Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.
BMC Psychiatry. 2019 Sep 18;19(1):287. doi: 10.1186/s12888-019-2274-5.
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.
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.
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.
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.
ISRCTN Registry identifier: ISRCTN37724980 , retrospectively registered 25 September 2015.
心血管疾病（CVD）是严重精神疾病（SMI）患者过早死亡的主要原因。久坐行为（SB）是 CVD 和死亡率的独立危险因素，而 SMI 患者久坐行为非常普遍。我们开发了一种名为“Walk this Way”的健康辅导干预措施，以减少 SMI 患者的 SB 并增加其身体活动（PA），并进行了一项试点随机对照试验（RCT）以测试其可行性和可接受性。
我们将来自三个社区心理健康团队的 SMI 患者随机分配到 WTW 干预组或常规治疗组。WTW 干预持续 17 周，包括初始教育课程、每两周一次的辅导、提供计步器以及参加每周一次的步行小组。使用加速度计测量客观的 SB 和 PA。收集心血管代谢风险因素和健康相关生活质量的测量结果。
我们招募了 40 名参与者，其中 33 名（82.5%）完成了随访。分配到辅导干预组的 13/20（65%）名参与者完成了干预。在干预组中，SB 平均减少了 56 分钟，每天的总 PA 增加了 32 分钟，并且在 6 个月后仍保持不变。对照组的 PA 或 SB 没有变化。当接受访谈时，干预组的参与者认为该干预措施是有帮助和可接受的。干预措施没有报告任何不良事件。
该干预措施对参与者来说是可行且可接受的。初步结果令人鼓舞，SB 和 PA 均有改善。需要进行更大规模的研究来评估干预措施的有效性并解决任何实施挑战。
ISRCTN 注册标识符：ISRCTN37724980，于 2015 年 9 月 25 日回顾性注册。
