Physical activity counselling in people with suicidal ideation: a secondary analysis of a pilot study in Ugandan primary care settings.

INTRODUCTION

primary care settings are ideal to implement suicide risk reduction initiatives in low-and middle-income countries. Health staff working in primary care settings are often over-burdened and under-resourced. Task-shifting through lifestyle counseling by lay health workers might be a relevant intervention. The aim of this secondary analysis from a pilot study exploring the efficacy of lay health worker (LHW)-led physical activity (PA) counselling for primary care patients with mental health problems (PCMH) was to investigate the efficacy of PA on reducing suicidal ideation.

METHODS

from 130 Ugandan PCMH screened in two centers, 8.5% (n=11) reported suicidal ideation. These 11 PCMH (9♀, median age= 52 years, interquartile range= 37 years) participated once weekly for 8 weeks in group PA counselling based on the mental contrasting and implementation of intentions framework. All participants completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Simple Physical Activity Questionnaire (SIMPAQ) pre- and immediately post-intervention.

RESULTS

in PCMH with suicidal ideation (PHQ-9 item 9≥1) the prevalence of suicidal ideation dropped to 9% post-intervention, i.e. only one patient reported suicidal ideation post-intervention. Following the intervention, significant (P<0.05) increases in walking, exercising and incidental PA (SIMPAQ) levels, and reductions in depressive and anxiety symptoms were observed.

CONCLUSION

our data demonstrate that LHW-led PA counselling might be promising intervention in reducing suicidal ideation in primary care patients in low-resourced settings. Randomized controlled trials are warranted to confirm these beneficial findings.