Peer Support for Increasing Physical Activity in People With Serious Mental Illnesses

Study Overview
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Brief Summary
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This study will determine the effectiveness of a peer support system in increasing physical activity and effecting health behavior change in people with serious mental illnesses.

Detailed Description
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People with serious mental illnesses (SMIs) are, by definition, significantly functionally impaired by the illness for an indefinite period of time. Schizophrenia, major depression, and bipolar disorder are considered SMIs. Severe anxiety disorders, cognitive disorders, and some personality disorders are sometimes categorized as SMIs, as well. The rate of obesity among people with SMIs is higher than that of people without mental illnesses. This disparity may be due to the negative symptoms that people with SMIs experience, such as vulnerability to stress, extreme dependency, and lack of motivation. This study will design and test a culturally appropriate physical activity intervention based on a peer support model for people with SMIs in an urban community psychiatry program. The intervention will be evaluated to determine its effectiveness in increasing physical activity and effecting health behavior change in people with SMIs. Participants in this 4-month, open-label study will be randomly assigned to participate in either a physical activity intervention with peer support (PA+PS) or a physical activity intervention without peer support (PA). Participants in the PA+PS group will have three exercise sessions each week, which will include group exercise classes and open gym hours for supervised individual exercise. They will also meet with a peer educator once a week for 15 minutes. Peer educators will provide emotional, informational, instrumental, and appraisal support that is aimed to motivate participants to partake in the exercise sessions. Participants in the PA group will attend the three weekly exercise sessions but will not attend meetings with the peer educator. All outcomes will be assessed at a follow-up visit at the end of the intervention.

Official Title
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Activating Consumers to Exercise in Community Psychiatry Through Peer Support

Conditions
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Schizophrenia, Depression, Bipolar Disorder, Anxiety Disorders, Cognitive Disorders, Personality Disorders

Intervention / Treatment
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* Behavioral: Physical activity intervention with peer support (PA+PS)
* Behavioral: Physical activity intervention without peer support (PA)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient at the Johns Hopkins Community Psychiatry program Plans to remain in Baltimore for 8 months after study entry If currently breastfeeding, has received approval from a physician to participate in the study Exclusion Criteria: Any condition that would make weight loss medically inadvisable Diagnosis of or treatment for cancer (except non-melanoma skin cancer) within 2 years prior to study entry Liver failure History of anorexia nervosa Pregnant or planning to become pregnant during the study Inability to walk or participate in an exercise class Consumes more than 14 alcoholic drinks per week Symptoms of angina or a cardiovascular event within 6 months prior to study entry

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>Participants will receive the peer-supported physical activity intervention | Behavioral: Physical activity intervention with peer support (PA+PS)<br>* Participants in the PA+PS group will have three exercise sessions each week for 4 months, which will include group exercise classes and open gym hours for supervised individual exercise. They will also meet with a peer educator once a week for 15 minutes. Peer educators will provide emotional, informational, instrumental, and appraisal support that is aimed to motivate participants to partake in the exercise sessions.<br>|
| Active Comparator: 2<br>Participants will receive physical activity without peer support | Behavioral: Physical activity intervention without peer support (PA)<br>* Participants in the PA group will attend the three weekly exercise sessions for 4 months but will not attend meetings with the peer educator.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiorespiratory fitness |  | Measured at Month 4 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight |  | Measured at Month 4 | 
| Waist circumference |  | Measured at Month 4 | 
| Physical activity |  | Measured at Month 4 | 
| Health status |  | Measured at Month 4 | 
| Center for Epidemiology Depression Scale |  | Measured at Month 4 | 
| Exercise-related self-efficacy |  | Measured at Month 4 | 
| General perceived efficacy |  | Measured at Month 4 | 
| Participation |  | Measured at Month 4 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise, Mental Illness, Community Psychiatry, Peer Support, Mental Disorders