Psychosocial factors associated with physical activity behavior among patients with psychosis

Risk prevalence, readiness and confidence to change lifestyle risk factors among clients of community mental health services

OBJECTIVE

People with mental health conditions have high rates of chronic physical diseases, partially attributable to lifestyle risks factors. This study examined risk prevalence among community mental health service clients, their readiness and confidence to change, and associations with participant characteristics.

METHODS

Cross-sectional survey of adult clients from 12 community mental health services across 3 local health districts in New South Wales, Australia, collected from 2021 to 2022. Participants (n = 486) completed a telephone interview determining five risk factors, and readiness and confidence to change these. Multiple binary logistic regression models determined associations between readiness and confidence (for each risk), and participant characteristics (demographics and diagnosis).

RESULTS

Participants most commonly reported a diagnosis of schizophrenia (36.7%) or depression (21.1%). Risk factors were prevalent: ranging from 26% (harmful alcohol use) to 97% (poor nutrition). High readiness was greatest for smoking (68%), weight (66%) and physical inactivity (63%), while confidence was highest for changing alcohol use (67%). Two significant associations were identified; females were more likely than males to have high readiness to change nutrition (odds ratio = 1.14, confidence interval = [1.13, 2.34], p = 0.0092), with males more likely to have high confidence to change physical activity (odds ratio = 0.91, confidence interval = [0.45, 0.99], p = 0.0109).

CONCLUSIONS

Many participants were ready and confident to change risk factors. Gender influenced readiness to change nutrition and physical activity confidence. Training to upskill mental health clinicians in provision of preventive care that builds confidence and readiness levels may aid in supporting positive behaviour change.

Qualitative investigation of perceived barriers to and enablers of sport participation for young people with first episode psychosis

AIMS

The aim and objective of the study was building on a previous call for the development of sport-based life skills interventions for young people with first episode of psychosis (FEP) (Brooke, Lin, Ntoumanis, & Gucciardi, 2018), to explore the barriers and enablers to sport participation for young people with FEP.

METHOD

We used a semi-structured interview format to conduct one-to-one interviews with young people (aged 16-25; n = 10) with FEP, and one-to-one interviews and focus groups with their clinicians (n = 33). Questions focused on barriers and facilitators (intrapersonal, interpersonal, psychological, environment, health/safety, logistical) to sport participation young people with FEP. Thematic analysis was used to analyse the data.

RESULTS

Four themes (and 11 sub-themes) emerged from the analysis: (a) the need for sport in FEP recovery (perceived benefits; resource gap); (b) barriers (logistical; psychological); (c) enablers (positive environmental expectations and experiences) and (d) programme design (sport programme/type; life skills training; application to barriers/enablers).

CONCLUSION

The participants responded favourably to the idea of using sport to promote recovery post-FEP, and provided an insight into why sport is currently underutilized within FEP recovery efforts. The barriers, enablers, and specific suggestions for how to limit the barriers and strengthen the enablers are valuable for sport-based intervention design, and may be applicable to non-sport-based interventions for people with FEP.