Parkinson’s disease (PD) is a neurologic illness characterized by motor symptoms - including tremor, slowness, and stiffness, leading to progressive motor disability, as well as depression, cognitive impairment and sleep disturbances. PD is one the fastest-growing neurological illnesses, currently affecting over one million people in the US.
In this project, we will create a smartphone-based ECA intervention for people with PD designed to promote exercise and treat depressive symptoms using an adapted version of behavioral therapy delivered through the smartphone app. The intervention will systematically increase physical activity and meaningful life engagement. The ECA will function as a consistent virtual coach guiding participants through values clarification, activity monitoring, and collaborative activity scheduling, with a focus on small, achievable, and personally meaningful behaviors, including increase walking. Daily walking will be tracked with a smartphone and facilitated with structured monitoring using Master Activity Logs and daily Behavior Checkouts. The intervention will target core mechanisms known to reduce depression, including values-based action, reduction of avoidance, graded task engagement, and increased exposure to positive reinforcement. Interactions with the ECA will occur on a structured but flexible schedule that tapers over time (biweekly and then weekly), combining scheduled check-ins with optional participant-initiated sessions to support engagement while fostering autonomy.
This work is supported by the Parkinson’s Foundation, and is a collaboration with Ludy Shih (Beth Israel Deaconess), Paola Pedrelli (Harvard Medical School), and Michael Paasche-Orlow (Tufts Medical Center).