Health Behavior Change Processes Among Adults With Serious Mental Illness Engaged in Illness Self-Management

Abstract

Self-management interventions promote illness management among adults with chronic health conditions. Little is known regarding the processes by which these interventions have their effects. The present study examined how Living Well, an effective self-management intervention for adults with serious mental illness, led to health behavior change in a randomized controlled trial. A convenience subset (N = 15) of participants completed qualitative interviews regarding the feasibility/acceptability of Living Well. An inductive secondary qualitative analysis, using a combination of interpretive phenomenological and social constructivist approaches, was conducted to examine processes of change. Results indicate that Living Well provided information and knowledge, opportunities for learning from others and real-world practice, and an interpersonally supportive environment. These active ingredients led to enhanced self-awareness, confidence, sense of control, and behavior and health status changes among participants. These findings are considered in the context of prominent behavior change theories such as social cognitive theory and self-regulation.

Trial registration: ClinicalTrials.gov NCT01676909.

Keywords: Mid-Atlantic United States; health behavior change; inductive coding; qualitative; self-management; serious mental illness.

Figures

Figure 1.

A model of health behavior change process among adults with serious mental illness participating in Living Well