Effectiveness of a Lifestyle Intervention for Increasing Physical Activity in Adults With Schizophrenia

Schizophrenia is a severely disabling brain disorder. People with schizophrenia often
experience hallucinations, delusions, thought disorders, and movement disorders. Physical
activity (PA) has been shown not only to increase quality of life, but also to reduce risk
factors for several chronic diseases and conditions. The majority of adults, however, do not
engage in the recommended amount of PA. Research has shown that people with schizophrenia
are even less likely to be regularly physically active. Symptoms of schizophrenia,
pharmacological treatments for the disease, and the lifestyle associated with the disease
tend to contribute to physical inactivity and the resulting complications. Effective
interventions to increase PA have been developed for the general adult population, but very
little is known about how to adapt them for use in adults with schizophrenia. The PRIME
(Physically Ready for Invigorating Movement Every Day) program is a lifestyle intervention
focused on increasing physical activity. This study will evaluate the effectiveness of a
modified PRIME program in reducing the risk for morbidity in sedentary adults with
schizophrenia.

Participants in this 24-week, single-blind study will be randomly assigned to either the
PRIME intervention group or the comparison group, which will involve the Program for
Activity, Leisure Skills, and Socialization (PALSS). All participants will attend 90-minute
sessions weekly for the first 16 weeks, then biweekly for the remaining 8 weeks. PRIME
sessions will focus on learning about PA, setting PA-related goals, and assessing short- and
long-term goals. Goals may include early-stage process-oriented goals, such as reading about
PA benefits or finding a walking partner. Goals tailored to later stages of change include
explicit PA goals, such as increasing frequency, duration, and intensity of PA. Training
will also be accomplished online and via printed material. PALSS sessions will focus on
motivating participants to engage in leisure and social activity. Sessions will include
interactive, structured activity that will be led by a therapist, as well as unstructured
leisure activities, such as board games, cards, general socialization, and viewing a travel
video. Social and communication skills will not be explicitly taught or practiced. All
participants will attend study visits at Months 2, 6, and 8 to assess outcomes. A follow-up
visit will be held 2 months post-intervention.

Inclusion Criteria:

- Speaks English

- Diagnosis of schizophrenia or schizoaffective disorder

- Currently living in a residential facility

- Currently receiving outpatient care

- Medical clearance

- Willing to sign a release of medical information

Exclusion Criteria:

- Inability to complete assessments

- Medical conditions that may make increasing physical activity unsafe

- Pregnant

- Currently participating in regular moderate to vigorous physical activity (defined as
more than 150 minutes per week)