title: A qualitative study exploring facilitators for improved health behaviors and health behavior programs: mental health service users' perspectives.
abstract: OBJECTIVE
  Mental health service users experience high rates of cardiometabolic disorders and have a 20-25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1) facilitators that help mental health service users engage in better health behaviors and (2) the types of health programs mental health service users want to develop.
  
  
  METHODS
  A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada.
  
  
  RESULTS
  Four major facilitator themes were identified: (1) factors of empowerment, self-value, and personal growth; (2) the need for social support; (3) pragmatic aspects of motivation and planning; and (4) access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily.
  
  
  CONCLUSIONS
  Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
authors.affiliation: Northern Medical Program, Department of Psychiatry, University of Northern British Columbia, 3333 University Way, Prince George, BC, Canada V2K 4C2 ; University of British Columbia, Vancouver, BC, Canada V6T 1Z3.
authors.forename: Candida
authors.initials: C
authors.lastname: Graham
authors.affiliation: Northern Medical Program, Department of Psychiatry, University of Northern British Columbia, 3333 University Way, Prince George, BC, Canada V2K 4C2.
authors.forename: Crystal
authors.identifier: 0000-0003-2991-0879
authors.initials: C
authors.lastname: Rollings
authors.affiliation: Northern Medical Program, Department of Psychiatry, University of Northern British Columbia, 3333 University Way, Prince George, BC, Canada V2K 4C2 ; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada V6T 1Z4.
authors.forename: Sarah
authors.initials: S
authors.lastname: de Leeuw
authors.affiliation: Northern Medical Program, Department of Psychiatry, University of Northern British Columbia, 3333 University Way, Prince George, BC, Canada V2K 4C2.
authors.forename: Lesley
authors.identifier: 0000-0001-9731-3238
authors.initials: L
authors.lastname: Anderson
authors.affiliation: University of British Columbia, Vancouver, BC, Canada V6T 1Z3.
authors.forename: Brenda
authors.initials: B
authors.lastname: Griffiths
authors.affiliation: Activity Centre, BC Schizophrenia Society, Prince George Branch, Prince George, BC, Canada V2L 5G5.
authors.forename: Nansi
authors.identifier: 0000-0003-4586-4729
authors.initials: N
authors.lastname: Long
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D002318:Cardiovascular Diseases / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012944:Social Support