Development of a Traditional Chinese Medicine Lifestyle Medicine Program for Depression: A Multi-Method Study

Introduction: Evidence supports using multicomponent lifestyle medicine programs to alleviate depression, yet few studies detail the program development process. This study aimed to systematically develop a complex lifestyle medicine program for depression based on Traditional Chinese Medicine theory. Methods: A stepwise, multi-method study was conducted. The preparation phase involved understanding the public health issue, identifying resources, and reviewing published evidence. Based on these results, a Delphi survey was performed, followed by an analysis of the context understanding as well as design and refinement of the program. Subsequently, the program was modeled, and a program theory was developed, incorporating explanations and assumptions in a relevant conceptual framework and logic model. Results: A complex lifestyle medicine program and program manual were established. The program involves three major themes, each with six 120 min weekly consecutive sessions: nourishing the heart (two sessions), nourishing according to the time (two sessions), and nourishing the Qi (two sessions). The program covered TCM theory and practice to promote healthy sleep, diet, stress management, and self-administered acupressure and TCM exercise. Teaching materials were created accordingly. Conclusions: This study reports the development of a complex multicomponent TCM lifestyle medicine program to relieve depression thoroughly and transparently, with a specific focus on the Hong Kong context and a particular focus on TCM theory. The developed program will be examined for feasibility, acceptability, and preliminary efficacy in alleviating depression in a mixed-methods clinical study.