title: 'Walk This Way' - a pilot of a health coaching intervention to reduce sedentary behaviour and increase low intensity exercise in people with serious mental illness: study protocol for a randomised controlled trial.
abstract: People with serious mental illness (SMI) (psychosis, bipolar disorder and major depressive disorder) experience a considerable risk of premature mortality because of cardiovascular disease. Recent research has demonstrated that this population spends almost 13 h per day being sedentary. Sedentary behaviour is an independent risk factor for cardiovascular disease and mortality. Given the potential for physical activity to improve health and well-being in people with SMI, we developed a pilot randomised controlled trial (RCT) to evaluate a coaching intervention aimed at reducing sedentary behaviour and increasing physical activity in people with SMI. Our primary aim was to assess the acceptability and feasibility of the intervention. Secondary aims were to see if the Walk This Way (WTW) intervention decreased sedentary behaviour and increased activity levels.
  
  
  
  People with SMI who met any of the following criteria were recruited by two community mental health teams in South London: (1) overweight, (2) at risk for or have diabetes, (3) smoke tobacco or (4) have a sedentary lifestyle. Care co-coordinators (clinical case managers) identified potentially eligible participants within their caseload, and these individuals were subsequently invited to participate. All participants' physical activity (self-reported and accelerometer-recorded), health status (including metabolic blood tests) and motivation to exercise were assessed at baseline. Participants were randomised to receive treatment as usual or the WTW intervention. WTW consisted of an educational intervention at baseline on the benefits of an active lifestyle. Participants were then given a pedometer and received fortnightly coaching from a staff member trained in coaching skills to help them to set daily walking targets, and they were invited to a weekly walking group. The WTW intervention lasted 17 weeks in total.
  
  
  
  To our knowledge, WTW is the first RCT to investigate the impact of a health coaching intervention targeting sedentary behaviour in people with SMI. It is hoped that if the intervention is feasible and acceptable, further large scale study can be developed and implemented in routine care.
  
  
  
  ISRCTN37724980 . Registered on 4 Aug 2015.
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK. julie.williams@kcl.ac.uk.|The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London, UK. julie.williams@kcl.ac.uk.
authors.forename: Julie
authors.initials: J
authors.lastname: Williams
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.|The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London, UK.|Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London, UK.|Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Gaughran
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.|The Collaboration for Leadership in Applied Health Research and Care (CLAHRC), South London, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Craig
mesh_terms: D056044:Actigraphy / Q000295:instrumentation; D002985:Clinical Protocols; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D000072936:Fitness Trackers; D006304:Health Status; D006801:Humans; D008131:London; D001523:Mental Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008603:Mental Health; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D012107:Research Design; D057185:Sedentary Behavior; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
keywords: Metabolic syndrome; Physical activity; Psychosis; Sedentary behaviour; Serious mental illness