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Williams J, Stubbs B, Richardson S, Flower C, Barr-Hamilton L, Grey B, Hubbard K, Spaducci G, Gaughran F, Craig T. 'Walk this way': results from a pilot randomised controlled trial of a health coaching intervention to reduce sedentary behaviour and increase physical activity in people with serious mental illness. BMC Psychiatry 2019; 19:287. [PMID: 31533686 PMCID: PMC6749630 DOI: 10.1186/s12888-019-2274-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/05/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of premature death among people with serious mental illness (SMI). Sedentary behaviour (SB) is an independent risk factor for CVD and mortality and people with SMI are highly sedentary. We developed a health coaching intervention called 'Walk this Way' to reduce SB and increase physical activity (PA) in people with SMI and conducted a pilot randomised controlled trial (RCT) to test its feasibility and acceptability. METHODS We randomised people with SMI from three community mental health teams into either the WTW intervention or treatment as usual. The WTW intervention lasted 17 weeks and included an initial education session, fortnightly coaching, provision of pedometers and access to a weekly walking group. Objective SB and PA were measured with accelerometers. Cardiometabolic risk factors and wellbeing measures were collected. RESULTS We recruited 40 people of whom 33 (82.5%) were followed up. 13/20 (65%) of participants allocated to the coaching intervention completed it. In the intervention group SB decreased by 56 min and total PA increased by 32 min per day on average which was sustained 6 months later. There was no change in PA or SB in the control group. When interviewed, participants in the intervention found the intervention helpful and acceptable. No adverse events were reported from the intervention. CONCLUSIONS The intervention was feasible and acceptable to participants. Preliminary results were encouraging with improvement seen in both SB and PA. A larger study is needed to assess the effectiveness of the intervention and address any implementation challenges. TRIAL REGISTRATION ISRCTN Registry identifier: ISRCTN37724980 , retrospectively registered 25 September 2015.
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Affiliation(s)
- Julie Williams
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Brendon Stubbs
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0000 9439 0839grid.37640.36Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK ,0000 0001 2322 6764grid.13097.3cPsychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sol Richardson
- 0000 0001 2322 6764grid.13097.3cAddiction Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.501140.1UK Centre for Tobacco and Alcohol Studies, Nottingham, UK
| | - Cathy Flower
- 0000 0000 9439 0839grid.37640.36Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lucy Barr-Hamilton
- 0000 0000 9439 0839grid.37640.36Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Barbara Grey
- 0000 0000 9439 0839grid.37640.36Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kathryn Hubbard
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gilda Spaducci
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Fiona Gaughran
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0001 2322 6764grid.13097.3cPsychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0000 9439 0839grid.37640.36National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Tom Craig
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Slade M, Bird V, Le Boutillier C, Farkas M, Grey B, Larsen J, Leamy M, Oades L, Williams J. Development of the REFOCUS intervention to increase mental health team support for personal recovery. Br J Psychiatry 2015; 207:544-50. [PMID: 26450586 DOI: 10.1192/bjp.bp.114.155978] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 02/13/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking. AIMS To develop a theoretically based and empirically defensible new pro-recovery manualised intervention--called the REFOCUS intervention. METHOD Seven systematic and two narrative reviews were undertaken. Identified evidence gaps were addressed in three qualitative studies. The findings were synthesised to produce the REFOCUS intervention, manual and model. RESULTS The REFOCUS intervention comprises two components: recovery-promoting relationships and working practices. Approaches to supporting relationships comprise coaching skills training for staff, developing a shared team understanding of recovery, exploring staff values, a Partnership Project with people who use the service and raising patient expectations. Working practices comprise the following: understanding values and treatment preferences; assessing strengths; and supporting goal-striving. The REFOCUS model describes the causal pathway from the REFOCUS intervention to improved recovery. CONCLUSIONS The REFOCUS intervention is an empirically supported pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940).
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Affiliation(s)
- Mike Slade
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Victoria Bird
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Clair Le Boutillier
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Marianne Farkas
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Barbara Grey
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - John Larsen
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Mary Leamy
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Lindsay Oades
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Julie Williams
- Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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