BACKGROUND: Obesity is prevalent in individuals with serious mental illness (SMI). OBJECTIVE: The purpose of this study is to examine the feasibility of a telephone-delivered physical activity (PA) intervention for outpatients with serious mental illness to maintain PA and to explore the preliminary efficacy of the intervention on health status. DESIGN: This study used a randomized experimental design. The treatment group received pedometers and eight weekly phone calls; the control group received written information regarding PA. Descriptive statistics were used to analyze data collected at baseline and 8 weeks. RESULTS: Twenty-two subjects with SMI (mean age = 44.09 ± 7.6 years; 54.5% were male) were recruited and 16 subjects completed the study in 8 weeks. PA (z = −2.37, p = .02) increased in the treatment group (n = 8) whereas the control group (n = 8) maintained baseline PA level (z = −1.61, p = .11). Health outcomes were not changed (ps > .05). CONCLUSION: Telephone-delivered intervention is feasible and has the potential to improve PA in individuals with SMI.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
AppelL. J.ClarkJ. M.YehH. C.WangN. Y.CoughlinJ. W.DaumitG.. . . BrancatiF. L. (2011). Comparative effectiveness of weight-loss interventions in clinical practice. New England Journal of Medicine, 365, 1959-1968. doi:10.1056/NEJMoa1108660
3.
BanduraA. (1997). Self-efficacy: The exercise of control. New York, NY: W. H. Freeman.
4.
BanduraA. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31, 143-164.
5.
Ben-ZeevD.DavisK. E.KaiserS.KrzsosI.DrakeR. E. (2013). Mobile technologies among people with serious mental illness: Opportunities for future services. Administration and Policy in Mental Health, 40, 340-343. doi:10.1007/s10488-012-0424-x
6.
BoardmanJ. (2006). Health access and integration for adults with serious and persistent mental illness. Families, Systems, & Health, 24(1), 3-18. doi:10.1037/1091-7527.24.1.3
7.
BodenheimerT.AbramowitzS. (2010). Helping patients help themselves: How to implement self-management support. Oakland: California Healthcare Foundation.
8.
BrarJ. S.GanguliR.PandinaG.TurkozI.BerryS.MahmoudR. (2005). Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder. Journal of Clinical Psychiatry, 66, 205-212.
9.
BravataD. M.Smith-SpanglerC.SundaramV.GiengerA. L.LinN.LewisR.. . . SirardJ. R. (2007). Using pedometers to increase physical activity and improve health: A systematic review. Journal of the American Medical Association, 298, 2296-2304. doi:10.1001/jama.298.19.2296
10.
CabassaL. J.EzellJ. M.Lewis-FernandezR. (2010). Lifestyle interventions for adults with serious mental illness: A systematic literature review. Psychiatric Services, 61, 774-782. doi:10.1176/appi.ps.61.8.774
11.
CallaghanP. (2004). Exercise: A neglected intervention in mental health care?Journal of Psychiatric and Mental Health Nursing, 11, 476-483. doi:10.1111/j.1365-2850.2004.00751.x
CunninghamP.McKenzieK.TaylorE. F. (2006). The struggle to provide community-based care to low-income people with serious mental illnesses. Health Affairs, 25, 694-705. doi:10.1377/hlthaff.25.3.694
14.
DaumitG. L.DickersonF. B.WangN. Y.DalcinA.JeromeG. J.AndersonC. A.. . . AppelL. J. (2013). A behavioral weight-loss intervention in persons with serious mental illness. New England Journal of Medicine, 368, 1594-1602. doi:10.1056/NEJMoa1214530
15.
DaumitG. L.GoldbergR. W.AnthonyC.DickersonF.BrownC. H.KreyenbuhlJ.. . . DixonL. B. (2005). Physical activity patterns in adults with severe mental illness. Journal of Nervous and Mental Disease, 193, 641-646.
16.
De HertM.DekkerJ. M.WoodD.KahlK. G.HoltR. I. G.MöllerH. J. (2009). Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). European Psychiatry, 24, 412-424. doi:10.1016/j.eurpsy.2009.01.005
17.
De HertM.SchreursV.VancampfortD.Van WinkelR. (2009). Metabolic syndrome in people with schizophrenia: A review. World Psychiatry, 8(1), 15-22. doi:10.1002/j.2051-5545.2009.tb00199.x
18.
DigenioA. G.MancusoJ. P.GerberR. A.DvorakR. V. (2009). Comparison of methods for delivering a lifestyle modification program for obese patients: A randomized trial. Annals of Internal Medicine, 150, 255-262.
19.
DonnellyJ. E.BlairS. N.JakicicJ. M.ManoreM. M.RankinJ. W.SmithB. K. (2009). American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercise, 41, 459-471.
20.
EastepE.BeveridgeS.EisenmanP.RansdellL.ShultzB. (2004). Does augmented feedback from pedometers increase adults’ walking behavior?Perceptual and Motor Skills, 99, 392-402.
21.
FaulknerG.CohnT.RemingtonG. (2006). Validation of a physical activity assessment tool for individuals with schizophrenia. Schizophrenia Research, 82, 225-231.
22.
FjeldsoeB. S.MarshallA. L.MillerY. D. (2009). Behavior change interventions delivered by mobile telephone short-message service. American Journal of Preventive Medicine, 36, 165-173. doi:10.1016/j.amepre.2008.09.040
23.
GanguliR.VreelandB.NewcomerJ. W. (2007). Monitoring and managing weight gain in the mentally ill. Journal of Clinical Psychiatry, 68, e14.
24.
GoldbergR. W.ReevesG.TapscottS.MedoffD.DickersonF.GoldbergA. P.. . . DixonL. B. (2013). “MOVE!” Outcomes of a weight loss program modified for veterans with serious mental illness. Psychiatry Services, 64, 737-744. doi:10.1176/appi.ps.201200314
25.
HamptonM.WhiteM.ChafetzL. (2009). Eligibility, recruitment, and retention of African Americans with severe mental illness in community research. Community Mental Health Journal, 45, 137-143. doi:10.1007/s10597-008-9162-7
26.
HarrisT.KerryS.VictorC.ShahS.IliffeS.UssherM.. . . CookD. (2013). PACE-UP (Pedometer and Consultation Evaluation: UP): A pedometer-based walking intervention with and without practice nurse support in primary care patients aged 45-75years: Study protocol for a randomised controlled trial. Trials, 14(1), 418. doi:10.1186/1745-6215-14-418
27.
HaskellW. L.LeeI.PateR. R.PowellK. E.BlairS. N.FranklinB. A.. . . BaumanA. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39, 1423-1434.
28.
International Physical Activity Questionnaire Group. (2005). Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ): Short and long forms. Retrieved from http://www.ipaq.ki.se/scoring.pdf
29.
KaneI.LeeH.SereikaS.BrarJ. (2012). Feasibility of pedometers for adults with schizophrenia: Pilot study. Journal of Psychiatric and Mental Health Nursing, 19(1), 8-14. doi:10.1111/j.1365-2850.2011.01747.x
30.
KoltG. S.SchofieldG. M.KerseN.GarrettN.OliverM. (2007). Effect of telephone counseling on physical activity for low-active older people in primary care: A randomized, controlled trial. Journal of the American Geriatric Society, 55, 986-992. doi:10.1111/j.1532-5415.2007.01203.x
31.
LeeH.ScheppK. G. (2013). Lessons learned from research with adolescents with schizophrenia and their families. Archives of Psychiatric Nursing, 27, 198-200.
32.
LeeI. M.SkerrettP. J. (2001). Physical activity and all-cause mortality: What is the dose-response relation?Medicine and Science in Sports and Exercise, 33(Suppl. 6), S459-S471.
33.
MarshallS. J.LevyS. S.Tudor-LockeC. E.KolkhorstF. W.WootenK. M.JiM.. . . AinsworthB. E. (2009). Translating physical activity recommendations into a pedometer-based step goal. American Journal of Preventive Medicine, 36, 410-415. doi:10.1016/j.amepre.2009.01.021
34.
McDevittJ.WilburJ.KoganJ.BrillerJ. (2005). A walking program for outpatients in psychiatric rehabilitation: Pilot study. Biological Research for Nursing, 7(2), 87-97. doi:10.1177/1099800405278116
35.
McElroyS. L. (2009). Obesity in patients with severe mental illness: Overview and management. Journal of Clinical Psychiatry, 70(Suppl. 3), 12-21. doi:10.4088/JCP.7075su1c.03
36.
MegnaJ. L.SchwartzT. L.SiddiquiU. A.Herrera RojasM. (2011). Obesity in adults with serious and persistent mental illness: A review of postulated mechanisms and current interventions. Annals of Clinical Psychiatry, 23, 131-140.
37.
The National Alliance on Mental Illness. (2008). Schizophrenia: Public attitudes, personal needs. Arlington, VA: National Alliance on Mental Illness.
38.
ParikhP.MochariH.MoscaL. (2009). Clinical utility of a fingerstick technology to identify individuals with abnormal blood lipids and high-sensitivity C-reactive protein levels. American Journal of Health Promotion, 23, 279-282. doi:10.4278/ajhp.071221140
39.
ParksJ.RadkeA. Q.RuterT. J. (2008). Obesity reduction and prevention strategies for individuals with serious mental illness. Alexandria, VA: National Association of State Mental Health Program Directors Medical Directors Council.
40.
ParksJ.SvendsenD.SingerP.FotiM. E.MauerB. (2006). Morbidity and mortality in people with serious mental illness. Alexandria, VA: National Association of State Mental Health Program Directors Medical Directors Council.
41.
PersingerR.FosterC.GibsonM.FaterD. C. W.PorcariJ. P. (2004). Consistency of the Talk Test for exercise prescription. Medicine and Science in Sports and Exercise, 36, 1632-1636.
42.
PintoB. M.RabinC.AbdowS.PapandonatosG. D. (2008). A pilot study on disseminating physical activity promotion among cancer survivors: A brief report. Psychooncology, 17, 517-521. doi:10.1002/pon.1268
43.
Ramirez-MarreroF. A.SmithB. A.ShermanW. M.KirbyT. E. (2005). Comparison of methods to estimate physical activity and energy expenditure in African American children. International Journal of Sports Medicine, 26, 363-371.
44.
RichardsonC. R.AvripasS. A.NealD. L.MarcusS. M. (2005). Increasing lifestyle physical activity in patients with depression or other serious mental illness. Journal of Psychiatric Practice, 11, 379-388.
45.
RichardsonC. R.FaulknerG.McDevittJ.SkrinarG. S.HutchinsonD. S.PietteJ. D. (2005). Integrating physical activity into mental health services for persons with serious mental illness. Psychiatric Services, 56, 324-331.
46.
SmithJ. D.SchroederC. A. (2008). Assessing pedometer accuracy while walking, skipping, galloping, sliding, and hopping. Journal of Strength and Conditioning Research, 22, 276-282.
47.
StrassnigM.BrarJ. S.GanguliR. (2005). Dietary intake of patients with schizophrenia. Psychiatry, 2(2), 31-35.
48.
ThomasS.ReadingJ.ShephardR. J. (1992). Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Canadian Journal of Sport Sciences, 17, 338-345.
49.
U.S. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD: Author.
50.
UssherM.StanburyL.CheesemanV.FaulknerG. (2007). Physical activity preferences and perceived barriers to activity among persons with severe mental illness in the United Kingdom. Psychiatric Services, 58, 405-408. doi:10.1176/appi.ps.58.3.405
51.
WarburtonD. E. R.NicolC. W.BredinS. S. D. (2006). Prescribing exercise as preventive therapy. Canadian Medical Association Journal, 174, 961-974. doi:10.1503/cmaj.1040750
52.
WenC. P.WaiJ. P. M.TsaiM. K.YangY. C.ChengT. Y. D.LeeM.-C.. . . WuX. (2011). Minimum amount of physical activity for reduced mortality and extended life expectancy: A prospective cohort study. Lancet, 378, 1244-1253.
53.
WilcoxS.DowdaM.WegleyS.OryM. G. (2009). Maintenance of change in the Active-for-Life initiative. American Journal of Preventive Medicine, 37, 501-504. doi:10.1016/j.amepre.2009.07.016
54.
World Health Organization. (2010). Global recommendations on physical activity for health. Geneva, Switzerland: WHO Press.
