-up (Time 2): PHQ-9 (p=.001; d=.41), GAD-7 (p=.000; d=.51), and ORS (p=.001; d=.34). Physical activity motivation significantly improved at Time 1 (p=.035; d=.22). GLEQ/COMPASS did not significantly improve at Time 1 or 2.
To examine the facilitators and barriers to Mind Fit implementation and success, 39 telephone interviews were conducted post-program with teens and 41 with program instructors. Unique to this thesis, factors influencing implementation were assessed by all site coordinators at the end of each cycle using an evidence-based questionnaire. Facilitators included: strong motivation and staff buy-in, uniqueness of Mind Fit in the community/organization, social connections among participants, supportive instructors, and well-developed curriculum. Barriers included: available space and equipment, satisfactory staff training, and low teen recruitment. Descriptive statistics demonstrated a greater reduction in PHQ-9 and GAD-7 scores at high-implementation sites.
Findings of this research demonstrate the effectiveness of community-based, early-interventions delivered ‘at scale’ to improve the mental health of teens experiencing symptoms of depression and anxiety. Facilitators and barriers of program implementation and success can be used to inform future development of similar interventions.