From impact factors to real impact: translating evidence on lifestyle interventions into routine mental health care

Jeroen Deenik, Louise Czosnek, Scott B Teasdale, Brendon Stubbs, Joseph Firth, Felipe B Schuch, Diederik E Tenback, Peter N van Harten, Erwin C P M Tak, Oscar Lederman, Philip B Ward, Ingrid J M Hendriksen, Davy Vancampfort, Simon Rosenbaum, Jeroen Deenik, Louise Czosnek, Scott B Teasdale, Brendon Stubbs, Joseph Firth, Felipe B Schuch, Diederik E Tenback, Peter N van Harten, Erwin C P M Tak, Oscar Lederman, Philip B Ward, Ingrid J M Hendriksen, Davy Vancampfort, Simon Rosenbaum

Abstract

The scandal of premature mortality in people with serious mental illness is well established. Despite an increase in studies evaluating the efficacy of lifestyle interventions, translating this evidence into routine clinical care and policies is challenging, in part due to limited effectiveness or implementation research. We highlight the challenge of implementation that is increasingly recognized in clinical practice, advocate for adopting implementation science to study the implementation and systematic update of effective interventions in practice and policy, and provide directions for future research.

Keywords: Implementation; Lifestyle; Physical activity; Schizophrenia; Severe mental illness.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.

Figures

Fig 1
Fig 1
The traditional translational pipeline from preintervention, efficacy, effectiveness to dissemination and implementation studies. Adapted from Brown et al. [24].

References

    1. Hjorthøj C, Stürup AE, McGrath JJ, Nordentoft M. Years of potential life lost and life expectancy in schizophrenia: A systematic review and meta-analysis. Lancet Psychiatry. 2017;4(4):295–301.
    1. Piotrowski P, Gondek TM, Królicka-Deręgowska A, Misiak B, Adamowski T, Kiejna A. Causes of mortality in schizophrenia: an updated review of European studies. Psychiatr Danub. 2017;29(2):108–120.
    1. Tanskanen A, Tiihonen J, Taipale H. Mortality in schizophrenia: 30-year nationwide follow-up study. Acta Psychiatr Scand. 2018;138(6):492–499.
    1. Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: A systematic review and meta-analysis. JAMA Psychiatry. 2015;72(4):334–341.
    1. Correll CU, Solmi M, Veronese N, et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: A large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry. 2017;16(2):163–180.
    1. de Leon J, Diaz FJ. A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors. Schizophr Res. 2005;76(2–3):135–157.
    1. Stubbs B, Chen LJ, Chung MS, Ku PW. Physical activity ameliorates the association between sedentary behavior and cardiometabolic risk among inpatients with schizophrenia: A comparison versus controls using accelerometry. Compr Psychiatry. 2017;74:144–150.
    1. Vancampfort D, Probst M, Scheewe T, et al. Relationships between physical fitness, physical activity, smoking and metabolic and mental health parameters in people with schizophrenia. Psychiatry Res. 2013;207(1–2):25–32.
    1. Firth J, Stubbs B, Teasdale SB, et al. Diet as a hot topic in psychiatry: A population-scale study of nutritional intake and inflammatory potential in severe mental illness. World Psychiatry. 2018;17(3):365–367.
    1. Teasdale SB, Ward PB, Samaras K, et al. Dietary intake of people with severe mental illness: Systematic review and meta-analysis. Br J Psychiatry. 2019;214(5):251–259.
    1. Dauwan M, Begemann MJ, Heringa SM, Sommer IE. Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: A systematic review and meta-analysis. Schizophr Bull. 2016;42(3):588–599.
    1. Rosenbaum S, Tiedemann A, Sherrington C, Curtis J, Ward PB. Physical activity interventions for people with mental illness: A systematic review and meta-analysis. J Clin Psychiatry. 2014;75(9):964–974.
    1. Vera-Garcia E, Mayoral-Cleries F, Vancampfort D, Stubbs B, Cuesta-Vargas AI. A systematic review of the benefits of physical therapy within a multidisciplinary care approach for people with schizophrenia: An update. Psychiatry Res. 2015;229(3):828–839.
    1. Firth J, Cotter J, Elliott R, French P, Yung AR. A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med. 2015;45(7):1343–1361.
    1. Firth J, Stubbs B, Rosenbaum S, et al. Aerobic exercise improves cognitive functioning in people with schizophrenia: A systematic review and meta-analysis. Schizophr Bull. 2017;43(3):546–556.
    1. Stubbs B, Vancampfort D, Hallgren M, et al. EPA guidance on physical activity as a treatment for severe mental illness: A meta-review of the evidence and Position Statement from the European Psychiatric Association (EPA), supported by the International Organization of Physical Therapists in Mental Health (IOPTMH). Eur Psychiatry. 2018;54:124–144.
    1. Czosnek L, Lederman O, Cormie P, Zopf E, Stubbs B, Rosenbaum S. Health benefits, safety and cost of physical activity interventions for mental health conditions: A meta-review to inform translation efforts. Ment Health Phys Act. 2019;16:140–151.
    1. Pratt SI, Jerome GJ, Schneider KL, et al. Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: A position statement from the Society of Behavior Medicine and the American College of Sports Medicine. Transl Behav Med. 2016;6(3):478–481.
    1. Stewart R. Mental disorders and mortality: So many publications, so little change. Acta Psychiatr Scand. 2015;132(5):410–411.
    1. Bartels SJ. Can behavioral health organizations change health behaviors? The STRIDE study and lifestyle interventions for obesity in serious mental illness. Am J Psychiatry. 2015;172(1):9–11.
    1. Mitchell AJ, De Hert M. Promotion of physical health in persons with schizophrenia: Can we prevent cardiometabolic problems before they begin? Acta Psychiatr Scand. 2015;132(2):83–85.
    1. McGrath JJ. No mental health without physical health - A call to arms. Epidemiol Psychiatr Sci. 2016;25(3):195–196.
    1. Suetani S, Rosenbaum S, Scott JG, Curtis J, Ward PB. Bridging the gap: What have we done and what more can we do to reduce the burden of avoidable death in people with psychotic illness? Epidemiol Psychiatr Sci. 2016;25(3):205–210.
    1. Brown CH, Curran G, Palinkas LA, et al. An overview of research and evaluation designs for dissemination and implementation. Annu Rev Public Health. 2017;38:1–22.
    1. Liu NH, Daumit GL, Dua T, et al. Excess mortality in persons with severe mental disorders: A multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry. 2017;16(1):30–40.
    1. Vancampfort D, Stubbs B, Ward PB, Teasdale S, Rosenbaum S. Why moving more should be promoted for severe mental illness. Lancet Psychiatry. 2015;2(4):295.
    1. Naslund JA, Whiteman KL, McHugo GJ, Aschbrenner KA, Marsch LA, Bartels SJ. Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis. Gen Hosp Psychiatry. 2017;47:83–102.
    1. Jakobsen AS, Speyer H, Nørgaard HCB, et al. Effect of lifestyle coaching versus care coordination versus treatment as usual in people with severe mental illness and overweight: Two-years follow-up of the randomized CHANGE trial. PLoS One. 2017;12(10):e0185881.
    1. Koorts H, Eakin E, Estabrooks P, Timperio A, Salmon J, Bauman A. Implementation and scale up of population physical activity interventions for clinical and community settings: The PRACTIS guide. Int J Behav Nutr Phys Act. 2018;15(1):51.
    1. Lennox L, Maher L, Reed J. Navigating the sustainability landscape: A systematic review of sustainability approaches in healthcare. Implement Sci. 2018;13(1):27.
    1. Firth J, Rosenbaum S, Stubbs B, Gorczynski P, Yung AR, Vancampfort D. Motivating factors and barriers towards exercise in severe mental illness: A systematic review and meta-analysis. Psychol Med. 2016;46(14):2869–2881.
    1. Robson D, Haddad M, Gray R, Gournay K. Mental health nursing and physical health care: A cross-sectional study of nurses’ attitudes, practice, and perceived training needs for the physical health care of people with severe mental illness. Int J Ment Health Nurs. 2013;22(5):409–417.
    1. Stanton R, Happell B, Reaburn P. Investigating the exercise-prescription practices of nurses working in inpatient mental health settings. Int J Ment Health Nurs. 2015;24(2):112–120.
    1. Chapman JJ, Fraser SJ, Brown WJ, Burton NW. Physical activity preferences, motivators, barriers and attitudes of adults with mental illness. J Ment Health. 2016;25(5):448–454.
    1. Way K, Kannis-Dymand L, Lastella M, Lovell GP. Mental health practitioners’ reported barriers to prescription of exercise for mental health consumers. Ment Health Phys Act. 2018;14:52–60.
    1. Wheeler AJ, Roennfeldt H, Slattery M, Krinks R, Stewart V. Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia. Health Soc Care Community. 2018;26(6): 860–870.
    1. Matthews E, Cowman M, Denieffe S. Using experience-based co-design for the development of physical activity provision in rehabilitation and recovery mental health care. J Psychiatr Ment Health Nurs. 2017;24(7):545–552.
    1. Farholm A, Sørensen M, Halvari H. Motivational factors associated with physical activity and quality of life in people with severe mental illness. Scand J Caring Sci. 2017;31(4):914–921.
    1. Hargreaves J, Lucock M, Rodriguez A. From inactivity to becoming physically active: The experiences of behaviour change in people with serious mental illness. Ment Health Phys Act. 2017;13:83–93.
    1. Lundström S, Ahlström BH, Jormfeldt H, Eriksson H, Skärsäter I. The meaning of the lived experience of lifestyle changes for people with severe mental illness. Issues Ment Health Nurs. 2017;38(9):717–725.
    1. Ward MC, White DT, Druss BG. A meta-review of lifestyle interventions for cardiovascular risk factors in the general medical population: Lessons for individuals with serious mental illness. J Clin Psychiatry. 2015;76(4):e477–e486.
    1. Bartels S, Brunette M, Aschbrenner K, Daumit G. Implementation of a system-wide health promotion intervention to reduce early mortality in high risk adults with serious mental illness and obesity. Implement Sci. 2015;10(suppl 1):A15.
    1. Patel V, Hanlon C.. Where There Is No Psychiatrist: A Mental Health Care Manual. 2nd ed. Cambridge, UK: Royal College of Psychiatrists; 2018.
    1. Wiltsey Stirman S, Kimberly J, Cook N, Calloway A, Castro F, Charns M. The sustainability of new programs and innovations: A review of the empirical literature and recommendations for future research. Implement Sci. 2012;7:17.
    1. Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci. 2013;8:117.
    1. Proctor E, Silmere H, Raghavan R, et al. Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65–76.
    1. Braithwaite J, Churruca K, Long JC, Ellis LA, Herkes J. When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Med. 2018;16(1):63.
    1. Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: Combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50(3):217–226.

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