Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-05-29T09:58:22.565Z Has data issue: false hasContentIssue false
  • English
  • Français

A qualitative evaluation of a telehealth healthy lifestyle intervention for people with serious mental illness

Published online by Cambridge University Press:  04 August 2023

D. O’Keeffe Open the ORCID record for D. O’Keeffe [Opens in a new window]  and
M. Clarke
D. O’Keeffe*
Affiliation:
DETECT Early Intervention in Psychosis Service, County Dublin, Ireland ARCHES (Advancing Recovery in Community Healthcare East Services) Recovery College, Clonskeagh Hospital, Dublin, Ireland
M. Clarke
Affiliation:
DETECT Early Intervention in Psychosis Service, County Dublin, Ireland School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
*
Corresponding author: D. O’Keeffe; Email: donalokee@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

There are high levels of nutritional and metabolic, cardiovascular, and respiratory tract diseases among people diagnosed with serious mental illness (SMI). Consequently, we developed a pragmatic, affordable nutritional and exercise intervention: Choices4Health. Due to the COVID-19 pandemic, we modified this intervention so it could be delivered online. The aim of this study was to explore the experience of participating in online Choices4Health, in a real-world clinical setting, from the perspectives of service users with SMI.

Methods:

The study aim was addressed using thematic analysis. Service users who had attended online Choices4Health, received a SMI diagnosis (defined as a schizophrenia spectrum disorder or an affective disorder), and resided in a South Dublin catchment were invited to participate. Nine participants were purposefully sampled. Semi-structured interviews were conducted by telephone. Data analysis was guided by thematic analysis procedures.

Results:

Six themes were generated: Being ready and not overburdened (Engagement); Gaining knowledge and implementing it (Learning and doing); Viewing the intervention as appropriate and effective (Targeted impact); Being at home with others online (Belonging); Having a positive affective attitude towards the intervention (Feeling); and Perceiving problems with intervention delivery (Recommended change).

Conclusions:

Findings suggest that online Choices4Health is, broadly speaking, acceptable from a service user perspective, but that further refinement is required to address specific issues participants identified. These relate to follow-up or programme extension, technology access, in-person contact preference, and participant inclusion criteria. Further research is required into online Choices4Health efficacy, innovations to reduce digital exclusion, and managing group dynamics in telehealth interventions.

Keywords

Physical healthtelehealthserious mental illnessacceptabilityqualitative
Type
Original Research
Information
Irish Journal of Psychological Medicine , First View , pp. 1 - 9
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bartels, S (2015). Can behavioral health organizations change health behaviors? The STRIDE study and lifestyle interventions for obesity in serious mental illness. American Journal of Psychiatry 172, 9–11.CrossRefGoogle ScholarPubMed
Bartels, S, Pratt, S, Aschbrenner, K, Barre, L, Naslund, J, Wolfe, R, et al. (2015). Pragmatic replication trial of health promotion coaching for obesity in serious mental illness and maintenance of outcomes. American Journal of Psychiatry 172, 344–352.CrossRefGoogle ScholarPubMed
Braun, V, Clark, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.CrossRefGoogle Scholar
Braun, V, Clarke, V (2021). To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative Research in Sport, Exercise and Health, 13, 201–216.CrossRefGoogle Scholar
Broughan, J, McCombe, G, Lim, J, O’Keeffe, D, Brown, K, Clarke, M, et al. (2021). Keyworker mediated enhancement of physical health in patients with first episode psychosis: a feasibility/acceptability study. Early Intervention in Psychiatry 116, 883–890.Google Scholar
Caemmerer, J, Correll, C, Maayan, L (2012). Acute and maintenance effects of non-pharmacologic interventions for antipsychotic associated weight gain and metabolic abnormalities: a meta-analytic comparison of randomized controlled trials. Schizophrenia Research 140, 159–168.CrossRefGoogle ScholarPubMed
Chatzisarantis, N, Hagger, M, Brickell, T (2008). Using the construct of perceived autonomy support to understand social influence within the theory of planned behavior. Psychology of Sport and Exercise 9, 27–44.CrossRefGoogle Scholar
Correll, C, Detraux, J, De Lepeleire, J, De Hert, M (2015). Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. World Psychiatry 14, 119–136.CrossRefGoogle ScholarPubMed
Correll, C, Solmi, M, Veronese, N, Bortolato, B, Rosson, S, Santonastaso, P, et al. (2017). Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry 16, 163–180.CrossRefGoogle Scholar
First, M, Williams, J, Karg, R, Spitzer, R (2015). Structured Clinical Interview for DSM-5 disorders: SCID-5- CV (clinician version), American Psychiatric Association Publishing: Arlington, VA.Google Scholar
Firth, J, Cotter, J, Elliott, R, French, P, Yung, A (2015). A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychological Medicine 45, 1343–1361.CrossRefGoogle ScholarPubMed
Firth, J, Solmi, M, Wootton, R, Vancampfort, D, Schuch, F, Hoare, E, et al. (2020). A meta-review of ‘lifestyle psychiatry 19;: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry 19, 360–380.CrossRefGoogle Scholar
Gallagher, P, Boland, C, McClenaghan, A, Fanning, F, Lawlor, E, Clarke, M (2021). Improved self-esteem and activity levels following a 12-week community activity and healthy lifestyle programme in those with serious mental illness: a feasibility study. Early Intervention in Psychiatry 15, 367–373.CrossRefGoogle ScholarPubMed
Gardner, A, Filia, K, Killackey, E, Cotton, S (2019). The social inclusion of young people with serious mental illness: a narrative review of the literature and suggested future directions. Australian and New Zealand Journal of Psychiatry 53, 15–26.CrossRefGoogle ScholarPubMed
Gaughran, F, Stahl, D, Ismail, K, Greenwood, K, Atakan, Z, Gardner-Sood, P, et al. (2017). Randomised control trial of the effectiveness of an integrated psychosocial health promotion intervention aimed at improving health and reducing substance use in established psychosis (IMPaCT). BMC Psychiatry 17, 1–14.CrossRefGoogle ScholarPubMed
Hardcastle, S, Hancox, J, Hattar, A, Maxwell-Smith, C, Thøgersen-Ntoumani, C, Hagger, M (2015). Motivating the unmotivated: how can health behavior be changed in those unwilling to change? Frontiers in Psychology 6, 835.CrossRefGoogle ScholarPubMed
Holt, R, Gossage-Worrall, R, Hind, D, Bradburn, M, McCrone, P, Morris, T, et al. (2019). Structured lifestyle education for people with schizophrenia, schizoaffective disorder and first-episode psychosis (STEPWISE): randomised controlled trial. British Journal of Psychiatry 214, 63–73.CrossRefGoogle ScholarPubMed
Love, B, Vetere, A, Davis, P (2020). Should interpretative phenomenological analysis (IPA) be used with focus groups? Navigating the bumpy road of iterative loops 19, idiographic journeys, and phenomenological bridges. International Journal of Qualitative Methods 19, 1–17.CrossRefGoogle Scholar
Malterud, K, Siersma, V, Guassora, A (2016). Sample size in qualitative interview studies: guided by information power. Qualitative Health Research 26, 1753–1760.CrossRefGoogle ScholarPubMed
Martland, R, Teasdale, S, Murray, R, Gardner-Sood, P, Smith, S, Ismail, K, et al. (2023). Dietary intake, physical activity and sedentary behaviour patterns in a sample with established psychosis and associations with mental health symptomatology. Psychological Medicine 53, 1565–1575.CrossRefGoogle Scholar
O’Keeffe, D, Keogh, B, Higgins, A (2021). Meaning in life in long-term recovery in first-episode psychosis: an interpretative phenomenological analysis. Frontiers in Psychiatry 12, 676593.CrossRefGoogle ScholarPubMed
O’Keeffe, D, Sheridan, A, Kelly, A, Doyle, R, Madigan, K, Lawlor, E, et al. (2018). Recovery’ in the real world: service user experiences of mental health service use and recommendations for change 20 years on from a first episode psychosis. Administration and Policy in Mental Health and Mental Health Services Research 45, 635–648.CrossRefGoogle ScholarPubMed
Palinkas, L, Engstrom, A, Whiteside, L, Moloney, K, Zatzick, D (2021). A rapid ethnographic assessment of the impact of the COVID-19 pandemic on mental health services delivery in an acute care medical emergency department and trauma center. Administration and Policy in Mental Health and Mental Health Services Research 49, 157–167.CrossRefGoogle Scholar
Pedley, R, Lovell, K, Bee, P, Bradshaw, T, Gellatly, J, Ward, K, et al. (2018). Collaborative, individualised lifestyle interventions are acceptable to people with first episode psychosis: a qualitative study. BMC Psychiatry 18, 1–9.CrossRefGoogle ScholarPubMed
Rains, L, Johnson, S, Barnett, P, Steare, T, Needle, J, Carr, S, et al. (2021). Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses. Social Psychiatry and Psychiatric Epidemiology 56, 13–24.CrossRefGoogle Scholar
Ransing, R, Adiukwu, F, Pereira-Sanchez, V, Ramalho, R, Orsolini, L, Teixeira, A, et al. (2020). Mental health interventions during the COVID-19 pandemic: a conceptual framework by early career psychiatrists. Asian Journal of Psychiatry 51, 102085.CrossRefGoogle ScholarPubMed
Reinharz, S (1997). Who am I? The need for a variety of selves in the field. In: Reflexivity and Voice, (ed R. Hertz), pp. 3–20. Thousand: Sage, Oaks, CA.Google Scholar
Roberts, E, Mehrotra, A (2020). Assessment of disparities in digital access among medicare beneficiaries and implications for telemedicine. JAMA Internal Medicine 180, 1386–1389.CrossRefGoogle ScholarPubMed
Santesteban-Echarri, O, Piskulic, D, Nyman, R, Addington, J (2020). Telehealth interventions for schizophrenia-spectrum disorders and clinical high-risk for psychosis individuals: a scoping review. Journal of Telemedicine and Telecare 26, 14–20.CrossRefGoogle ScholarPubMed
Sheridan, A, O’Keeffe, D, Coughlan, B, Frazer, K, Drennan, J, Kemple, M (2018). Friendship and money: a qualitative study of service users’ experiences of participating in a supported socialisation programme. International Journal of Social Psychiatry 64, 326–334.CrossRefGoogle Scholar
Speyer, H, Jakobsen, A, Westergaard, C, Nørgaard, H, Pisinger, C, Krogh, J, et al. (2019). Lifestyle interventions for weight management in people with serious mental illness: a systematic review with meta-analysis, trial sequential analysis, and meta-regression analysis exploring the mediators and moderators of treatment effects. Psychotherapy and Psychosomatics 88, 350–362.CrossRefGoogle ScholarPubMed
Stubbs, B, Williams, J, Shannon, J, Gaughran, F, Craig, T (2016). Peer support interventions seeking to improve physical health and lifestyle behaviours among people with serious mental illness: a systematic review. International Journal of Mental Health Nursing 25, 484–495.CrossRefGoogle ScholarPubMed
Summers-Gabr, N (2020). Rural-urban mental health disparities in the United States during COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy 12, S222–S224.CrossRefGoogle ScholarPubMed
Teasdale, S, Ward, P, Rosenbaum, S, Samaras, K, Stubbs, B (2017). Solving a weighty problem: systematic review and meta-analysis of nutrition interventions in severe mental illness. British Journal of Psychiatry 210, 110–118.CrossRefGoogle ScholarPubMed
Tong, A, Sainsbury, P, Craig, J (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care 19, 349–357.CrossRefGoogle ScholarPubMed
Van Citters, A, Pratt, S, Jue, K, Williams, G, Miller, P, Xie, H, et al. (2010). A pilot evaluation of the in SHAPE individualized health promotion intervention for adults with mental illness. Community Mental Health Journal 46, 540–552.CrossRefGoogle ScholarPubMed
Van Jaarsveld, G (2020). The effects of COVID-19 among the elderly population: a case for closing the digital divide. Frontiers in Psychiatry 11, 577427.CrossRefGoogle Scholar
Vera San Juan, N, Shah, P, Schlief, M, Appleton, R, Nyikavaranda, P, Birken, M, et al. (2021). Service user experiences and views regarding telemental health during the COVID-19 pandemic: a co-produced framework analysis. PLoS One 16, e0257270.CrossRefGoogle ScholarPubMed
Walker, E, McGee, R, Druss, B (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 72, 334–341.CrossRefGoogle ScholarPubMed
Watkins, A, Denney-Wilson, E, Curtis, J, Teasdale, S, Rosenbaum, S, Ward, P, et al. (2020). Keeping the body in mind: a qualitative analysis of the experiences of people experiencing first-episode psychosis participating in a lifestyle intervention programme. International Journal of Mental Health Nursing 29, 278–289.CrossRefGoogle Scholar
Supplementary material: File

O’Keeffe and Clarke supplementary material

Appendix

Download O’Keeffe and Clarke supplementary material(File)
File 19.8 KB