Pilot outcomes of an online physical activity intervention for individuals with serious mental illnesses
DOI:
https://doi.org/10.5055/ajrt.2017.0123Keywords:
physical activity, mental health, tele-healthAbstract
Objective: This article describes the development and feasibility of an online physical activity (PA) intervention for individuals with serious mental illnesses (SMI), who are at greater risk for obesity and obesity-related diseases than the general population. Individuals with SMI are more likely to lead sedentary lifestyles, which is a modifiable risk factor that has been identified as an intervention area by the National Institutes of Mental Health.
Methods: Ten subjects were recruited to participate in a single group, interrupted time series design. Data (weight, body mass index, PA, and quality of life) were collected at baseline, 6 weeks, and 12 weeks. Exit interviews were conducted with participants and the recreational therapist to evaluate perception and feasibility of the intervention.
Results: No significant differences were noted on outcome measures. Participants reported high satisfaction with participation and self-reported higher engagement in PA.
Conclusions and Implications for Practice: This pilot study demonstrates that an online PA intervention is both feasible and accepted by consumers with SMI and provides diverse roles for recreational therapists working in behavioral health. This study provides valuable feedback for future implementation of an online PA intervention. Recommendations include: incorporate a “readiness to change” screening tool; extend the intervention; incorporate a nutrition component; incorporate opportunities for social interaction; and integrate objective measures of PA and self-monitoring strategies.
References
De Hert M, Correll CU, Bobes J, et al.: Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011; 10(1): 52-77.
Ohaeri JU, Akanji AO: Metabolic syndrome in severe mental disorders. Metab Syndr Relat Disord. 2011; 9(2): 91-98.
Beebe LH: Obesity in schizophrenia: Screening, monitoring, and health promotion. Perspect Psychiatr Care. 2008; 44(1): 25-31.
Everett A, Mahler J, Biblin J, et al.: Improving the health of mental health consumers: Effective policies and practices. Int J Mental Health. 2008; 37(2): 8-48.
Lysaker PH, Roe D, Buck KD: Recovery and wellness amidst schizophrenia: Definitions, evidence, and the implications for clinical pracitce. J Am Psychiatr Nurses Assoc. 2010; 16: 36-42.
Hutchinson DS, Gagne C, Bowers A, et al.: A framework for health promotion services for people with psychiatric disabilities. Psychiatr Rehabil J. 2006; 29(4): 241-250.
Galletly CL, Murray LE: Managing weight in persons living with severe mental illness in community settings: A review of strategies used in community interventions. Issues Ment Health Nurs. 2009; 30: 660-668.
Wildgust HJ, Beary M: Are there modifiable risk factors which will reduce the excess mortality in schizophrenia. J Psychopharmacol. 2010; 24(11)(suppl 4): 37-50.
Richardson CR, Faulkner G, McDevitt J, et al.: Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005; 56(3): 324-331.
Brown DR, Wang G, Safran MA: A preliminary analysis of medical expenditures among active and sedentary US adults with mental disorders. Am J Health Behav. 2005; 29(3): 195-205.
Chuang HT, Mansell C, Patten SB: Lifestyle characteristics of psychiatric outpatients. Can Psychiatr Assoc. 2008; 53(4): 260-266.
Lindamer LA, McKibbin C, Norman GJ, et al.: Assessment of physical activity in middle-aged and older adults with schizophrenia. Schizophr Res. 2008; 104(1-3): 294-301.
Vancampfort D, Probst M, Knapen J, et al.: Associations between sedentary behaviour and metabolic parameters in patients with schizophrenia. Psychiatry Res. 2012; 200(2-3): 73-78.
Scott D, Happell B: The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs. 2011; 32(9): 589-597.
Kilbourne AM, Rofey DL, McCarthy JF, et al.: Nutrition and exercise behavior among patients with bipolar disorder1. Bipolar Disord. 2007; 9(5): 443-452.
Faulkner G, Soundy AA, Lloyd K: Schizophrenia and weight management: A systematic review of interventions to control weight. Acta Psychiatr Scand. 2003; 108(5): 324-332.
Happell B, Davies C, Scott D: Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: A systematic review. Int J Ment Health Nurs. 2012; 21: 236-247.
World Health Organization: Global Recommendations on Physical Activity for Health. Geneva, Switzerland: WHO Press, 2010.
Vancampfort D, De Hert M, Skjerven LH, et al.: International organization of physical therapy in mental health consensus on physical activity within multidisciplinary rehabilitation programs for minimizing cardio-metabolic risk in patients with schizophrenia. Disabil Rehabil. 2012; 34(1): 1-12.
Services UDoHaH: Physical Activity Guidelines for Americans. Washington, DC: Services UDoHaH, 2008.
Vancampfort D, Knapen J, Probst M, et al.: A systematic review of correlates of physical activity in patients with schizophrenia. Acta Psychiatr Scand. 2012; 125(5): 352-362.
Roick C, Fritz-Wieacker A, Matschinger H, et al.: Health habits of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2007; 42(4): 268-276.
Healy GN, Wijndaele K, Dunstan DW, et al.: Objectively measured sedentary time, physical activity, and metabolic risk. Diabetes Care. 2008; 31(2): 369-371.
Healy GN, Matthews CE, Dunstan DW, et al.: Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. Eur Heart J. 2011: 32(5): 590-597.
Salmon K, Owen N, Crawford DW, et al.: Physical activity and sedentary behavior: A population-based study of barriers, enjoyment, and preference. Health Psychol. 2003; 22(2): 178-188.
Brown S, Inskip H, Barraclough B: Causes of the excess mortality of schizophrenia. Br J Psychiatry. 2000; 177: 212-217.
Tremblay MS, Colley RC, Saunders TJ, et al.: Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab. 2010; 35(6): 725-740.
Owen N, Healy GN, Matthews CE, et al.: Too much sitting: The population health science of sedentary behavior. Exerc Sport Sci Rev. 2010; 38(3): 105-113.
Owen N, Sparling PB, Healy GN, et al.: Sedentary behavior: Emerging evidence for a new health risk. Mayo Clin Proc. 2010; 85(12): 1138-1141.
Hutchinson DS: Structured exercise for persons with serious psychiatric disabilities. Psychiatr Serv. 2005; 56(3): 353-354.
Schwee TW, Backx FJG, Takken T, et al.: Exercise therapy improves mental and physical health in schizophrenia: A randomized controlled trial. Acta Psychiatr Scand. 2013; 127(6): 464-473.
Skrinar GS, Huxley NA, Hutchinson DS, et al.: The role of a fitness intervention on people with serious psychiatric disabilities. Psychiatr Rehabil J. 2005; 29(2): 122-127.
Brown C, Goetz J, Van Sciver A, et al.: A psychiatric rehabilitation approach to weight loss. Psychiatr Rehabil J. 2006; 29(4): 267-273.
Forsberg K, Bjorkman T, Sandman P, et al.: Physical health—A cluster randomized controlled lifestyle intervention among persons with a psychiatric disability and their staff. Nord J Psychiatry. 2008; 62(6): 486-495.
Roberts SH, Bailey JE: Incentives and barriers to lifestyle interventions for people with severe mental illness: A narrative synthesis of quantitative, qualitative and mixed methods studies. J Adv Nurs. 2011; 67(4): 690-708.
Daumit GL, Dickerson FB, Wang NY, et al.: A behavioral weight-loss intervention in persons with serious mental illness. N Engl J Med. 2013; 368(17): 1594-1602.
Temmingh H, Claassen A, van Zyl S, et al.: The evaluation of a telephonic wellness coaching intervention for weight reduction and wellness improvement in a community-based cohort of persons with serious mental illness. J Nerv Ment Dis. 2013; 201(11): 977-986.
Carras MC, Mojtabai R, Furr-Holden CD, et al.: Use of mobile phones, computers and internet among clients of an inner-city community psychiatric clinic. J Psychiatr Pract. 2014; 20(2): 94-103.
Alvarez-Jimenez M, Alcazar-Corcoles MA, Gonzalez-Blanch C, et al.: Online, social media and mobile technologies for psychosis treatment: A systematic review on novel user-led interventions. Schizophr Res. 2014; 156(1): 96-106.
Joseph RP, Durant NH, Benitez TJ, et al.: Internet-based physical activity interventions. Am J Lifestyle Med.
; 8: 42-67.
Gitlin LN: Introducing a new intervention: An overview of research phases and common challenges. Am J Occup Ther. 2013; 67(2): 177-184.
Kleinman MS, Mold JW: Defining the components of the research pipeline. Clin Transl Sci. 2009; 2(4): 312-314.
Zauszniewski JA: Intervention development: assessing critical parameters from the intervention recipient's perspective. Appl Nurs Res. 2012; 25(1): 31–39.
CSEP: PAR-Q & You. Available at http://www.csep.ca/view.asp?ccid=517%3E. Accessed March 17, 2016.
ACSM: ACSM's Guidelines for Exercise Testing and Prescription. Philadelphia, PA: Lippincott Williams & Wilkins, 2014.
Shephard RJ: PAR-Q, Canadian home fitness test and exercise screening alternatives. Sports Med. 1988; 5(3): 185-195.
WHO: Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation. Geneva, Switzerland: WHO Press, 2008.
White B: Measuring patient satisfaction: How to do it and why to bother—Family practice management. Fam Pract Manag.1999; 6(1): 40-44.
van Teijlingen E, Hundley V: The importance of pilot studies. Nurs Stand. 2002; 16(40): 33-36.
Musiat P, Goldstone P, Tarrier N: Understanding the acceptability of e-mental health—Attitudes and expectations towards computerised self-help treatments for mental health problems. BMC Psychiatry. 2014; 14(109): 1-8.
Ross R, McGuire KA: Incidental physical activity is positively associated with cardiorespiratory fitness. Med Sci Sports Exerc. 2011; 43(11): 2189-2194.
Reed GR: Measuring Stages of Change for Exercise. South Kingstown: University of Rhode Island, 1995.
Pekmezi D, Barbera B, Marcus BH: Using the transtheoretical model to promote physical activity. ACSM's Health Fitness J. 2010; 14(4): 8-13.
Thorogood A, Mottillo S, Shimony A, et al.: Isolated aerobic exercise and weight loss: A systematic review and meta-analysis of randomized controlled trials. Am J Med. 2011; 124(8): 747-755.
Wu T, Gao X, Chen M, et al.: Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: A meta-analysis. Obes Rev. 2009; 10: 313-323.
Bonfioli E, Berti L, Goss C, et al.: Health promotion lifestyle interventions for weight management in psychosis: A systematic review and meta-analysis of randomised controlled trials. BMC Psychiatry. 2012; 12(1): 78.
Vorunganti LN, Whatham J, Bard E, et al.: Going beyond: An adventure and recreation based group intervention promotes well-being and weight loss in schizophrenia. Can J Psychiatry. 2006; 51(9): 575-580.
Elfhag K, Rossner S: Who succeeds in maintaining weight loss?. A conceptual review of factors associated with weight loss and maintenance and weight regain. Obes Rev. 2005; 6: 67-85.
Published
How to Cite
Issue
Section
License
Copyright 2000-2023, Weston Medical Publishing, LLC
All Rights Reserved
