Abstract

BackgroundPeople with mental health disorders live, on average, 20 years less than those without, often because of poor physical health including cardiovascular disease (CVD). Evidence-based interventions are required to reduce this lifespan gap.ObjectiveThis study aimed to develop, test, and evaluate a mobile phone–based lifestyle program (MyHealthPA) to help people with mental health problems improve key health risk behaviors and reduce their risk of CVD.MethodsThe development of MyHealthPA occurred in 3 stages: (1) scoping of the literature, (2) a survey (n=251) among people with and without the experience of mental health problems, and (3) program development informed by stages 1 and 2. A small pilot trial among young people with and without mental health disorders was also conducted. Participants completed a baseline assessment and were given access to the MyHealthPA program for a period of 8 weeks. They were then asked to complete an end-of-treatment assessment and a follow-up assessment 1 month later.ResultsIn the study, 28 young people aged 19 to 25 years were recruited to the pilot trial. Of these, 12 (12/28, 43%) had been previously diagnosed with a mental illness. Overall, 12 participants (12/28, 43%) completed the end-of-treatment assessment and 6 (6/28, 21%) completed the follow-up assessment. Small improvements in fruit and vegetable consumption, level of physical activity, alcohol use, and mood were found between baseline and end of treatment and follow-up, particularly among people with experience of mental health issues. Most participants (history of mental illness: 4/7, 57%; no history of mental illness: 3/5, 60%) reported the program had above average usability; however, only 29% (2/7, no history of mental illness) to 40% (2/5, history of mental illness) of participants reported that they would like to use the program frequently and would recommend it to other young people. Participants also identified a number of ways in which the program could be improved.ConclusionsThis study describes the formative research and process of planning that formed the development of MyHealthPA and the evidence base underpinning the approach. The MyHealthPA program represents an innovative approach to CVD risk reduction among people with mental health problems. MyHealthPA appears to be an acceptable, easy-to-use, and potentially effective mHealth intervention to assist young people with mental illness to monitor risk factors for CVD. However, ways in which the program could be improved for future testing and dissemination were identified and discussed.

Highlights

  • People with mental health disorders live on average 20 years less than the general population [1]

  • The MyHealthPA program represents an innovative approach to cardiovascular disease (CVD) risk reduction among people with mental health problems

  • MyHealthPA is unique, as it targets the top 4 behavioral risk factors associated with CVD, which are extremely common among people with mental health problems, while addressing mood and the way in which mood and psychiatric symptoms might interact with these health behaviors

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Summary

Introduction

People with mental health disorders live on average 20 years less than the general population [1]. Alcohol misuse, physical inactivity, and poor diet are consistently identified as the top 4 behavioral risk factors associated with CVD in the general population [3]. These modifiable behavioral risk factors are over-represented among people with mental health problems [4]. Recent research has shown that changing multiple behavioral risk factors and reducing CVD risk is possible among people with mental health problems [5]. People with mental health disorders live, on average, 20 years less than those without, often because of poor physical health including cardiovascular disease (CVD). Evidence-based interventions are required to reduce this lifespan gap

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