A 12-week app-based exercise program may reduce depressive symptoms in health care professionals, according to study results published in JAMA Psychiatry.

However, adherence to the exercise program decreased by the end of the study, suggesting that optimizing adherence to exercise programs could be critical for supporting mental health improvements in health care workers.

To evaluate whether a 12-week app-based exercise intervention improved measures of depressive symptoms, burnout, and absenteeism, researchers in the COPE trial (ClinicalTrials.gov Identifier: NCT05271006) randomly assigned 288 health care workers to the intervention arm (n=142) or a wait list control arm (n=146). Mean age was 41.0 years, and 85.4% of participants were female.

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Participants in the intervention arm were requested to complete four 20-minute exercise sessions each week, using a selection of yoga, barre, running, and bodyweight interval training apps. Participants in the waitlist control arm received the apps at the end of the trial.

In the intervention arm, participants experienced significant reductions in depressive symptoms by week 4 (effect size [ES], −0.19; 95% CI, −0.37 to 0.002) compared with the control arm. This reduction progressed throughout the trial, with the largest reduction in depressive symptoms seen at week 12 (ES, −0.41; 95% CI, −0.69 to −0.13).

Burnout in the trial participants was assessed by looking at 3 subfacets of the condition: cynicism, emotional exhaustion, and professional efficacy. By week 12, treatment effects favored the intervention arm for cynicism (ES, −0.33; 95% CI, −0.53 to −0.13) and emotional exhaustion (ES, −0.39; 95% CI, −0.64 to −0.14). There was no significant difference between the arms for professional efficacy.

Participants in the intervention group also reported fewer sick days (mean [SD], 0.86 [1.05]; median, 0 [range, 0-4]) than participants in the control group (mean [SD], 1.26 [1.32]; median, 1 [range, 0-5]).

Adherence to the exercise program lessened over time. In the first week, 54.9% of participants in the intervention arm completed at least 80 minutes of app-based exercise. However, by week 12 this number had decreased to 23.2%.

“Although exercise was able to reduce depressive symptoms among HCWs [health care workers], adherence was low toward the end of the trial,” the researchers concluded. “Scaled-up effectiveness trials are needed whereby all HCWs from an organization are provided longer opportunities to access the suite of apps to determine interest, uptake, adherence, and mental, physical, and economic effects.”


Boucher VG, Haight BL, Hives BA, et al. Effects of 12 weeks of at-home, application-based exercise on health care workers’ depressive symptoms, burnout, and absenteeism: A randomized clinical trial. JAMA Psychiatry. Published online August 9, 2023. doi:10.1001/jamapsychiatry.2023.2706


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