‘Walk this way’: results from a pilot randomised controlled trial of a health coaching intervention to reduce sedentary behaviour and increase physical activity in people with serious mental illness

Abstract

Background 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. Methods 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. Results 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. Conclusions 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. Trial registration ISRCTN Registry identifier: ISRCTN37724980, retrospectively registered 25 September 2015.

Lifestyle interventions to reduce sedentary behaviour in clinical populations: A systematic review and meta-analysis of different strategies and effects on cardiometabolic health

“…All included studies were published in the last 10 years (2010 to 2019), with the majority originating after 2017 (n = 10). Six studies included a follow-up measure 7 to 40 weeks post-intervention (Thomsen et al, 2019;Biddle et al, 2020;De Greef et al, 2010;De Greef et al, 2011;Williams et al, 2019;Ryan et al, 2019). All studies were written in the English language and could be categorised in five clinical population groups, including overweight/obesity (n = 6), (pre) diabetes mellitus type 2 (T2DM, n = 4), cardiovascular diseases (CVD; n = 4), neurological and cognitive disorders (n = 2) and musculoskeletal disorders (n = 2).…”

“…Eight studies met either two (n: 5) (De Greef et al, 2010;De Greef et al, 2011;Ryan et al, 2019;Laslovich et al, 2019;Lyons et al, 2017) or one (n: 3) (Biddle et al, 2020;Paul et al, 2016;Prince et al, 2018) of the six risk of bias criteria. However, 13 studies provided insufficient information to assess three (n: 3) (Kozey Keadle et al, 2014;MacEwen et al, 2017;Yang et al, 2017), two (n: 4) (Paul et al, 2016;English et al, 2016;Holliday et al, 2020;Miyamoto et al, 2017) and one (n: 6) (Thomsen et al, 2017;Biddle et al, 2020;Williams et al, 2019;Laslovich et al, 2019;Carr et al, 2013;Thomsen et al, 2016) risk of bias criteria. Although a selection bias could be precluded in all studies, five studies did not describe the concealment procedure in sufficient detail.…”

How VA Whole Health Coaching Can Impact Veterans’ Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation

“…Prior studies of health coaching interventions have shown coaching to be effective in promoting health behavior change and improving some health outcomes. 10 – 12 , 33 In particular, coaching toward a defined purpose to facilitate health behavior change—for example, tobacco cessation, 34 , 35 increasing physical activity, 12 , 36 , 37 or improving diet and weight management 11 ,12 —often results in a significant, measurable impact. However, unlike many coaching programs (and other health behavior interventions), the broad aims of Whole Health Coaching are not defined in advance; they are instead defined by participants in the course of the coaching relationship.…”

A feasibility hybrid II randomised controlled trial of volunteer ‘Health Champions’ supporting people with serious mental illness manage their physical health: study protocol

“…As we know there will be participants who drop out of the study, we will recruit 120 participants—60 in the intervention group and 60 in the control group to account for this drop out. We are basing this dropout rate partly on a pilot study undertaken with this population evaluating an intervention to support people to be more physically active [ 20 ]. This sample size is used due to the resources of the study.…”