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Healy LC, Benkwitz A, McVinnie Z, Sarkar M, Islin M, Brinded A, Dodge B, Opacic S, Swithenbank Z, Ranasinghe S, Oliver J, Karanika-Murray M, Nevill ME. Embedding Physical Activity into Community-Based Peer Support Groups for those Severely Affected by Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2291. [PMID: 36767657 PMCID: PMC9916288 DOI: 10.3390/ijerph20032291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Despite a growing evidence base on the effectiveness of community-based physical activity interventions for mental health, there is a lack of studies that focus on those affected by severe mental illness (SMI), who often experience poorer physical health, and are less physically active than the wider population. The use of peer support groups in this context is also understudied, despite benefits being documented in other contexts. This study examined the impact and process of a nationwide project to embed physical activity into peer support groups for those affected by SMI. Following the embedding of physical activity within peer support groups, interviews and focus groups were conducted to explore the experiences of those involved with the project and analysed using reflexive thematic analysis. The key findings related to: 1) the social aspects of embedding physical activity in the groups; 2) the focus on peer support and informal physical activity (rather than organised sport) being beneficial; 3) doing things differently and lessons to learn; and 4) the impact of the COVID-19 pandemic. Overall, we found that peer support is an important feature to include in projects encouraging those severely affected by mental illness to become more physically active.
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Affiliation(s)
- Laura C. Healy
- Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Adam Benkwitz
- Sport, Physical Activity and Health Research Centre, Newman University, Birmingham B32 3NT, UK
| | - Zoe McVinnie
- Department of Psychology, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
| | - Mustafa Sarkar
- Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Mel Islin
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Andy Brinded
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - B. Dodge
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Sofija Opacic
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Zoe Swithenbank
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Shanika Ranasinghe
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Jennie Oliver
- Rethink Mental Illness, The Dumont, 28 Albert Embankment, London SE1 7GR, UK
| | - Maria Karanika-Murray
- School of Business, University of Leicester, Brookfield, 266 London Road, Leicester LE2 1RQ, UK
| | - Mary E. Nevill
- Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
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Hassan J, Shannon S, Tully MA, McCartan C, Davidson G, Bunn R, Breslin G. Systematic review of physical activity interventions assessing physical and mental health outcomes on patients with severe mental illness (SMI) within secure forensic settings. J Psychiatr Ment Health Nurs 2022; 29:630-646. [PMID: 35426209 PMCID: PMC9544360 DOI: 10.1111/jpm.12832] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/26/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Individuals with a severe mental illness (SMI) are less physically active and have a lower life expectancy than the general population due to increased risks of cardiometabolic diseases (obesity, diabetes and respiratory diseases) and other health risks. Physical activity has been used as an adjunct therapy for individuals with SMI yielding improvements in cognitive functioning, quality of life and a reduction in psychiatric symptoms. Individuals with SMI residing within a secure forensic setting have reduced physical activity opportunities, possibly due to a number of factors including low motivation and restricted access to exercise facilities combined with a lack of knowledge and/or confidence in staff members to assist in physical activity programmes. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review demonstrates that little is known around the effects of physical activity for people with SMI who reside in secure forensic settings, with little to no long-term effects reported. Physical activity interventions have shown some positive results through decreasing weight and waist circumference as well as a reduction in negative symptom scores in an exercise group compared with the "no treatment" control group post-intervention. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Service users' reluctance to engage in physical activity may be overcome by improving staff commitment, creating a motivational atmosphere and promoting service user decision making. ABSTRACT INTRODUCTION: Participating in physical activity has many benefits, yet those with severe mental illness (SMI) living in forensic settings are less likely to be active, and more likely to experience ill-health. The aim of this study was to systematically review the effectiveness of physical activity programmes on mental and physical health and specifically on reducing symptoms of SMI in forensic settings. METHOD A systematic search of six databases was conducted, in addition to a grey literature search. Studies were included if they had participants with SMI; were based in a forensic setting; involved a physical activity programme and reported physical and mental health outcomes. RESULTS A total of 112 participants were included in four studies. One study showed a significant improvement in negative symptom scores in the exercise group compared with a treatment as usual group. Two studies reported improvements in psychiatric symptoms with no significant difference between groups; however, statistically significant changes in weight and waist circumference were evident (p < .001). No adverse effects were reported. CONCLUSION Only a small number of studies were included and of limited design and quality, with no follow-up assessments; therefore, more research is needed to determine the true effects of physical activity for improving SMI symptoms in a forensic setting. This review highlights the need for further studies exploring the barriers and facilitators of physical activity in secure forensic settings. Studies are required that include a more thorough research design. Furthermore, interventions if designed with patients and caring staff in mind may lead to lowered psychiatric symptoms and increased physical health benefits for all in forensic settings.
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Affiliation(s)
- Jessica Hassan
- School of Sport, Faculty of Life and Health Sciences, Ulster University, Newtownabbey, UK
| | - Stephen Shannon
- School of Sport, Faculty of Life and Health Sciences, Ulster University, Londonderry, UK
| | - Mark A Tully
- School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Claire McCartan
- Centre for Evidence and Social Innovation, School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Gavin Davidson
- Centre for Evidence and Social Innovation, School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Richard Bunn
- Belfast Health & Social Care Trust, Shannon Clinic, Regional Secure Unit, Belfast, UK
| | - Gavin Breslin
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Coleraine, UK
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Matthews EW, Cowman M, Brannigan M, Rosenbaum S, Sloan D, Ward PB, Denieffe S. Implementing experience-based co-design to develop a physical activity programme in recovery-focused outpatient mental health services. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2021.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims As mental health services focus on recovery orientated service delivery, there is a need to adopt recovery orientated approaches in interventions that promote physical activity. This article presents a process of using and modifying an experience-based co-design approach to develop an intervention that can be used to promote physical activity in mental health services: the ‘Move with Recovery’ programme. Methods A facilitated experience-based co-design approach was undertaken over four sessions. This approach included the use of a trigger film of touchpoints and sample physical activity experiences of service users, in addition to the use of a storyboard for emotional mapping and prioritising exercises. The final two co-design sessions involved programme prototyping and development using the TIDieR framework. Results The outcome of this process, the Move with Recovery programme, was a peer-developed and peer-led, community-focused programme structured around nine action points. It is made up of a combination of motivation, education and support sessions, together with light intensity aerobic activity sessions that is structured using the TIDieR framework, and intended for implementation in the recovery college. In this regard, the developed programme is inherently recovery orientated in its design and its aim. Conclusions The developed programme can be embedded into existing mental health services that lack integrated exercise resources. This articles details the experience-based co-design process undertaken here and offers future learning for using experience-based co-design to promote physical activity in mental health.
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Affiliation(s)
- Evan W Matthews
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
- Nursing and Midwifery Planning and Development Unit, South-East, The Health Service Executive, Ireland
| | - Mary Cowman
- School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Michele Brannigan
- The Health Service Executive, Mental Health Services, South-East, Ireland
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Darina Sloan
- The Health Service Executive, Mental Health Services, South-East, Ireland
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Suzanne Denieffe
- School of Humanities, Waterford Institute of Technology, Waterford, Ireland
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Evans M, Barker H, Peddireddy S, Zhang A, Luu S, Qian Y, Tang PY, Fisher EB. Peer-delivered services and peer support reaching people with schizophrenia: A scoping review. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1975441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Megan Evans
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hannah Barker
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Snigdha Peddireddy
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Angela Zhang
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Samantha Luu
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yiqing Qian
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Patrick Y. Tang
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Edwin B. Fisher
- Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Gallagher P, Boland C, McClenaghan A, Fanning F, Lawlor E, Clarke M. Improved self-esteem and activity levels following a 12-week community activity and healthy lifestyle programme in those with serious mental illness: A feasibility study. Early Interv Psychiatry 2021; 15:367-373. [PMID: 32337860 DOI: 10.1111/eip.12965] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 02/25/2020] [Accepted: 03/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Those with serious mental illness (SMI) including both psychotic and affective disorders are recognized to have a premature mortality compared to the general population, at least in part due to elevated cardiovascular risk profile. AIM To examine the effect of a 12-week, pragmatic, sustainable, low-cost intervention involving community activity, nutritional advice and exercise that could be accessible to patients attending a community clinic. METHODS Participants (N = 35) with SMI attending a community mental health service who were considered at risk of metabolic syndrome were referred by their clinical teams to a specialized healthy activity and nutritional programme. The intervention involved participation in exercise, dietary education and targeted lifestyle advice focused on community activities. Data on physical health and clinical parameters were collected pre- and post-intervention. RESULTS Physical activity increased following the intervention along with a statistically significant increase in self-esteem scores. There was no significant reduction in body mass index or lowering of anxiety and depression scores. CONCLUSIONS It is feasible to develop a relatively low-cost, community-based physical activity programme, integrating both nutritional advice and healthy activities. This may lead to improved outcomes in cardiovascular risk profile and improved life expectancy.
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Affiliation(s)
- Peter Gallagher
- Detect Early Intervention in Psychosis Service, Dublin, Ireland.,Saint John of God Community Services CLG, Dublin, Ireland
| | - Cailín Boland
- Detect Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Aisling McClenaghan
- Detect Early Intervention in Psychosis Service, Dublin, Ireland.,Saint John of God Community Services CLG, Dublin, Ireland
| | - Felicity Fanning
- Detect Early Intervention in Psychosis Service, Dublin, Ireland.,Saint John of God Community Services CLG, Dublin, Ireland
| | - Elizabeth Lawlor
- Detect Early Intervention in Psychosis Service, Dublin, Ireland.,Saint John of God Community Services CLG, Dublin, Ireland
| | - Mary Clarke
- Detect Early Intervention in Psychosis Service, Dublin, Ireland.,Saint John of God Community Services CLG, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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Quirk H, Hock E, Harrop D, Crank H, Peckham E, Traviss-Turner G, Machaczek K, Stubbs B, Horspool M, Weich S, Copeland R. Understanding the experience of initiating community-based group physical activity by people with serious mental illness: A systematic review using a meta-ethnographic approach. Eur Psychiatry 2020; 63:e95. [PMID: 33087211 PMCID: PMC7681136 DOI: 10.1192/j.eurpsy.2020.93] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND People living with serious mental illness (SMI) experience debilitating symptoms that worsen their physical health and quality of life. Regular physical activity (PA) may bring symptomatic improvements and enhance wellbeing. When undertaken in community-based group settings, PA may yield additional benefits such as reduced isolation. Initiating PA can be difficult for people with SMI, so PA engagement is commonly low. Designing acceptable and effective PA programs requires a better understanding of the lived experiences of PA initiation among people with SMI. METHODS This systematic review of qualitative studies used the meta-ethnography approach by Noblit and Hare (1988). Electronic databases were searched from inception to November 2017. Eligible studies used qualitative methodology; involved adults (≥18 years) with schizophrenia, bipolar affective disorder, major depressive disorder, or psychosis; reported community-based group PA; and captured the experience of PA initiation, including key features of social support. Study selection and quality assessment were performed by four reviewers. RESULTS Sixteen studies were included in the review. We identified a "journey" that depicted a long sequence of phases involved in initiating PA. The journey demonstrated the thought processes, expectations, barriers, and support needs of people with SMI. In particular, social support from a trusted source played an important role in getting people to the activity, both physically and emotionally. DISCUSSION The journey illustrated that initiation of PA for people with SMI is a long complex transition. This complex process needs to be understood before ongoing participation in PA can be addressed. Registration-The review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 22/03/2017 (registration number CRD42017059948).
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Affiliation(s)
- Helen Quirk
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, United Kingdom
| | - Emma Hock
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, United Kingdom
| | - Deborah Harrop
- Health and Social Care Research, Sheffield Hallam University, Sheffield, United Kingdom
| | - Helen Crank
- Health and Social Care Research, Sheffield Hallam University, Sheffield, United Kingdom
| | - Emily Peckham
- Department of Health Sciences, University of York, Heslington, United Kingdom
| | | | - Katarzyna Machaczek
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Brendon Stubbs
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Michelle Horspool
- Sheffield Health & Social Care NHS Foundation Trust, Sheffield, United Kingdom
| | - Scott Weich
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, United Kingdom
| | - Robert Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
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Tweed LM, Rogers EN, Kinnafick FE. Literature on peer-based community physical activity programmes for mental health service users: a scoping review. Health Psychol Rev 2020; 15:287-313. [PMID: 31937185 DOI: 10.1080/17437199.2020.1715812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Physical activity is a key determinant of mental health; community programmes aim to increase health and well-being on a community wide scale with emphasis on social interaction. Regular physical activity participation in community settings yields additional social benefits, such as peer support. This scoping review aimed to explore existing literature that has included peer support as a component of community-based physical activity programmes for MHSU. Published literature was examined using electronic databases (SportDiscus, Web of Science, MEDLINE, and PsycINFO), reference lists, and hand searching of journals. Thirteen eligible articles included; adults aged 18 and over, a peer support component, physical activity and/or sport, participants with mental health diagnoses and were community-based. Research published between 2007 and 2019, peer-reviewed and written in English was included. Nine studies found a significant increase in perceived social support, seven studies reported increased mental wellbeing and five studies reported increased physical activity levels. Effectiveness of reviewed programmes were categorised as; overall improvements in physical activity levels, improvements to mental health, exercise related psychosocial benefits, knowledge relating to self-care, and improved social connections. Community-based physical activity programmes produced psychosocial benefits and positive behaviour change for MHSU, warranting greater focus towards implementing effective peer support into community programmes.
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Affiliation(s)
- Lorna M Tweed
- School of Sport and Exercise Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Eva N Rogers
- School of Sport and Exercise Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Florence-E Kinnafick
- School of Sport and Exercise Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
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