title: An ethnographic study of the incentives and barriers to lifestyle interventions for people with severe mental illness.
abstract: OBJECTIVE
  To explore incentives and barriers to an educational lifestyle intervention for people with severe mental illness.
  
  
  BACKGROUND
  Social and lifestyle factors along with long-term antipsychotic therapy contribute to poorer physical health in people with severe mental illness. Behavioural lifestyle interventions for this clinical group have shown some benefit. Evidence relating to the incentives and barriers to interventions is limited.
  
  
  METHODS
  An ethnographic qualitative study was undertaken.
  
  
  METHODS
  Data collection was carried out through participant observations and semi-structured interviews with eight mental health service users attending, or previously attended, a group-based lifestyle intervention. Interview data were collected between September 2008-April 2009 and observation data were collected between September-December 2009.
  
  
  RESULTS
  Participant observation highlighted environment, facilitator style, group ownership, group cohesion, information and learning, incentives and barriers as important. Participant interviews identified weight management, social networking, information and communication, role of healthcare professionals and perceived benefits as key themes.
  
  
  CONCLUSIONS
  This study provides evidence about the incentives and barriers to lifestyle interventions from service users' perspective, which should inform developments to improve the delivery of lifestyle interventions for this group.
authors.affiliation: Institute of Medical and Social Care Research (IMSCaR), Bangor University, Wrexham, UK.
authors.forename: Seren Haf
authors.initials: SH
authors.lastname: Roberts
authors.forename: Jois Elisabeth
authors.initials: JE
authors.lastname: Bailey
mesh_terms: D000328:Adult; D000368:Aged; D000884:Anthropology, Cultural; D001521:Behavior Therapy; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D036301:Qualitative Research; D055815:Young Adult
keywords: ethnography; health promotion; incentives and barriers; lifestyle interventions; mental health; nursing; schizophrenia; severe mental illness