Developing physical activity interventions for individuals with schizophrenia


Schizophrenia is the most disabling and persistent form of severe mental illness (SMI). Life expectancy is shorter by 15 years primarily because of coronary artery disease. Research is urgently required in developing evidence-based behavioural interventions for preventing and treating obesity and diabetes that are specific to this population. In particular, reducing the high prevalence of physical inactivity is a priority. This presentation will provide an overview of a research programme of a sequential series of phases leading to the creation and piloting of two interventions that promote active lifestyles including an individual level, modified form of exercise counselling and a group-mediated cognitive behavioural intervention. These studies have demonstrated mixed success in changing key psychological mediators and physical activity as measured by accelerometry or self-report.  The development and ongoing implementation of this work will be discussed in light of a number of systemic barriers to physical activity promotion within mental health settings. These range from the nature of the illness as being one characterized by amotivation, to the increasing shift to ‘care in the community’ models of practice, and reductions in the number of specialized professionals who could play a role in promoting physical activity.  Overall, this phased pilot work suggests multi-level ecological interventions are feasible and acceptable to individuals with schizophrenia, and that modest benefits can be attained through intervention. Developing sustainable forms of intervention that can be delivered in community settings remains a future challenge. Kinesiologists may have an important role to play as extended members of community mental health teams. 

Acknowledgments: Work reported in this abstract was supported by the Canadian Institutes of Health Research and the Ontario Mental Health Foundation.