Walking fOR Health (WORtH) Study: reflections on the delivery of a feasibility randomised controlled trial of an intervention to increase physical activity and reduce sedentary behaviour in people with severe mental illness

Sarah Howes, John Brady, Mary Clarke, CLARKE MIKE, Maurice Dillon, Duana McArdle, Judith McAuley, Catherine M. McDonough, Marie H Murphy, Ailsa Niven, Tony O'Neill, Mark Tully, Julie Williams, Iseult Wilson, S McDonough

Research output: Contribution to conferenceAbstractpeer-review

Abstract

Title: Walking fOR Health (WORtH) Study: reflections on the delivery of a feasibility randomised controlled trial of an intervention to increase physical activity and reduce sedentary behaviour in people with severe mental illness
Background: People with severe mental illness (SMI), such as schizophrenia, psychosis, bipolar affective disorder and major depressive disorder, are less physically active and more sedentary than healthy controls, contributing to poorer physical health outcomes in this population. People with SMI experience unique challenges to increasing their physical activity and reducing their sedentary behaviour which are both directly and indirectly related to their mental health condition. These include amotivation, fatigue, cognitive challenges and sedative effects of psychotropic medication. Hence, there is a need to understand the best way to target physical activity and sedentary behaviour in this population to improve physical health outcomes. Previous feasibility research showed that a walking-based intervention to increase physical activity and reduce sedentary behaviour in adults SMI living in a densely populated urban setting was feasible and acceptable (Williams et al. 2019). It is not clear how these findings will transfer to rural and semi-rural settings; therefore, the WORtH Study aims to understand the feasibility and acceptability, and explore the effective components, of a walking-based health behaviour change intervention targeting physical activity and sedentary behaviour in this population in rural and semi-rural settings.
Methods: The Walking fOR Health (WORtH) study is a 13-week feasibility randomised controlled trial comparing the WORtH multi-component behaviour change intervention with a one-off education session. Participants allocated to the WORtH intervention receive an education session, a wrist-worn activity monitor and activity diary for self-monitoring and six coaching sessions for goal-setting and action planning related to physical activity and sedentary behaviour with a clinician trained to deliver the intervention. The WORtH study aims to recruit 60 inactive adults with SMI via four community mental health teams in Ireland and Northern Ireland. Primary outcomes are related to feasibility and acceptability, including recruitment, retention and adherence rates, adverse events and qualitative feedback from participants and clinicians. Secondary outcome measures include self-reported and accelerometer-measured physical activity and sedentary behaviour (using the Axivity AX3, SIMPAQ and Sedentary Behaviour Questionnaire), anthropometry measures, physical function, mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale) and measures of motivation (BREQ-2) and psychological needs in exercise (PNSE), measured at baseline and at post-intervention for all participants and at six and 12 months post-intervention for a sub-group of participants. A mixed-methods process evaluation will be undertaken to understand how the intervention works, the effective intervention components and mediators of behaviour change.
Results/Discussion: At the time of abstract submission, recruitment and data collection are ongoing for the WORtH Study. This presentation will provide an overview of the study protocol, including changes in response to the COVID-19 pandemic. We will present an overview of the intervention components and behaviour change techniques included within the WORtH intervention. The presentation will also include reflections on study delivery to date, with observations on clinician training, study recruitment and delivery, participant and clinician feedback on the acceptability of the intervention and requirements for delivery, and the challenges faced and strategies implemented in response.
Trial registration: The trial was registered on clinicaltrials.gov (NCT04134871) on 22 October 2019.
Keywords: Physical activity, Sedentary behaviour, Behaviour change, Severe mental illness
Original languageEnglish
Publication statusPublished (in print/issue) - 21 Sept 2022
EventWalk 21 Ireland Conference -
Duration: 19 Sept 202223 Sept 2022

Conference

ConferenceWalk 21 Ireland Conference
Period19/09/2223/09/22

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