Participant Experiences With a Peer-Led Healthy Lifestyle Intervention for People With Serious Mental Illness

Effects of Shared Decision Making Model-Based Guided Self-Help Program on Emotional Eating and Uncontrolled Eating Behavior in Individuals with a Severe Mental Disorder: A Randomized Controlled Trial

PURPOSE

The study was aimed at determining the effectiveness of the Shared Decision Making Model-based Guided Self-Help Program (SDM-GSH) on emotional eating behavior and uncontrolled eating behavior in individuals with a severe mental disorder.

METHOD

This randomized controlled experimental study was conducted in the Community Mental Health Center of a university hospital between September 2020 and November 2022. The sample of the study consisted of 64 participants. Of them, 33 were in the Experimental Group and 31 were in the control group. To collect the study data, the Patient Information Form, Emotional Eater Questionnaire, and Three-Factor Eating Questionnaire were administered. The participants in the Experimental Group took part in the SDM-GSH. The study data were collected from the participants in the Experimental and Control Groups before, right after and 6 months after the intervention.

RESULTS

The comparison of the BMI values of the participants with a severe mental disorder who took part in the SDM-GSH demonstrated that their pre-intervention BMI values significantly decreased at the measurements preformed right after and 6 months after the intervention (p < 0.05). The mean emotional eating (λ = 0.189, η2 = 0.811) and uncontrolled eating (λ = 0.218, η2 = 0.782) scores obtained by the participants in the Experimental Group before the intervention significantly decreased at the measurements preformed right after and 6 months after the intervention (p < 0.05).

CONCLUSION

Based on the results of our study, it is concluded that the SDM-GSH positively affected the BMI values, emotional eating behaviors and uncontrolled eating behaviors of the participants with a severe mental disorder.

Retention of older veterans with serious mental illness in a clinical exercise program

Older adults with serious mental illness (SMI) have compromised physical function that could be improved with exercise; however, retention in exercise programs is a challenge. This study was a retrospective analysis of retention for the 150 older veterans with SMI that enrolled in Gerofit, a clinical exercise program offered in the Veterans Health Administration. Chi-square and t-tests were conducted to evaluate baseline differences between those that were and were not retained at six and 12 months. Retention was 33% and better health-related quality of life and endurance were related to retention. Future work is needed to improve exercise program retention in this population.

Character Strength-Focused Positive Psychotherapy on Acute Psychiatric Wards: A Feasibility and Acceptability Study

OBJECTIVE

A manualized single-session positive psychotherapy intervention was developed and tested on acute psychiatric wards.

METHODS

Participants were invited in 2018-2019 to identify positive experiences, link them to a personal character strength, and plan a strengths-based activity. The intervention's feasibility was evaluated through fidelity to session components, character strengths identification, and activity completion. Acceptability was evaluated with self-reported pre- and postsession mood ratings, a postsession helpfulness rating, and narrative feedback.

RESULTS

Participants (N=70) had complex and severe mental health conditions. In 18 group sessions, 89% of components were delivered with fidelity; 80% of the participants identified a character strength, of whom 71% identified a strengths-based activity, and 58% completed the activity. The mean±SD helpfulness rating (N=23) was 8.5±1.5 (on a 10-point Likert scale), and positive mood significantly increased postsession (5.9 presession vs. 7.2 postsession).

CONCLUSIONS

Positive psychotherapy is feasible in challenging inpatient settings, and service users with severe and complex mental health conditions find it helpful.

Learning, doing and sticking with it: A qualitative study on achieving clinically significant reduction in cardiovascular disease risk in a healthy lifestyle intervention for people with serious mental illness

People with serious mental illness (SMI; e.g. schizophrenia) have mortality rates two to three times higher than the general population, largely due to a higher prevalence of cardiovascular disease (CVD). Healthy lifestyle interventions can improve the health of people with SMI, but information about why these interventions work for some and not others is scarce. Our study aims to qualitatively explore differences in these two groups' overall experiences and application of the intervention. Data were drawn from a randomised effectiveness trial of a peer-led healthy lifestyle intervention. Qualitative data from interviews and focus groups with 21 participants were linked to their 12-month outcome data. Grounded theory was used to compare the experiences of participants who achieved clinically significant CVD risk reduction (i.e. clinically significant weight loss or clinically significant improvements in cardiorespiratory fitness) versus those who did not. Three qualitative themes: learning, change, sticking with it - differentiated participants who achieved CVD risk reduction and those that did not. Participants achieving CVD risk reduction described learning and applying specific knowledge and skills related to a healthy lifestyle when making health decisions, made healthy concrete changes to diet and physical activity, and stuck with those changes. Participants not achieving clinically significant CVD risk reduction reported surface-level learning about healthy lifestyle practices, difficulty sticking with healthy changes, and were more likely to report ambiguous or no changes. Our findings suggest that healthy lifestyle interventions for people with SMI should provide experiential in-vivo learning experiences while periodically assessing participants' understanding and then tailoring the intervention to their needs. It is important to build self-efficacy for health behaviour changes by creating early perceptions of success, which was found to enhance motivation and sustain behaviour change. Helping people with SMI develop and strengthen their support systems will also be an important factor for building and sustaining health behaviour changes.

Correlates of Attendance in a Peer-Led Healthy Lifestyle Intervention for People with Serious Mental Illness Living in Supportive Housing

Healthy lifestyle interventions can improve the physical health of people with serious mental illness (SMI; e.g., schizophrenia). Yet, people with SMI report challenges participating in these interventions, thus limiting their potential benefits. This study examined attendance of participants (N = 155), largely comprised of racial and ethnic minorities, in a peer-led healthy lifestyle intervention living in supportive housing. A logistic regression model was used to identify correlates associated with attendance. Results indicated that females, those with at least a high school education, and a diagnosis of schizophrenia were more likely to attend. In contrast, the odds of attending at least one session were significantly lower for those who reported any drug use and for those who rated their health as good or excellent. Our findings indicate certain subgroups of people with SMI could benefit from tailored motivational strategies and supports to improve their participation in healthy lifestyle interventions. clinicaltrials.gov (NCT02175641).