Motivational Group Intervention Improves Exercise Self Efficacy in Outpatients with Schizophrenia Spectrum Disorders (SSDs)

Thursday, 15 July 2010: 1:45 PM

Lora Humphrey Beebe, PhD, PMHNP-BC
College of Nursing, University of Tennessee, Knoxville, TN

Learning Objective 1: analyze theoretical linkages between exercise attitudes and behavior

Learning Objective 2: synthesize the current state of scientific knowledge regarding the development of exercise-enhancing interventions for persons with SSDs


The over 2 million Americans with Schizophrenia Spectrum Disorders (SSDs) have high rates of obesity and related illnesses resulting in 12 times greater risk for cardiovascular disease than  the general population. Despite well-known benefits of exercise, persons with SSDs are less active than people with no mental illness or with other mental illnesses.  Evidence based interventions are needed to enhance exercise attitudes and  motivation in this group.

We examined the effect of the Walk, Address Sensations, Learn About Exercise, Cue Exercise for SSDs (WALC-S) intervention upon the attitudes of exercise self efficacy (SEE) and outcome expectations (OEES) in outpatients with SSDs.

The theory of self efficacy provided the study framework.  Self efficacy theory posits that the more strongly individuals believe in their ability to perform a course of action (self efficacy) and in the positive outcomes of those actions (outcome expectations), the higher their motivation to initiate and persist in the activity.

Methods: Experimental, pre test posttest.   Randomization to experimental (WALC-S) or time-and-attention control  (TAC) group after baseline SEE and OEES.  WALC-S consisted of four weekly groups to provide information, support and motivation to undertake walking for exercise.  TAC consisted of four weekly socialization groups.  SEE and OEES were repeated after WALC-S or TAC.
Results: N = 97, 46% female and 43% African American.  Age range: 21-72 ; average 46.9 years (SD = 2.0).  There were no statistically significant differences between groups at baseline.  Mean SEE scores were significantly higher in experimentals versus controls after intervention (f (1,41) = 6.4, p = 0.015).

To our knowledge this is the first study to examine exercise attitudes in SSDs. Interventions designed to enhance exercise attitudes are a critical first step toward the ultimate goal of enhancing exercise participation of persons with SSDs.  Future studies will examine correlations between exercise attitudes and exercise behavior.