Table 1 Study, participant, intervention and outcome characteristics of the included studies.
Author, year, and study acronym | Country, study design, and setting | Condition type, prevalence | Condition diagnosis and severity at baseline | Age (mean), gender, and BMI (mean) | Intervention characteristics | Duration (minutes), frequency, length, and adherence ((number of intervention sessions attended/number of total sessions available)*100) to the behavioural intervention | Outcomes and (outcome measure) |
|---|---|---|---|---|---|---|---|
Koukouvou et al. [50] | Greece, 2-arm RCT, outpatient fitness centres | D (100%) HF (100%) H (12%) | D (BDI = 18, mild to moderate) HF (NYHA class II to III) H (SBP ≥ 140 DBP ≥ 90) | 52 years 0% female BMI 28 | Exercise therapy | 60 min, 4 times per week for 26 weeks at a moderate intensity. Adherence 78%. | Weight (BMI)* HRQoL (QLI) Depression (BDI) |
Kulcu et al. [49] | Turkey, 2-arm RCT, cardiopulmonary rehabilitation clinic | D (100%) HF (100%) | D (BDI = 19, moderate to severe) HF (NYHA class II to III) | 59 years 27% female | Exercise therapy | 60 min, 3 times per week for 8 weeks at a moderate intensity. Adherence NR. | HRQoL (HQOL) Depression (BDI) |
Katon et al. [43] | USA, 2-arm RCT, primary care clinics | D (100%) T2DM (100%) Coronary heart disease (27%) | D (PHQ-9 = 14, moderate) T2DM (glycated haemoglobin = %8) Coronary heart disease (MI, IHD angina pectoris) | 57 years 52% female BMI 37 | Self-care + pharmacotherapy | Clinic visits every 2 to 3 weeks, for 52 weeks. Adherence NR. | PA (adherence to exercise plan ≥ 2 days per week) Depression (SCL-20) HRQoL (QoL 10 scale) |
Gary et al. [42] | USA, 4-arm RCT, home-based | D (100%) HF (100%) H (88%) T2DM (29%) | D (BDI-II = 20, moderate) HF (NYHA class II to III) H (SBP ≥ 140 DBP ≥ 90) T2DM (NA) | 66 years 57% female | (1) Exercise therapy (2) CBT and exercise therapy (3) CBT | 45 min, 3 times per week for 12 weeks at a moderate intensity. Adherence 82%. | HRQoL (MLHFQ) PF (6MWT) Depression (HADS-D) |
Piette et al. [40] | USA, 2-arm RCT, telephone based + home-based | D (100%) T2DM (100%) | D (BDI = 26, moderate to severe) T2DM (Hba1c (%) = 7.6%) | 56 years 51% female 38 BMI | CBT + walking program | 12 weekly sessions followed by nine monthly booster sessions in 52 weeks. Adherence CBT 64%. | PA (step counts) HRQoL (SF-12 pcs) PF (SF-12 PF) Depression (BDI) |
Åsa et al. [47] | Sweden, 2-arm RCT, outpatient centre-based | HF (100%) T2DM (100%) | HF (NYHA II–III) T2DM (Hba1c (%) = 7.4) | 61 years 20% female BMI 29 | Exercise therapy | 45 min, 3 times a week for 8 weeks at a low to moderate intensity. Adherence 92%. | HRQoL (MLHFQ) PF (6MWT) |
Lynch et al. [44] | USA, 2-arm RCT, community-based | H (100%) T2DM (100%) | H (medication usage) T2DM (medication usage) | 54 years 67% female 36 BMI | Self-management | 120 min, 18 sessions in 26 weeks + weekly telephone calls. Adherence NR. | Self-reported physical activity (CHAMP) Weight loss (kg) |
Dunbar et al. [41] | USA, 2-arm RCT, home-based and clinic-based | HF (100%) T2DM (100%) | HF (NYHA II–IV) T2DM (Hba1c (%) = 8) | 57 years, 34% female, BMI 37 | Integrated self-care Intervention + usual care | One individualised counselling session with family members + one home visit by the research nurse + four telephone calls + one visit clinic. Duration 17 weeks. Adherence NR. | PA (CHAMP) |
Keihani et al. [48] | Iran, 2-arm RCT, institute of cardiovascular rehabilitation in Isfahan | D (100%) HF (100%) | D (BDI = 43, severe) HF (ejection fraction equal to or less than 35%) | 61 years 40% female BMI 29 | Exercise therapy | 60 min, 3 times per week for 8 weeks at a moderate intensity. Adherence NR. | PF (SF-36 PF) Depression (BDI-D) |
Freedland et al. [38] | USA, 2-arm RCT, academic centre | D (100%) HF (100%) H (72%) T2DM (38%) COPD (18%) | D (BDI-II = 30, severe) HF (NYHA class I to III) | 56 years, 46% female, 36 BMI | CBT + usual care | 60 min, once per week for 26 weeks and 4 telephone calls from week 26 to 52. | PA (actigraphy 7-d average activity) PF (6MWT) Depression BDI-II) Weight loss (BMI)* |
Pibernik-Okanović et al. [46] | Croatia, 3-arm RCT, tertiary diabetes clinic | D (100%) T2DM (100%) | D (CES-D = 30, severe) T2DM (Hba1c (%) = 7.3) | 66 years 54% female BMI 30 | (1)Exercise therapy (2)Psychoeducation | 75 min, for once a week for 6 weeks. Adherence NR. | HRQoL (SF-12) Depression (CES-D) |
Huang et al. [39] | Taiwan, 2-arm RCT, clinic | D (100%) T2DM (100%) | D (CES-D ≥ 16, moderate) T2DM (Hba1c (%) = 7.7) | 54 years, 52% female, BMI 26 | CBT + motivational enhancement therapy + usual care | 80 min, once a week for 12 weeks (4 weeks of motivational enhancement therapy and 8 CBT sessions) | Weight loss (BMI) HRQoL (SF-12 pcs) Depression (CES-D) |
Schneider et al. [45] | USA, 2-arm RCT, University of Massachusetts Medical School’s | D (100%) T2DM (100%) | D (BDI-II = 20, moderate) T2DM (Hba1c (%) = 7.9) | 53 years 100% female BMI 31 | Exercise therapy | 90 min, 2 times per week for 12 weeks at a moderate intensity. Adherence 51%. | Depression symptoms (BDI-II) |
de Groot et al. [37] (ACTIVE II) | USA, 2-arm RCT, community fitness centres | D (100%) T2DM (100%) | D (BDI-II = 25, moderate) T2DM (Hba1c (%) ≥ 7%) | 56 years 77% female | (1) Exercise therapy (2) Exercise therapy and CBT (3) CBT | 50 min (10 min warm up and 10 min cool down) 2 times per week for 12 weeks at a moderate intensity | Depression (BDI-II) HRQoL (SF-12 pcs) PF (6MWT) |