The Development of an Integrated Physical Activity and Mental Health Intervention for Veterans With COPD, Emotion Distress, and Low Physical Activity

Inclusion Criteria: * Any gender-identified, greater than or equal to 40 years of age * Clinical diagnosis of COPD defined as the presence of emphysema on a CT scan and one piece of clinical evidence of COPD (defined as a ratio of FEV1 to forced vital capacity \< 0.70, \> 10 pack-year cigarette smoking history, overall assessment of COPD in their problem list or in Pulmonary/Primary Care notes, or on bronchodilators (specifically antimuscarinics such as Tiotropium or Ipratropium). If there is no evidence of emphysema, or no CT on scan in their medical chart, three pieces of clinical evidence of COPD will suffice for a clinical diagnosis of COPD. * Ability to communicate * Able to participate in in-person study appointment at the VA * English speaking * Competent to provide informed consent * Emotional distress. Clinically significant depression and/or anxiety defined as PHQ-8 \> 10 and/or Beck Anxiety Inventory \> 13 * Wireless Internet connection and Bluetooth capability * Participants with \> 90% accuracy of device Fitbit to manual step counts * Agreeable to audio record study session * Agreeable to wearing an ActiGraphy device and Fitbit and downloading the Fitbit app * Email user for VVC visits links * Either owns a smartphone or iPad compatible with the Fitbit app and enabled with Bluetooth or agreeable to using a study-issued iPad with Wi-Fi and Bluetooth capabilities * Medical clearance from healthcare provider to participate in a physical activity program Exclusion …