Table 4.

Connected behavioral condition: Cognitive-behavioral training (CBT) and mHealth app integration

Major Content and Activities
Each session builds upon the content of the previous session. Session format includes: (1) review of previous session and collaborative agenda setting; (2) discussion of success and challenges with program; (3) revisiting value-based, personal goals; (4) introduction of new cognitive-behavioral training (CBT) content through discussion; and (5) building exercise program in Wellpepper mHealth app and establishing new goals.
	Cognitive-Behavioral Features	Connected Health Features in App
Sessions 1 & 2 Introduction to CBT; Initiate exercise program in app and establish value-based goals	▪ Discuss personal, value-based goals and add to Wellpepper platform ▪ Identify the pros and cons of exercise & multi-level factors that affect physical activity ▪ Discuss facilitators and barriers to exercise and set an action plan ▪ Introduce relationship between situations, thoughts, and behavior	▪ Instruct in use of tablet & mHealth app ▪ Develop walking program and video exercise catalog in app ▪ Discuss rating challenge in app and how to communicate with the physical therapist ▪ Introduce self-monitoring in app through review of calendars and graphs
Sessions 3 & 4 Challenge your thoughts, Balance your thinking and progressing the program	▪ Examine thoughts around exercise and how they are linked to situations/behaviors ▪ Introduce thinking traps and discuss potential impact on exercise behaviors ▪ Introduce thought challenging ▪ Incorporate thought challenging into self-monitoring	▪ Participant encouraged to demonstrate self-monitoring, self-assessment through adherence reports in app ▪ Additional video exercises recorded as program progressed to maintain challenge ▪ Review walking and exercise goals; revise goals as needed
Sessions 5 & 6 Identifying high risk situations and developing strategies to cope; Staying healthy	▪ Consider high risk situations when it will be difficult to stick with exercise program ▪ Develop both preventative and coping strategies to manage ▪ Devise plan for staying healthy	▪ Re-assess appropriate challenge level of program ▪ Review goals and discuss readiness for gradual increase in amount of walking and dose of exercise ▪ Discuss communication plan in app through messaging
Sessions 7 & 8 (Boosters)	▪ Reinforce benefits of program ▪ Address additional cognitive barriers ▪ Discuss/review relapse cycle and relapse prevention strategies ▪ Revisit unhelpful thoughts, cognitive restructuring, self-monitoring	▪ Discuss how to safely re-engage in the exercise program if set-backs occur ▪ Discuss adaptations to the program if set-backs occur ▪ Reinforce self-monitoring of progress ▪ Discuss how to self-monitor, determine how/when to adjust exercise level and dose over time