Peer Support for Increasing Physical Activity in People With Serious Mental Illnesses

People with serious mental illnesses (SMIs) are, by definition, significantly functionally
impaired by the illness for an indefinite period of time. Schizophrenia, major depression,
and bipolar disorder are considered SMIs. Severe anxiety disorders, cognitive disorders, and
some personality disorders are sometimes categorized as SMIs, as well. The rate of obesity
among people with SMIs is higher than that of people without mental illnesses. This disparity
may be due to the negative symptoms that people with SMIs experience, such as vulnerability
to stress, extreme dependency, and lack of motivation. This study will design and test a
culturally appropriate physical activity intervention based on a peer support model for
people with SMIs in an urban community psychiatry program. The intervention will be evaluated
to determine its effectiveness in increasing physical activity and effecting health behavior
change in people with SMIs.

Participants in this 4-month, open-label study will be randomly assigned to participate in
either a physical activity intervention with peer support (PA+PS) or a physical activity
intervention without peer support (PA). Participants in the PA+PS group will have three
exercise sessions each week, which will include group exercise classes and open gym hours for
supervised individual exercise. They will also meet with a peer educator once a week for 15
minutes. Peer educators will provide emotional, informational, instrumental, and appraisal
support that is aimed to motivate participants to partake in the exercise sessions.
Participants in the PA group will attend the three weekly exercise sessions but will not
attend meetings with the peer educator. All outcomes will be assessed at a follow-up visit at
the end of the intervention.

Inclusion Criteria:

- Patient at the Johns Hopkins Community Psychiatry program

- Plans to remain in Baltimore for 8 months after study entry

- If currently breastfeeding, has received approval from a physician to participate in
the study

Exclusion Criteria:

- Any condition that would make weight loss medically inadvisable

- Diagnosis of or treatment for cancer (except non-melanoma skin cancer) within 2 years
prior to study entry

- Liver failure

- History of anorexia nervosa

- Pregnant or planning to become pregnant during the study

- Inability to walk or participate in an exercise class

- Consumes more than 14 alcoholic drinks per week

- Symptoms of angina or a cardiovascular event within 6 months prior to study entry