Effects of a Peer-Assisted Physical Activity Program on Depression and Anxiety in College Students
DOI:
https://doi.org/10.18666/TPE-2025-V82-I2-12186Abstract
Physical activity is well-known to have a plethora of positive physiological, psychological, and sociological benefits. However, many college students do not meet the physical activity guidelines for Americans. In addition, depression and anxiety rates among college students have continued to rise. The purpose of this study was to examine the effects of a peer-assisted, self-selected physical activity program on depression and anxiety in college students. In-depth interviews were conducted with three program participants, six physical activity buddies, and three referring healthcare providers. Results showed significant benefits for everyone involved in the program. Program participants experienced reduced depression and anxiety, as well as increases in exercise self-efficacy and competence. The mechanism found to be primarily responsible for changes was the combination of physical activity and relatedness, and other mechanisms included routine, nature, and other lifestyle changes. Results illuminate a cost-effective way to address rising depression and anxiety rates in college students.
References
American College Health Association [ACHA]. (2022). American College Health Association National College Health Assessment III: Reference Group Executive Summary Spring 2022.
https://www.acha.org/documents/ncha/NCHA-III_SPRING_2022_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf
Anxiety and Depression Association of America. (2022, October 28). Anxiety disorders – facts & statistics. https://adaa.org/understanding-anxiety/facts-statistics
Bandura, A. (1997). Self-efficacy. Harvard Mental Health Letter, 13(9), 4-6.
Basudan, S., Binanzan, N., & Alhassan, A. (2017). Depression, anxiety and stress in dental
students. International Journal of Medical Education, 8, 179-186. https://doi.org/10.5116/ijme.5910.b961
Cai, S. (2000). Physical exercise and mental health: A content integrated approach in coping
with college students’ anxiety and depression. Physical Educator, 57(2), 69-76. Retrieved from https://www.proquest.com/docview/233005480
Center for Collegiate Mental Health. (2023, January). 2022 Annual Report. Retrieved from
https://ccmh.psu.edu/assets/docs/2022%20Annual%20Report.pdf
Centers for Disease Control and Prevention. (2022, December 15). Exercise or physical activity.
https://www.cdc.gov/nchs/fastats/exercise.htm
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative
analysis. London, ENG: Sage Publications.
Craft, L. (2005). Exercise and clinical depression: Examining two psychological mechanisms.
Psychology of Sport & Exercise, 6(2), 151-171. https://doi.org/10.1016/j.psychsport.2003.11.003
Daley, A. (2008). Exercise and depression: A review of reviews. Journal of Clinical
Psychology in Medical Settings, 15(2), 140-147. https://doi.org/10.1007/s10880-008-9105-z
Deci, E., & Ryan, R. (2008). Self-determination theory: A macrotheory of human motivation,
development, and health. Canadian Psychology, 49(3), 182-185. https://psycnet.apa.org/doi/10.1037/a0012801
Duffy, M. E., Twenge, J. M., & Joiner, T. E. (2019). Trends in mood and anxiety symptoms and suicide-related outcomes among U.S. undergraduates, 2007–2018: Evidence from two national surveys. Journal of Adolescent Health, 65(5), 590–598. https://doi.org/10.1016/j.jadohealth.2019.04.033
Edmunds, J., Ntoumanis, N., & Duda, J. (2007). Adherence and well-being in overweight
and obese patients referred to an exercise on prescription scheme: A self-determination theory perspective. Psychology of Sport & Exercise, 8(5), 722-740. https://doi.org/10.1016/j.psychsport.2006.07.006
Ensari, I., Greenlee, T. A., Motl, R. W., & Petruzzello, S. J. (2015). Meta-analysis of acute
exercise effects on state anxiety: An update of randomized controlled trials over the past
years. Depression and Anxiety, 32, 624-634. https://doi.org/10.1002/da.22370
Fletcher, J., & Banasik, J. (2001). Exercise self-efficacy: Clinical excellence for nurse
practitioners. The International Journal of NPACE, 5(3), 134-143. https://doi.org/10.1054/xc.2001.24203
Fuhr, D., Salisbury, T., De Silva, M., Atif, N., van Ginneken, N., Rahman, A., & Patel, V.
(2014). Effectiveness of peer-delivered interventions for severe mental illness and depression on clinical and psychosocial outcomes: A systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 49, 1691-1702.
https://doi.org/10.1007/s00127-014-0857-5
Gadermann, A. M., Alonso, J., Vilagut, G., Zaslavsky, A. M., & Kessler, R. C. (2012).
Comorbidity and disease burden in the National Comorbidity Survey Replication (NCS-R). Depression and Anxiety, 29(9), 797–806. https://doi.org/10.1002/da.21924
Gladwell, V. F., Brown, D. K., Wood, C. R., Sandercock, G. L., & Barton, J. (2013). The great
outdoors: How a green exercise environment can benefit all. Extreme Physiology and Medicine, 2(1), 1-7. https://doi.org/10.1186/2046-7648-2-3
Gold, S. M., Köhler-Forsberg Ole, Moss-Morris, R., Anja, M., Jaime, M. J., Monika, B., . . . Otte, C. (2020). Comorbid depression in medical diseases. Nature Reviews: Disease Primers, 6(1), 1-22. https://doi.org/10.1038/s41572-020-0200-2
Greenberg, P., Fournier, A., Sisitsky, T., Pike, C., & Kessler, R. (2015). The economic burden of
adults with major depressive disorder in the United States (2005 and 2010). The Journal of Clinical Psychiatry, 76(2), 155-162. Retrieved from https://www.psychiatrist.com/read-pdf/5356/
Greenberg, P., Fournier, A., Sisitsky, T., Simes, M., Berman, R., Koenigsberg, S. H. & Kessler,
R. C. (2021). The economic burden of adults with major depressive disorder in the United States (2010 and 2018). Pharmacoeconomics, 39(6), 653-665. https://doi.org/10.1007/s40273-021-01019-4
Greenberg, P., Kessler, R., Birnbaum, H., Leong, S., Lowe, S., Berglund, P., & Corey-Lisle, P.
(2003). The economic burden of depression in the United States: How did it change between 1990 and 2000? The Journal of Clinical Psychiatry, 64(12), 1465-1475. Retrieved from https://www.psychiatrist.com/read-pdf/5373/
Greenberg, P., Sisitsky, T., Kessler, R., Finkelstein, S., Berndt, E., Davidson, J., ... Fyer, A.
(1999). The economic burden of anxiety disorders in the 1990s. The Journal of Clinical Psychiatry, 60(7), 427-435. Retrieved from https://www.psychiatrist.com/read-pdf/5363/
Hoffman, D., Dukes, E., & Wittchen, H.-U. (2008). Human and economic burden of generalized
anxiety disorder. Depression and Anxiety, 25, 72–90. https://doi.org/10.1002/da.20257
Hwang, S. (2008). Utilizing qualitative data analysis software: A review of Atlas.ti. Social
Science Computer Review, 26(4), 519-527. https://doi.org/10.1177/0894439307312485
Kessler, R. (2012). The costs of depression. The Psychiatric Clinics of North America, 35(1), 1-
https://doi.org/10.1016/j.psc.2011.11.005
Kessler, R., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., … Wang, P.
(2003). The epidemiology of major depressive disorder: Results from the national comorbidity survey replication (NCS-R). Journal of the American Medical Association, 289(23), 3095-3105. https://doi.org/10.1001/jama.289.23.3095
Kessler, R., Berglund, P., Demler, O., Jin, R., & Walters, E. (2005). Lifetime prevalence and
age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6), 593-602. https://doi.org/ 10.1001/archpsyc.62.6.593
Kirsch, D., Pinder-Amaker, S., Morse, C., Ellison, M., Doerfler, L., & Riba, M. (2014).
Population-based initiatives in college mental health: Students helping students to overcome obstacles. Current Psychiatry Reports, 16(12), 1-8. https://doi.org/10.1007/s11920-014-0525-1
Konnopka, A., & König, H. (2020). Economic burden of anxiety disorders: A systematic review
and meta‑analysis. PharmacoEconomics, 38(1), 25-37. https://doi.org/10.1007/s40273-019-00849-7
Kvam, S., Kleppe, C. L., Nordhus, I. H., & Hovland, A. (2016). Exercise as a treatment for
depression: A meta-analysis. Journal of Affective Disorders, 202, 67-86. https://doi.org/10.1016/j.jad.2016.03.063
Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five
approaches. Health Promotion Practice, 16(4), 473-475. https://doi.org/10.1177/1524839915580941
Martin, L., Williams, S., Haskard, K., & Dimatteo, M. (2005). The challenge of patient
adherence. Therapeutics and Clinical Risk Management, 1(3), 189-199. Retrieved from https://www.tandfonline.com/doi/epdf/10.2147/tcrm.s12160382
McFadden, T., Fortier, M. S., & Guérin, E. (2017). Investigating the effects of physical activity
counseling on depressive symptoms and physical activity in female undergraduate
students with depression: A multiple baseline single-subject design. Mental Health and
Physical Activity, 12, 25-36. https://doi.org/10.1016/j.mhpa.2017.01.002
Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical perspective. Psychiatric
Rehabilitation Journal, 25(2), 134-141. https://doi.org/10.1037/h0095032
Merom, D., Phongsavan, P., Wagner, R., Chey, T., Marnane, C., Steel, Z., . . . Bauman, A.
(2008). Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders - A pilot group randomized trial. Journal of Anxiety Disorders, 22(6), 959-968. https://doi.org/10.1016/j.janxdis.2007.09.010
Moussavi, S., Chatterji, S., Verdes, E., Tandon, A., Patel, V., & Ustun, B. (2007). Depression,
chronic diseases, and decrements in health: Results from the World Health Surveys. The Lancet, 370(9590), 851–858. https://doi.org/10.1016/S0140-6736(07)61415-9
National Institute of Mental Health [NIMH]. (2023a, April). Anxiety disorders. Retrieved from
https://www.nimh.nih.gov/health/topics/anxiety-disorders
National Institute of Mental Health [NIMH]. (2023b, April). Depression. Retrieved from
https://www.nimh.nih.gov/health/topics/depression
Olafsdottir, G., Cloke, P., & Vögele, C., (2017). Place, green exercise and stress: An exploration
of lived experience and restorative effects. Health and Place, 46, 358-365. https://doi.org/10.1016/j.healthplace.2017.02.006
Olatunji, B., Cisler, J., & Tolin. D., (2007). Quality of life in the anxiety disorders: A meta-
analytic review. Clinical Psychology Review, 27(5), 572-581. https://doi.org/10.1016/j.cpr.2007.01.015
Pope, C., Ziebland, S., & Mays, N. (2000). Analysing qualitative data. British Medical
Journal, 320(7227), 114-116. https://doi.org/10.1136/bmj.320.7227.114
Post, S. G. (2005). Altruism, happiness, and health: It’s good to be good. International Journal
of Behavioral Medicine, 12(2), 66-77. https://doi.org/10.1207/s15327558ijbm1202_4
Revell, S., & McLeod, J. (2016). Experiences of therapists who integrate walk and talk into their
professional practice. Counseling and Psychotherapy Research, 16(1), 35-43. https://doi.org/10.1002/capr.12042
Ryan, M. (2008). The antidepressant effects of physical activity: Mediating self-esteem and
self-efficacy mechanisms. Psychology & Health, 23(3), 279-307. https://doi.org/10.1080/14768320601185502
Ryan, R., & Deci, E. (2001). On happiness and human potentials: A review of research on
hedonic and eudaimonic well-being. Annual Review of Psychology, 52(1), 141-166. https://doi.org/10.1146/annurev.psych.52.1.141
Sabourin, B., Hilchey, C., Lefaivre, M., Watt, M., & Stewart, S. (2011). Why do they exercise
less? Barriers to exercise in high-anxiety-sensitive women. Cognitive Behaviour Therapy, 40(3), 206-215. https://doi.org/10.1080/16506073.2011.573572
Shally-Jensen, M. (2013). Mental health care issues in America: An encyclopedia (Gale virtual
reference library). Santa Barbara, CA: ABC-CLIO.
Smith, A. (2003). Peer relationships in physical activity contexts: A road less traveled in youth
sport and exercise psychology research. Psychology of Sport & Exercise, 4(1), 25-39. https://doi.org/10.1016/S1469-0292(02)00015-8
Stanton, R., & Reaburn, P. (2014). Exercise and the treatment of depression: A review of the e
exercise program variables. Journal of Science and Medicine in Sport, 17(2), 177-182. https://doi.org/10.1016/j.jsams.2013.03.010
Stonerock, G. L., Hoffman, B. M., Smith, P. J., Blumenthal, J. A. (2015). Exercise as treatment
for anxiety: Systematic review and analysis. Annals of Behavioral Medicine, 49(4), 542–556. https://doi.org/10.1007/s12160-014-9685-9
Ströhle, A. (2009). Physical activity, exercise, depression and anxiety disorders. Journal of
Neural Transmission, 116(6), 777-784. https://doi.org/10.1007/s00702-008-0092-x
Teixeira, P., Carraça, E., Markland, D., Silva, M., & Ryan, R. (2012). Exercise, physical activity,
and self-determination theory: A systematic review. The International Journal of Behavioral Nutrition and Physical Activity, 9(1), 78-108. https://doi.org/10.1186/1479-5868-9-78
Weinberg, R. S., & Gould, D. (2019). Foundations of sport and exercise psychology (7th ed.).
Champaign, IL: Human Kinetics.
World Health Organization [WHO]. (2023, March 31). Depressive disorder (depression).
Retrieved from https://www.who.int/en/news-room/fact-sheets/detail/depression
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