Encouraging people to become more active by walking

South LondonMental Health
Start Date: 1 Sep 2015 End Date: 1 May 2017

Walk this Way: a pilot RCT of an intervention to reduce sedentary behaviour in people suffering from severe mental illness (psychosis)

'Walk this Way' is a CLAHRC South London pilot study that will investigate whether wearing a pedometer, and having coaching, can encourage people who have experienced psychosis to become more active, and whether walking regularly can help improve their physical health and mental wellbeing.

'There is a plethora of literature demonstrating that sedentary behaviour is associated with an increased risk of type 2 diabetes, cardiovascular disease and death,' says Fiona Gaughran. 'Recent research has shown that people who have a diagnosis of schizophrenia spend significantly more time being sedentary than people who do not have a diagnosis of severe mental illness.

'Other research has concluded there is promising evidence that walking interventions can reduce weight and positively influence psychiatric symptoms in people with schizophrenia.'

The research team will recruit 40 people who have a diagnosis of a serious mental illness like schizophrenia who are overweight, have a sedentary lifestyle, smoke tobacco and/or have diabetes to take part in the pilot study. Participants will be recruited via community mental health teams run by South London and Maudsley NHS Foundation Trust (SLaM). This is a randomised controlled trial and 20 of those recruited will take part in a structured 16-week walking programme, wear a pedometer and monitor the distance they walk each day. They will be invited to an initial session that aims to motivate and inspire them to increase their daily step count, and be given support to help them get going. They will be told about the benefits of exercise, how to walk safely and encouraged to set goals to increase their distances. They will be offered encouragement throughout the programme by staff who work in SLaM's SHARP (Social Inclusion, Hope and Recovery Project) team, and invited to join a weekly organised group walk.

The other 20 people will be a 'control group': they will be given some information about why being more active is beneficial to health.

At the start and end of the study, all 40 participants will be asked to wear an accelerometer on their wrist for 4 days to measure their activity levels and time spent sitting. Researchers will then be able to find out if those who take part in the 16-week programme end up being less sedentary. All 40 participants will also be asked to give information about themselves and their lifestyle, and have some simple physical tests (eg a blood test to measure sugar levels) at the beginning and end of the trial so researchers can measure the impact of increased walking on people's physical and mental health.

The research team is also going to recruit about 100 colleagues working in mental health services run by SLaM, or working for the CLAHRC South London and/or King's College London and ask them to wear accelerometers for four days. This will give the research team greater insight into sedentary behaviour and physical activity and also provide data about people who do not have a diagnosis of a serious mental illness for comparison's sake.

Manufacturers Activeinsights have donated five waterproof wristband accelerometers and the pilot study is part-funded by a grant from the Maudsley Charity.

Professor Brendon Stubbs