Physical activity in secure settings: A scoping review of methods, theory and practise

Evidence suggests that individuals with severe mental illness (SMI) engage in considerably less exercise and significantly more sedentary behaviour than the general population. It has been suggested that inactivity is likely to be exacerbated in secure services. The purpose of this scoping review was to explore and synthesise the existing literature with a view to facilitate discussion on methods, theory and practise used in current studies investigating exercise in secure settings. Additionally, this review aimed to identify gaps in the existing literature and highlight recommendations for future studies. Sixteen studies met the review inclusion criteria. Pre and post measurement was the most common study design. Only three studies utilised psychological or behaviour change theory to underpin their design. Self-report physical activity (e.g. attendance) and clinical measures (e.g. positive and negative symptomology) were the most commonly reported outcome. Length, type and intensity of sessions varied. Recruitment, attrition and limited staff involvement were noted as major challenges in data collection. Despite several uncertainties with methodology (design, validated scale and use of self-report data) and noted challenges with data collection (recruitment and attrition), the emerging data warrants future research into physical activity in secure settings.