Date of Award

Summer 8-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Human Movement Studies & Special Education

Program/Concentration

Human Movement Studies and Special Education

Committee Director

Xihe Zhu

Committee Member

Justin A. Haegele

Committee Member

Angela Eckhoff

Abstract

This dissertation aimed to co-produce a walking/jogging exercise intervention with and for young adults with depression, using the Behavior Change Wheel (BCW) framework (Study I). Although current physical activity (PA) guidelines include multiple pathways to achieve health benefits through different intensities and volumes, it remains unclear whether achieving these pathways is associated with similar depression prevalence. As such, this dissertation also examined the associations of guideline-based PA intensity and volume with depression among adults (Study II). In Study I, six young adults aged 20-27 years with mild-to-moderate depression participated in four individual face-to-face co-production sessions, resulting in a total of 24 co-produced sessions. Guided by BCW, participants completed the eight steps of intervention development to identify barriers and facilitators to PA, select intervention functions and behavior change techniques, and develop individualized intervention components that were subsequently synthesized and refined into a co-produced PA intervention. Qualitative data were analyzed using thematic analysis. Thirty factors influencing PA engagement were identified and mapped onto the Capability, Opportunity, Motivation-Behavior (COM-B) framework. Data informed the development of a five-component walking/jogging intervention comprising Education, Planning, Environmental Structuring, Tracking, and Social Support (EPETS). In Study II, cross-sectional data from the 2021-2023 National Health and Nutrition Examination Survey (NHANES) were analyzed for 4,541 U.S. adults. Survey-weighted logistic regression models examined associations between depression and meeting PA guidelines through moderate-intensity PA (MPA), vigorous-intensity PA (VPA), or moderate-to-vigorous PA (MVPA), and different PA volume categories. Adults accumulating >150 min/week of VPA only had significantly lower odds of depression (AOR = 0.16, 95% CI: 0.07, 0.39) compared to those meeting none, with lower odds also observed among those accumulating 150-300 min/week of MVPA, >300 min/week of MVPA, and 150-300 min/week of MPA only. The findings showed that meeting PA guidelines through higher intensity was associated with lower odds of depression, whereas the PA volume associated with lower odds of depression varied across PA intensity categories. By integrating the findings from both studies, EPETS combines participatory methods and evidence on guideline-based PA intensity and volume to develop a theory-informed, participant-centered exercise intervention for young adults with depression.

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DOI

10.25777/brf6-re37

ISBN

9798382773841

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Available for download on Tuesday, October 12, 2027

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