Study characteristics that influence community physical activities participation
Studies were conducted in the United Kingdom (Chalder et al., 2012;
Malcolm, Evans-Lacko, Little, Henderson, & Thornicroft, 2013; McGale, McArdle,
& Gaffney, 2011; Pentecost et al., 2015), United States of America (Aschbrenner et
al., 2016; Druss et al., 2010; Harrold et al., 2017; Hoffmann et al., 2015; Lesley &
Livingwood, 2015; Perlman et al., 2010; Van Citters et al., 2010) and Canada
(Graham et al., 2017). Seven out of 13 were pilot studies (Aschbrenner et al., 2016;
Druss et al., 2010; Hoffmann et al., 2015; McGale et al., 2011; Pentecost et al.,
2015; Perlman et al., 2010; Van Citters et al., 2010). Pilot studies were used to
explore the feasibility of implementation of an exercise intervention (Hoffmann et
al., 2015) and the acceptability of using a group-based approach (Perlman et al.,
2010).
One study evaluated an individualised health promotion intervention (Van Citters
et al., 2010). Five of the studies employed a randomised controlled trial
experimental design (Chalder et al., 2012; Druss et al., 2010; Matthews et al.,
2016; McGale et al., 2011; Pentecost et al., 2015) and five studies used a pre-post
measures design (Aschbrenner et al., 2013; Harrold et al., 2017; Hoffmann et al.,
2015; Perlman et al., 2010; Van Citters et al., 2010).
Seven studies used mixed methods (Aschbrenner et al., 2016; Druss et al.,
2010; Harrold et al., 2017; Hoffmann et al., 2015; Matthews et al., 2016; Pentecost
et al., 2015) with three studies employing a qualitative design (Graham et al., 2017;
Lesley & Livingwood, 2015; Malcolm et al., 2013). Interviews and focus groups
were used in five studies to: assess change post-recovery programme in
comparison to a control condition (Druss et al., 2010), evaluate and refine a PA
programme (Graham et al., 2017), gather qualitative experiences of engaging in a
fitness programme (Lesley & Livingood, 2015), readiness to disclose mental health
problems and participation in PA (Malcolm et al., 2013) and a process evaluation
of a walking intervention (Matthews et al., 2016).
Various PA behavioural measures were employed. These included self-
reported PA behaviour (Druss et al., 2015; Chalder et al., 2012; Lesley & Livingood,
2015; McGale et al., 2011), self-report diaries (Chalder et al., 2012), pedometers
(Aschbrenner et al., 2016; Harrold et al., 2017; Matthews et al., 2016), and
accelerometers (Pentecost et al., 2015). To evaluate the effectiveness of a peer group
lifestyle intervention, one study utilised experiential learning and used wearable
activity tracking devices (mHealth technology: Aschbrenner et al., 2016).
Psychosocial measures included mental wellbeing (Malcolm et al., 2013),
behavioural activation (Pentecost et al., 2015), mood (Chalder et al., 2012; Hoffmann
et al., 2015;
Malcolm et al., 2013), health-related quality of life (Chalder et al., 2012; Druss et al.,
2010; Pentecost et al., 2015; Perlman et al., 2010), depression symptoms (Chalder et
al., 2012; McGale et al., 2011; Van Citters et al., 2010), perceived social support
(Aschbrenner et al., 2016; Hoffman et al., 2015; McGale et al., 2011), self-reported
mental health (Hoffman et al., 2015), social wellbeing (Graham et al., 2017), stress
management (Perlman et al., 2010), and readiness to change (Harrold et al., 2017).
All 13 articles selected for review were published between 2007 and 2018.
Participant characteristics
All participants were MHSU, with studies that focused on a variety of
mental health diagnoses: adults with depression (Chalder et al., 2012; McGale et al.,
2011; Pentecost et al., 2015; Van Citters et al., 2010), bipolar disorder (Harrold et
al., 2017), post-traumatic stress disorder (PTSD) (Harrold et al., 2017; Perlman et
al., 2010), schizophrenia (Aschbrenner et al., 2016; Harrold et al., 2017; Van Citters
et al., 2010 ), schizoaffective disorder (Aschbrenner et al., 2016; Harrold et al.,
2017) and major depressive disorder (Aschbrenner et al., 2016; Harrold et al., 2017;
Van Citters et al., 2010). One study focused on young adult male participants only
(McGale et al., 2011), one study included adults with intellectual disabilities
(Matthews et al., 2016) and two studies included veteran participants with a variety
of mental illness diagnoses such as schizophrenia, schizoaffective disorder, bipolar
affective disorder, major depressive disorder, depression, anxiety and PTSD
(Harrold et al., 2017; Perlman et al., 2010). Study sample sizes ranged from nine to
531.
Peer characteristics
Definitions of peers or peer support were not reported in any of the studies.
Three out of 13 studies offered individualised peer support such as providing
tailored support to encourage engagement in PA (Chalder et al., 2012),
individualised physical fitness training sessions (Lesley & Livingwood, 2015) and a
combination support provided in person and/or by telephone dependent on
individuals’ preferences (Pentecost et al., 2015). A group-based peer support
approach was taken by the remaining 10 studies (Aschbrenner et al., 2016, Druss et
al., 2010; Graham et al., 2017; Harrold et al., 2017; Hoffmann et al., 2015; Malcolm
et al., 2013; Matthews et al., 2016; McGale et al., 2011; Perlman et al., 2010; Van
Citters et al., 2010).
There was variation in how a peer support element was implemented within
the studies. Two studies used peers within the programme design and development
process (Hoffmann et al., 2015; Malcolm et al., 2013) and three studies explicitly
used peers as a core element of the programme (Druss et al., 2010; Graham et al.,
2017; Malcolm et al., 2013).
For example, in one study, MHSU made up both study participants and peers who
were responsible for programme planning and the delivery of components such as a
peer-led walking programme (Graham et al., 2017). In some studies, peers-led
exercise sessions (e.g., Graham et al., 2017) whilst in other studies peers participated
alongside study participants and gave positive feedback during the PA session (e.g.,
Malcolm et al., 2013). Peers were trained and then charged with the delivery of PA
sessions in one study, modelling appropriate PA and health behaviours as well as
facilitating group-based sessions and discussions (Druss et al., 2010). Alongside
intervention delivery and leading sessions, peers adopted other roles which included
mentors, befrienders and health champions (Malcolm et al., 2013).
Intervention characteristics
Interventions ranged in duration from eight weeks to 12 months. Eight studies
included a description of a theoretical base that guided the programme development.
Theories used to inform intervention design included The transtheoretical model (or
Stages of change; (DiClemente & Prochaska, 1983) (Harrold et al., 2017; Perlman et
al., 2010), Self- determination theory (SDT: Ryan, Patrick, Deci, & Williams, 2008)
(Chalder et al., 2012; Graham et al., 2017; Lesley & Livingood, 2015), Cognitive
behavioural therapy (McGale et al., 2011), Social cognitive theory (Bandura, 1977)
(Matthews et al., 2016) with three studies
utilising the principles of, and developing tools from, behaviour change theories
(Matthews et al., 2016; Johnson et al., 2017; Harrold et al., 2017). A health
promotion framework was considered within one intervention study (Van Citters et
al., 2010). Five studies did not state any theoretical underpinning to their intervention
design or implementation (Aschbrenner et al., 2016; Druss et al., 2010; Hoffmann et
al., 2015; Malcolm et al., 2013; Pentecost et al., 2015).
Five of the 13 studies included a control condition (Druss et al., 2010;
Chalder et al., 2012; Matthews et al., 2016; McGale et al., 2011; Perlman et al.,
2010). Eleven studies followed participants beyond the end of the intervention with
follow up time points ranging from eight weeks to 12 months. Two studies did not
include any follow up evaluation (Aschbrenner et al., 2016; Harrold et al., 2017).
Interventions were conducted in a variety of community-based settings, including
community mental health centres, mental health agencies, routine consultation
practices, outpatient clinics, community-based fitness facilities, community-based
venues such as local day centres, mental health clinics and Improving Access to
Psychological Therapies (IAPT) services.
One study incorporated three intervention conditions; an exercise
condition, a sporting football condition and a control condition (McGale et al.,
2011). Another study detailed a lifestyle intervention that used experiential and
collaborative learning techniques, and popular technologies to create and
facilitate a peer support network to promote weight loss in obese adults with
serious mental illness (Aschbrenner et al., 2016). Two studies adopted a
community-based participatory research (CBPR) approach which, within this
review context, acknowledges the need to include individuals with experiences
of poor mental health into all aspects of the research process (Graham et al.,
2017; Hoffmann et al., 2015).
Additionally, one study adopted a ‘relaxed ethos’ approach where
participants were encouraged to engage in the programme as frequently or
infrequently as they felt most comfortable, rather than being constrained to a set
programme (Malcolm et al., 2013).
Another study adopted a ‘forgiving flexibility’ approach taking into account that
participants may dip in and out of interventions as a result of relapse (Graham et al.,
2017). Two studies provided incentives to participants in the form of monetary
rewards or free equipment (Graham et al., 2017; Hoffmann et al., 2015).
References
Ainsworth, B. E., Caspersen, C. J., Matthews, C. E., Mâsse, L. C., Baranowski, T., & Zhu,
W. (2016). Recommendations to Improve the Accuracy of Estimates of Physical
Activity Derived from Self Report. Journal of Physical Activity and Health.
https://doi.org/10.1123/jpah.9.s1.s76
Aknin, L. B., Dunn, E. W., Sandstrom, G. M., & Norton, M. I. (2013). Does social
connection turn good deeds into good feelings? On the value of putting the “social” in
prosocial spending. International Journal of Happiness and Development.
https://doi.org/10.1504/ijhd.2013.055643
Ali, K., Farrer, L., Gulliver, A., & Griffiths, K. M. (2015). Online Peer-to-Peer Support for
Young People With Mental Health Problems: A Systematic Review. JMIR Mental
Health, 2(2), e19. https://doi.org/10.2196/mental.4418
Allen, J., Balfour, R., Bell, R., & Marmot, M. (2014). Social determinants of mental health.
International Review of Psychiatry, 26(4), 392–
407.
https://doi.org/10.3109/09540261.2014.928270
Andersen, S. M., & Berk, M. S. (1998). Transference in everyday experience:
Implications of experimental research for relevant clinical phenomena. Review of
General Psychology. https://doi.org/10.1037/1089-2680.2.1.81
Anderson, K., Laxhman, N., & Priebe, S. (2015). Can mental health interventions change
social networks? A systematic review. BMC Psychiatry, 15(1).
https://doi.org/10.1186/s12888- 015-0684-6
Andrew, S., & Halcomb, E. J. (2006). Mixed methods research is an effective method of
enquiry for community health research. Contemporary Nurse.
https://doi.org/10.5172/conu.2006.23.2.145
Ashida, S., & Heaney, C. A. (2008). Differential associations of social support and
social connectedness with structural features of social networks and the health
status of older adults. Journal of Aging and Health.
https://doi.org/10.1177/0898264308324626
Bellamy, C., Schmutte, T., & Davidson, L. (2017). An update on the growing evidence base
for peer support. Mental Health and Social Inclusion. https://doi.org/10.1108/MHSI-
03-2017- 0014
Berger, M., Wagner, T. H., & Baker, L. C. (2005). Internet use and stigmatized illness.
Social Science and Medicine. https://doi.org/10.1016/j.socscimed.2005.03.025
Berry, K., Rana, R., Lockwood, A., Fletcher, L., & Pratt, D. (2019). Factors associated
with inattentive responding in online survey research. Personality and Individual
Differences. https://doi.org/10.1016/j.paid.2019.05.043
Bidee, J., Vantilborgh, T., Pepermans, R., Huybrechts, G., Willems, J., Jegers, M., & Hofmans,
J. (2013). Autonomous Motivation Stimulates Volunteers’ Work Effort: A
Self- Determination Theory Approach to Volunteerism. Voluntas, 24(1), 32–
47. https://doi.org/10.1007/s11266-012-9269-x
Bledin, K., Loat, M., Caffrey, A., Evans, K. B., Taylor, B., & Nitsun, M. (2016). ‘Most
Important Events’ and Therapeutic Factors: An Evaluation of Inpatient Groups for
Peoplewith Severe and Enduring Mental Health Difficulties. Group Analysis.
https://doi.org/10.1177/0533316416675442
Bopp, M., & Fallon, E. (2008). Community-based interventions to promote increased
physical activity: A primer. Applied Health Economics and Health Policy, 6(4), 173–
187. https://doi.org/10.2165/00148365-200806040-00001
Bowling, N. A., Huang, J. L., Bragg, C. B., Khazon, S., Liu, M., & Blackmore, C. E.
(2016). who cares and who is careless? Insufficient effort responding as a reflection of
respondent personality. Journal of Personality and Social Psychology, 111(2), 218–
229. https://doi.org/10.1037/pspp0000085
Brand, T., Pischke, C. R., Steenbock, B., Schoenbach, J., Poettgen, S., Samkange-Zeeb, F.,
& Zeeb, H. (2014). What works in community-based interventions promoting physical
activity and healthy eating? A review of reviews. International Journal of
Environmental Research and Public Health. https://doi.org/10.3390/ijerph110605866
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Using
Qualitative Research in Psychology, 3, 77–101. https://doi.org/The publisher’s
URL is: http://dx.doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative
Research in Psychology, 3(May 2015), 77–101.
https://doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2014). What can “thematic analysis” offer health and wellbeing
researchers? International Journal of Qualitative Studies on Health and Well-
Being, 9. https://doi.org/10.3402/qhw.v9.26152
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative
Research in Sport, Exercise and Health.
https://doi.org/10.1080/2159676X.2019.1628806
Bryant, W., Tibbs, A., & Clark, J. (2011). Visualising a safe space: The perspective of
people using mental health day services. Disability and Society.
https://doi.org/10.1080/09687599.2011.589194
Burr, J. A., Han, S. H., & Tavares, J. L. (2016). Volunteering and Cardiovascular Disease
Risk: Does Helping Others Get “under the Skin?” Gerontologist, 56(5), 937–947.
https://doi.org/10.1093/geront/gnv032
Burton, E., Farrier, K., Hill, K. D., Codde, J., Airey, P., & Hill, A. M. (2018). Effectiveness
of peers in delivering programs or motivating older people to increase their
participation in physical activity: Systematic review and meta-analysis. Journal of
Sports Sciences, 36(6), 666–678. https://doi.org/10.1080/02640414.2017.1329549
Carey, E. C., & Weissman, D. E. (2010). Understanding and finding mentorship: A review
for junior faculty. Journal of Palliative Medicine.
https://doi.org/10.1089/jpm.2010.0091
Carless, D., & Douglas, K. (2008a). Social support for and through exercise and sport in a
sample of men with serious mental illness. Issues in Mental Health Nursing, 29(11),
1179– 1199. https://doi.org/10.1080/01612840802370640
Carless, D., & Douglas, K. (2008b). The contribution of exercise and sport to mental
health promotion in serious mental illness: An interpretive project. International
Journal of Mental Health Promotion, 10(4), 5–12.
https://doi.org/10.1080/14623730.2008.9721771
Carless, D., Douglas, K., & D., C. (2012). The ethos of physical activity delivery in
mental health: A narrative study of service user experiences. Issues in Mental
Health Nursing, 33(3), 165–171.
https://doi.org/http://dx.doi.org/10.3109/01612840.2011.637659
Carneiro, L. S. F., Fonseca, A. M., Vieira-Coelho, M. A., Mota, M. P., & Vasconcelos-Raposo,
J. (2015). Effects of structured exercise and pharmacotherapy vs. pharmacotherapy
for adults with depressive symptoms: A randomized clinical trial. Journal of
Psychiatric Research, 71(July), 48–55.
https://doi.org/10.1016/j.jpsychires.2015.09.007
Cattan, M., Kime, N., & Bagnall, A. M. (2011). The use of telephone befriending in low
level support for socially isolated older people - an evaluation. Health and Social
Care in the Community, 19(2), 198–206. https://doi.org/10.1111/j.1365-
2524.2010.00967.x
Charlesworth, G., Sinclair, J. B., Brooks, A., Sullivan, T., Ahmad, S., & Poland, F. (2017).
The impact of volunteering on the volunteer: findings from a peer support programme
for family carers of people with dementia. Health and Social Care in the Community,
25(2), 548–558. https://doi.org/10.1111/hsc.12341
