Results Summary

What was the research about?

People with depression are four times more likely to die from heart disease than those without depression. Exercise like walking can improve symptoms of depression and prevent heart disease. But it can be hard for people with depression to find the desire and energy to exercise.

In this study, the research team compared three ways to encourage patients with depression who have or are at risk for heart disease to increase their daily steps:

  • Fitbit® activity tracker, which tracks how many steps the wearer takes each day.
  • Fitbit plus web-based cognitive behavioral therapy, or CBT. CBT helps patients change patterns in their thinking to encourage positive thoughts about exercise.
  • Fitbit plus web-based, mindfulness-based cognitive therapy, or MBCT. MCBT helps patients become aware of their daily experiences that may prevent a healthy lifestyle.

What were the results?

After two months, the differences in daily steps across the three groups weren’t meaningful. The number of steps:

  • Decreased by 8.2 steps per day for patients who received the Fitbit alone
  • Increased by 2.9 steps per day for patients who also received CBT
  • Increased by 2.8 steps per day for patients who also received MBCT

After four months, the three groups didn’t differ in the number of daily steps.

Who was in the study?

The study included 361 patients with depression who had or were at risk for heart disease. Of these patients, 83 percent were White, 7 percent were Black, 7 percent were more than one race, and 3 percent were another race; 7 percent were Hispanic. The average age was 45, 83 percent were women, and 92 percent had a college education or more.

What did the research team do?

The research team recruited patients from two Patient-Powered Research Networks, or PPRNs: MoodNetwork and Health eHeart. In PPRNs, patients, families, caregivers, and community members work closely with research teams to plan and conduct research. These PPRNs were part of PCORnet®.

The research team assigned patients by chance to one of three groups. Patients in all groups wore a Fitbit activity tracker for two months. In the first group, patients just wore the Fitbit. In the second group, patients viewed weekly, self-guided web-based courses using CBT for two months. In the third group, patients viewed weekly, self-guided web-based courses using MBCT for two months. Both courses encouraged patients to practice skills taught in each week’s course.

Patients in all groups filled out surveys every other week for the first two months and a final survey two months later.

Patients from the two PPRNs helped create research questions and plan the study.

What were the limits of the study?

Most patients were women, White, and had a college degree. Results may have differed if the study included patients with different backgrounds.

Future research could test the two types of therapy with live support from a coach or therapist.

How can people use the results?

Researchers can use the results when considering other ways to encourage patients with depression to exercise.

MoodNetwork and Health eHeart online networks formerly were Network Partners in PCORnet®, the National Patient-Centered Clinical Research Network. PCORnet has been developed with funding from the Patient-Centered Outcomes Research Institute (PCORI).

Final Research Report

This project's final research report is expected to be available by October 2022.

Peer-Review Summary

The Peer-Review Summary for this project will be posted here soon.

Project Information

Andrew A. Nierenberg, MD
Massachusetts General Hospital
Healthy Hearts Healthy Minds: A PPRN Demonstration Pragmatic Trial

Key Dates

March 2016
February 2022

Study Registration Information


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Last updated: December 27, 2021