Exploring how health behaviours are supported and changed in people with severe mental illness: A qualitative study of a cardiovascular risk reducing intervention in Primary Care in England

Abstract

Objectives. This study explored how health behaviours were supported and changed in people with severe mental illness by primary health care professionals trained in delivering behaviour change techniques (BCTs) within a cardiovascular disease risk reducing intervention.Design. Secondary qualitative analysis of 30 staff and patient interviews.Methods. We mapped coded data to the BCT Taxonomy (version 1) to identify BCT application. Thematic analysis was conducted to explore the barriers and facilitators of supporting and changing health behaviours. Themes were then interpreted using the Capability, Opportunity, Motivation, and Behaviour model to gain greater explanation behind the processes.Results. Twenty BCTs were identified. Staff and patients perceived that health behaviours were commonly affected by both automatic and reflective motivation, sometimes in turn affected by psychological capability, social, and physical opportunity. Staff and patients suggested that motivation was enhanced by both patient and staff ability to observe health benefits, in some cases patients' health knowledge, mental health status, and social support networks. It was suggested that engaging in/sustaining healthy behaviours was influenced by physical opportunities to engrain behaviours into routine.Conclusions. According to staff and patients, health behaviour change in this population was driven by complex processes. It was suggested that capability, opportunity, and motivation were in some cases enhanced by BCTs, but variable. Behaviour change may be optimized by individualized behavioural assessments, identifying drivers of behaviour and applying a range of BCTs may help to target individual needs. Patient peer-led approaches, techniques to encourage awareness of visible success, and normalizing health behaviours may increase behaviour change.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Mental health consumers' perspectives of physical health interventions: An integrative review

“…2020; Hassan et al . 2020a, 2020b; Rönngren et al . 2018) and a physiotherapist (Hemmings & Soundy 2020).…”

“…Some consumers attributed the success of the interventions to the flexible person‐centred approach to intervention delivery (Edmunds 2018; Fogarty & Happell 2005; Hassan et al . 2020a, 2020b), accessibility to the intervention (Edmunds 2018; Hassan et al . 2020a, 2020b), and peer and health professional support (Fogarty & Happell 2005; Furness et al .…”

“…2020a, 2020b), accessibility to the intervention (Edmunds 2018; Hassan et al . 2020a, 2020b), and peer and health professional support (Fogarty & Happell 2005; Furness et al . 2020; Park et al .…”

“…Additionally, these positive experiences with healthcare professionals enhanced motivation and enabled consumers' perseverance with an intervention (Hassan et al . 2020a, 2020b; Watkins et al . 2020).…”

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

“…Further research about which MoAs are likely to support people with SMI and long-term conditions to engage with health services is warranted. Here, the perspectives of health professionals and carers might be insightful as there may be some mechanisms that people with SMI are less likely to self-report ( 107 ). Furthermore, by focusing on evidence originating from people with SMI alone, the relationship between self-management and the organisation and delivery of care may be overlooked ( 87 ).…”