Determinants of Physical Health Self-Management Behaviours in Adults With Serious Mental Illness: A Systematic Review

Abstract

Behavioural interventions can support the adoption of healthier lifestyles and improve physical health outcomes, but it is unclear what factors might drive success of such interventions in people with serious mental illness (SMI). We systematically identified and reviewed evidence of the association between determinants of physical health self-management behaviours in adults with SMI. Data about American Association of Diabetes Educator's Self-Care Behaviours (AADE-7) were mapped against the novel Mechanisms of Action (MoA) framework. Twenty-eight studies were included in the review, reporting evidence on 104 determinant-behaviour links. Beliefs about capabilities and beliefs about consequences were the most important determinants of behaviour, especially for being physically active and healthy eating. There was some evidence that emotion and environmental context and resources played a role in determining reducing risks, being active, and taking medications. We found very limited evidence associated with problem solving, and no study assessed links between MoAs and healthy coping. Although the review predominantly identified evidence about associations from cross-sectional studies that lacked validated and objective measures of self-management behaviours, these findings can facilitate the identification of behaviour change techniques with hypothesised links to determinants to support self-management in people with SMI.Systematic Review Registration: PROSPERO, registration CRD42018099553.

Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis

“…Here we report findings from the qualitative studies in the review. Findings from quantitative studies have been reported [ 20 ].…”

Non-Pharmacological Integrated Interventions for Adults Targeting Type 2 Diabetes and Mental Health Comorbidity: A Mixed-Methods Systematic Review

“…To achieve this, professionals within a multidisciplinary team or from different teams and/or services work collaboratively to identify behaviours to change and provide individualised care that utilises skills from their different specialisms [ 27 ]. Common non-pharmacological interventions for people with T2D and SMI may include motivational interviewing, psychoeducation, nutritional support, physical activity support, or talking therapies (e.g., diabetes or depression focused cognitive behavioural therapy) [ 28 ]. These interventions often include the use of behaviour change techniques [ 29 30 31 ] to promote positive health behaviours.…”

Interventions to Promote the Utilization of Physical Health Care for People with Severe Mental Illness: A Scoping Review

“…Interventions which mainly focus on the patient side to directly improve the physical health of people with a SMI have often been explored, in terms of lifestyle interventions [9][10][11][12]. These interventions focus on the promotion of healthy lifestyles and wellness, including structured approaches to change physical activity, weight, healthy diet, and healthy habits (e.g., quit or reduce smoking).…”

“…Peer specialists were implemented in six studies, four of them were peer-led without additional health care professionals. Most common elements of interventions included care-management (27), self-management support (23), physical health education (16), health screening and monitoring (16), lifestyle changes (12), training on the better utilization of health care (13), mental health education (10), care-plan development (9), and staff training (9). The duration of the interventions ranged from two to 24 months, most included six (8) or 12 (13) months of duration.…”