Educating staff on physical activity promotion in secure psychiatric care: the development of a self-determination theory informed intervention

Background: Healthcare assistants (HCAs) are well placed to promote physical activity (PA) in secure hospitals, though multiple barriers limit these opportunities. Using a Medical Research Council (MRC) commissioned framework, this study aimed to develop a self-determination theory (SDT) informed e-learning module for HCA's. Methods: The development process included three phases. (1) a preparatory phase involved a scoping review, immersive fieldwork and 15 patient interviews. (2), a development phase involved establishing an intervention development team, selecting appropriate theory (SDT) and collecting pilot data (3) a user testing phase exploring intervention acceptability through a staff survey. Results: The outputs from each phase informed the production of an e-learning educational module. The first section of the module incorporated information on: the importance of PA and consequences of prolonged inactivity in inpatient settings, benefits of PA in secure settings and the role of ward staff in PA promotion. The second section, underpinned by the tenets of SDT, outlined the three basic needs, highlighted the importance of these needs in motivating behaviour change and provided specific practical examples of how HCAs can adopt need supportive behaviours. The final section provided interactive case studies where HCAs identified strategies to meet patients individualised needs regarding PA engagement. Following preliminary testing, 71 % of staff reported changing PA promotion practices after the training. Conclusions: Following MRC guidelines on the development phase of an intervention allowed for exploration of both population and environmental considerations and provided a strategy to develop an intervention that can be integrated into routine care.