Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Chyrell Bellamy

Second Advisor

Mark Costa

Abstract

Individuals living with mental illness have significantly reduced physical health compared to the general population, leading to a significantly decreased life expectancy. Physical activity has been shown to be an effective strategy to address many of the conditions contributing to this disparity. However, many people with mental illness do not meet the recommended levels of daily physical activity. Peer support has been shown to be effective in some aspects of recovery for individuals living with mental illness, but its effectiveness in increasing engagement with physical activity in that population is not well established. The specific aim of this report is therefore to investigate whether peer interventions increase physical activity in people living with mental illness. A literature search was performed, and results were reviewed for eligibility. The population was restricted to individuals with mental illness. Quantitative studies including peer support interventions and physical activity outcomes were eligible. Qualitative studies characterizing benefits of peer support and physical activity facilitators/barriers were also eligible. Data was extracted and charted. Twenty eligible studies were identified: eight quantitative studies investigating the effect of peer support-containing interventions on physical activity, seven qualitative studies describing the benefits of peer support in health interventions for individuals with mental illness, and five qualitative studies describing physical activity facilitators/barriers among people with mental illness. Two of the eight quantitative studies reported no significant increase in any measured aspect of physical activity. Two studies reported no significant increase in physical activity at the post-intervention time point, but significant increases appeared at 2-month or 3-month follow-up. The remaining four studies reported significant increases in physical activity measures at the post-intervention time point. The twelve reviewed qualitative studies showed that peer support in healthy lifestyle interventions provides many benefits to individuals with mental illness (support, role-modeling, hope, motivation, shared experience, practical advice, building relationships/social skills), and that those benefits align with the facilitators of physical activity (peer support, mutual support, social support, social modeling, encouragement, accountability, friends making activities innately enjoyable, group strength in facing stigma in the community, lack of power imbalance). These results suggest that peer interventions hold promise for increasing physical activity in individuals living with mental illness, based on the positive results seen in this small group of quasi-experimental and randomized control trials and the conceptual overlap seen between peer support benefits and physical activity facilitators. However, given the small number of heterogenous studies in this area to date, additional future research is needed in order to definitively answer the question and suggest the ideal form of peer support intervention to implement.

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This is an Open Access Thesis.

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