Promoting physical activity in a secure psychiatric hospital: the development of a theoretically informed intervention
There is now a large body of evidence documenting mental and physical benefits of physical activity (PA) for those with severe mental illness (SMI). However, those with SMI engage in considerably less PA than their counterparts in the general population. Individuals with SMI who present a risk to themselves or others may be detained in secure psychiatric hospitals. Such hospitals have been termed ‘obesogenic’ environments, with a large proportion of inpatients at risk of developing physical health conditions, due to unrestricted access to high calorie foods and limited opportunity to exercise (Long et al. 2014). Following an established Medical Research Council framework, this thesis details the development of an intervention to increase PA in a secure psychiatric hospital. Firstly, a scoping review explored the literature surrounding PA in secure hospitals and mapped the findings regarding study methods, included theory and implications for practice. Secondly, a period of immersive fieldwork explored the physical activity ‘culture’ of the hospital and identified intervention relevant insights for data collection. Next, interviews exploring the PA experiences of inpatients in secure care were conducted. Findings indicated a range of individual and environmental barriers to PA; most notably, the influence of staff in PA promotion. The following chapter assessed the acceptability of wrist-worn accelerometers and detailed the challenges of deployment in secure care. The final chapter of this thesis details the development of a theoretically informed intervention for hospital staff to promote PA to secure inpatients. Findings of this thesis carry important implications for both research: staff involvement in PA promotion, the inclusion of motivational theory in PA research for SMI, the need to determine optimal PA ‘dosage’ for those with SMI. In practice, a larger service effort to embed PA as a valued and routine therapeutic tool within secure mental health care is needed.
- Sport, Exercise and Health Sciences
Rights holder© Eva Natalie Rogers
NotesA thesis submitted in partial fulfilment of the requirements for the award of the degree of Doctor of Philosophy of Loughborough University.
Supervisor(s)Florence Kinnafick ; Anthony Papathomas
This submission includes a signed certificate in addition to the thesis file(s)
- I have submitted a signed certificate