Healthy Hearts Healthy Minds

Healthy Hearts Healthy Minds: An Overview Individuals with depression are four times more
likely to die from coronary heart disease than someone who does not have depression. At the
same time, the risk of having a heart attack with depression is double that of individuals
who do not have depression. Exercise, improves both depression and risk factors for heart
disease; yet, most Americans do not exercise regularly, especially those with depression
and/or heart disease.

This study is important to these individuals as most of them want to exercise, but have
difficulty finding the motivation and energy to do so, which has a substantially negative
impact on their physical and mental health. This study will compare two empirically supported
treatments designed to help individuals with a mood disorder at risk or with heart disease to
increase their physical activity as objectively measured by a Fitbit (which we will provide
to participants at no cost).

This new study, focused on getting people moving, is funded by the Patient Centered Outcome
Research Institute (PCORI) and involves 2 Patient Powered Research Networks (PPRNs) known as
the MoodNetwork and the Health eHeart Alliance. With the help of patients across the country
the Healthy Hearts Healthy Minds study team aims to be able to study the best method to get
people to be more physically active - making them happier and healthier in the process.

What is the purpose of the study? Healthy Hearts Healthy Minds aims to compare two kinds of
empirically supported treatment programs to see which is most effective at motivating people
to be more physically active and increasing well-being: an online, standard, eight-week
mindfulness training and an online, eight-session "cognitive-behavioral" training. The study
may also tell us what groups of people do better with one or the other program.

How does the study work? 500 participants will be recruited from the MoodNetwork and the
Health eHeart Alliance. They will be randomly assigned to either the mindfulness training,
the cognitive-behavioral training, or a control group. Participants, regardless of group
assignment, will receive a Fitbit Charge II at no cost.

All participants will fill out standard well-being and safety assessments every other week
for eight weeks to see how they are doing. Participants will also do follow-up assessments
after sixteen weeks has elapsed since starting the study. All sessions and assessments will
be done online.

You may qualify if:

- You are physically active less than 150 minutes per week

- Have a body mass index (BMI) greater than 25kg/m2

- You possess an internet enabled device (e.g. smartphone, tablet/iPad, or desktop) with
the Fitbit app and a registered personal account with Fitbit

What does participation involve?

- Wearing a FitBit Charge II throughout the duration of the 16 week study

- Filling out questionnaires via a secure, online system

- Potentially participating in additional weekly program sessions for 8 weeks, depending
on which program you are assigned to.

Inclusion Criteria:

- Ability to give informed consent

- Fluent in English

- Between the ages of 18-65

- Lives in the United States

- Self-report of having experienced depression as assessed by the Mini International
Neuropsychiatric Interview (MINI)

- Self report an elevated risk for or of having cardiovascular disease ( >150 minutes of
physical activity a week and BMI >25)

- Registered a personal account with Fitbit prior to enrollment in the study

Exclusion Criteria:

- Unwilling/unable to comply with study procedures

- Pregnant

- A total score of a 20 on the PHQ-9 (indicative of "very severe" depression) and/or a
total score of a 16 on the ASRM (or indicative of "very severe" mania).

- Responds to item 9 (Suicidal ideation) on the PHQ-9 with a 2 or higher (i.e.,
"Thoughts that you would be better off dead or of hurting yourself in some way on more
than half the days")

- Contraindications to exercise or diet interventions as assessed by the DASI

- Already owns a fitbit device or other activity monitor

- Suffers from repeated episodes of "blacking out" or "fainting"

- Survived a cardiac arrest or sudden death

- Has recurrent chest discomfort with activity that goes away within 10 minutes of rest
or with nitroglycerin

- Has heart failure

- Has been hospitalized recently (within past 6 weeks) for a cardiovascular problem