The development and evaluation of a complex health education intervention for adults with a diagnosis of schizophrenia

Accessible summary People with schizophrenia often develop serious physical health problems at a young age and on average die 15 years younger than others in the population. Physical health problems such as diabetes and cardiovascular disease are much more common in people with this diagnosis, partly because many of them lead unhealthy lifestyles but also the psychiatric medication they are prescribed may cause them to gain a lot of weight. Not much research has been carried out to develop health education interventions, which might help them to develop healthier lifestyles. In this paper we described how we developed and evaluated a health education intervention designed specifically to meet the needs of a small group of adults all of whom had a diagnosis of schizophrenia. Abstract Life expectancy in adults with schizophrenia is reduced by approximately 15 years compared with others in the population. Two thirds of premature deaths result from natural causes triggered by unhealthy lifestyles and the side-effects of antipsychotic medication. There is a need to develop and evaluate health education interventions for people with this diagnosis. In this paper we describe how with reference to the UK Medical Research Council's complex interventions framework we developed and evaluated a health education intervention designed specifically for adults with schizophrenia. The study was completed in three separate but interrelated phases: (1) theoretical work was undertaken to identify the components of effective health education interventions; (2) this information was synthesized to develop the intervention; and (3) the intervention was tested in an open exploratory trial which used mixed methods to evaluate the feasibility, acceptability and potential effect of the intervention. 45 service users were referred, 39 attended the groups and 65% attended at least half of the sessions. Participants reported significant increases in their consumption of fruit and vegetables and levels of physical activity. Results suggest that this model of health education is feasible and acceptable for this population and that it shows promise in supporting health-related behaviour changes.