Abstract
BackgroundUsers with mental health problems (users) have a substantially higher risk of developing type 2 diabetes than the general population. Recent studies show that traditional lifestyle interventions focusing solely on exercise and diet among users have limited effect. Studies suggest collaborative models as a starting point for health behaviour change are more beneficial, but implementation in practice is a challenge. Using the Medical Research Council’s guidance for process evaluation, we explored implementation of a collaborative model in health education activities targeting users. The collaborative model focused on involving users in agenda setting and reflection about readiness to change health behaviour and was supported by dialogue tools (e.g., quotes and games). Educators received 3 days of training in applying the model.MethodsCollected data included questionnaires for users (n = 154) and professionals (n = 158), interviews with users (n = 14), and observations of health education activities (n = 37) and the professional development programme (n = 9). Data were analysed using descriptive statistics and systematic text condensation.ResultsNinetysix percent (152) of professionals tested the model in practice and tried at least one tool. Users reported that the model supported them in expressing their thoughts about their health and focused on their needs rather than the agenda of the professional. Ninetythree percent (143) of users strongly agreed that professionals were open-minded and responsive. However, observations showed that some professionals overlooked cues from users about motivation for health behaviour change. Furthermore, professionals identified lack of involvement from their managers as a barrier to implementation.ConclusionsImplementation of a collaborative model was feasible in practice. Training of professionals in active listening and involvement of managers prior to implementation is crucial.
Highlights
Users with mental health problems have a substantially higher risk of developing type 2 diabetes than the general population
We explored how the collaborative model was put into practice by comparing data from each health education activity with elements of the collaborative model
Summary of findings Using the Medical Research Council (MRC) framework for process evaluation, we explored implementation of a collaborative model in health education activities targeting users with mental health problems
Summary
Users with mental health problems (users) have a substantially higher risk of developing type 2 diabetes than the general population. Recent studies show that traditional lifestyle interventions focusing solely on exercise and diet among users have limited effect. Using the Medical Research Council’s guidance for process evaluation, we explored implementation of a collaborative model in health education activities targeting users. Health education is important for users with mental health problems As a group, they are motivated to engage in health-promoting behaviour but experience barriers related to medication, symptoms of mental illness, and social isolation [5]. Lifestyle interventions targeting users with mental health problems (users) have been developed. One study of a comprehensive individual lifestyle coaching intervention among people with schizophrenia and obesity found no intervention effects for any outcomes including cardiorespiratory fitness, physical activity, weight, diet, and smoking [7]
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