Assessing sustainability of InSHAPE participants' fitness activities in a community mental health setting.

InSHAPE (Self Help Action Plan for Empowerment), an exercise and nutrition wellness program, is gaining national recognition for its success in helping individuals with serious mental illness (SMI) improve physical fitness and dietary habits. Although gains have been reported in objective measures of fitness as participants progressed through the year-long program, there is little information about what happens with participants after program completion. To address this gap in knowledge, the authors conducted a longitudinal qualitative study in which 11 InSHAPE participants were interviewed both near the end of their year in the program and 9 months later. Participants identified the trainer's ability to contain their initial feelings of distress and form a working alliance as factors that contributed to their exercise persistence. Current findings suggest that individuals with SMI may need a longer period of time working closely with fitness trainers to sustain physical activity levels achieved during the program.