Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention
Abstract Background Obesity is twice as common in people with schizophrenia as the general population and associated with significantly worsened psychiatric and physical health. Despite National Institute for Health and Care Excellence guidelines for the management of psychosis recommending that men...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40814-018-0378-1 |
| _version_ | 1811269834207395840 |
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| author | Marian E. Carey Janette Barnett Yvonne Doherty Katherine Barnard Heather Daly Paul French Rebecca Gossage-Worrall Michelle Hadjiconstantinou Daniel Hind Jonathan Mitchell Alison Northern John Pendlebury Shanaya Rathod David Shiers Cheryl Taylor Richard I. G. Holt On behalf of the STEPWISE Research Group |
| author_facet | Marian E. Carey Janette Barnett Yvonne Doherty Katherine Barnard Heather Daly Paul French Rebecca Gossage-Worrall Michelle Hadjiconstantinou Daniel Hind Jonathan Mitchell Alison Northern John Pendlebury Shanaya Rathod David Shiers Cheryl Taylor Richard I. G. Holt On behalf of the STEPWISE Research Group |
| author_sort | Marian E. Carey |
| collection | DOAJ |
| description | Abstract Background Obesity is twice as common in people with schizophrenia as the general population and associated with significantly worsened psychiatric and physical health. Despite National Institute for Health and Care Excellence guidelines for the management of psychosis recommending that mental health services offer lifestyle programmes to people with schizophrenia to improve physical health, this is not currently occurring. The aim of the STEPWISE research programme was to develop a lifestyle intervention addressing obesity and preventing weight gain in people with schizophrenia, schizoaffective disorder, or first episode psychosis taking antipsychotic medication, through an approach and fundamental principles drawn from existing diabetes and diabetes prevention interventions. This paper describes the often under-reported process of developing such an intervention from first principles. Methods Following an extensive literature review, an iterative cycle of development with input from people with schizophrenia, mental healthcare professionals, facilitators, and other stakeholders, a new weight management intervention for the target group was developed. A set of four core weekly sessions was piloted in Sheffield, followed at 3-monthly intervals by three booster sessions and telephone support contact once every 2 weeks, to form an intervention lasting 12 months. Facilitators were provided with a 4-day training package to support delivery of the intervention. Results This paper reports the process of development, including challenges and how these were addressed. It describes how user input influenced the structure, topics, and approach of the intervention. The outcome of this process was a feasible and acceptable lifestyle intervention to support people with schizophrenia, schizoaffective disorder, or first episode psychosis to manage their weight. This pilot provided opportunities for refinement of the intervention and facilitator training prior to testing in a multi-centre randomised controlled trial. Key findings from the pilot were linked to accessibility, focus, uptake, and retention, which influenced session length, travel arrangements, refreshment, breaks, and supporting tools to incentivise participants. Conclusions The STEPWISE intervention has been evaluated in a randomised controlled trial in 10 mental health trusts in England, and the results will be published in the British Journal of Psychiatry and the NIHR Journals Library. Trial registration ISRCTN19447796. Date registered: 20/03/2014 |
| first_indexed | 2024-04-12T21:50:12Z |
| format | Article |
| id | doaj.art-e03da48b74f34f7d95af2893eb3dca1e |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-04-12T21:50:12Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-e03da48b74f34f7d95af2893eb3dca1e2022-12-22T03:15:31ZengBMCPilot and Feasibility Studies2055-57842018-12-014111610.1186/s40814-018-0378-1Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) interventionMarian E. Carey0Janette Barnett1Yvonne Doherty2Katherine Barnard3Heather Daly4Paul French5Rebecca Gossage-Worrall6Michelle Hadjiconstantinou7Daniel Hind8Jonathan Mitchell9Alison Northern10John Pendlebury11Shanaya Rathod12David Shiers13Cheryl Taylor14Richard I. G. Holt15On behalf of the STEPWISE Research GroupLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustFaculty of Health & Social Science, Bournemouth UniversityLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustPsychosis Research Unit, Greater Manchester Mental Health NHS Foundation TrustClinical Trials Research Unit, University of SheffieldLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustClinical Trials Research Unit, University of SheffieldSheffield Health and Social Care NHS Foundation TrustLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustPsychosis Research Unit, Greater Manchester Mental Health NHS Foundation TrustSouthern Health NHS Foundation TrustPsychosis Research Unit, Greater Manchester Mental Health NHS Foundation TrustLeicester Diabetes Centre, University Hospitals of Leicester NHS TrustHuman Development and Health Academic Unit, University of SouthamptonAbstract Background Obesity is twice as common in people with schizophrenia as the general population and associated with significantly worsened psychiatric and physical health. Despite National Institute for Health and Care Excellence guidelines for the management of psychosis recommending that mental health services offer lifestyle programmes to people with schizophrenia to improve physical health, this is not currently occurring. The aim of the STEPWISE research programme was to develop a lifestyle intervention addressing obesity and preventing weight gain in people with schizophrenia, schizoaffective disorder, or first episode psychosis taking antipsychotic medication, through an approach and fundamental principles drawn from existing diabetes and diabetes prevention interventions. This paper describes the often under-reported process of developing such an intervention from first principles. Methods Following an extensive literature review, an iterative cycle of development with input from people with schizophrenia, mental healthcare professionals, facilitators, and other stakeholders, a new weight management intervention for the target group was developed. A set of four core weekly sessions was piloted in Sheffield, followed at 3-monthly intervals by three booster sessions and telephone support contact once every 2 weeks, to form an intervention lasting 12 months. Facilitators were provided with a 4-day training package to support delivery of the intervention. Results This paper reports the process of development, including challenges and how these were addressed. It describes how user input influenced the structure, topics, and approach of the intervention. The outcome of this process was a feasible and acceptable lifestyle intervention to support people with schizophrenia, schizoaffective disorder, or first episode psychosis to manage their weight. This pilot provided opportunities for refinement of the intervention and facilitator training prior to testing in a multi-centre randomised controlled trial. Key findings from the pilot were linked to accessibility, focus, uptake, and retention, which influenced session length, travel arrangements, refreshment, breaks, and supporting tools to incentivise participants. Conclusions The STEPWISE intervention has been evaluated in a randomised controlled trial in 10 mental health trusts in England, and the results will be published in the British Journal of Psychiatry and the NIHR Journals Library. Trial registration ISRCTN19447796. Date registered: 20/03/2014http://link.springer.com/article/10.1186/s40814-018-0378-1SchizophreniaPsychosisAntipsychoticObesityLifestyleSelf-management |
| spellingShingle | Marian E. Carey Janette Barnett Yvonne Doherty Katherine Barnard Heather Daly Paul French Rebecca Gossage-Worrall Michelle Hadjiconstantinou Daniel Hind Jonathan Mitchell Alison Northern John Pendlebury Shanaya Rathod David Shiers Cheryl Taylor Richard I. G. Holt On behalf of the STEPWISE Research Group Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention Pilot and Feasibility Studies Schizophrenia Psychosis Antipsychotic Obesity Lifestyle Self-management |
| title | Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention |
| title_full | Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention |
| title_fullStr | Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention |
| title_full_unstemmed | Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention |
| title_short | Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention |
| title_sort | reducing weight gain in people with schizophrenia schizoaffective disorder and first episode psychosis describing the process of developing the structured lifestyle education for people with schizophrenia stepwise intervention |
| topic | Schizophrenia Psychosis Antipsychotic Obesity Lifestyle Self-management |
| url | http://link.springer.com/article/10.1186/s40814-018-0378-1 |
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