Thoughts about physical activity: questionnaire study
Research type
Research Study
Full title
What people think about doing physical activity: a questionnaire study
IRAS ID
319599
Contact name
Rowan Diamond
Contact email
Sponsor organisation
University of Oxford Research Governance, Ethics and Assurance
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
Many people who experience psychosis spend too much time sitting down and not enough time exercising. In order to design effective treatments to help people be more active we need to understand what helps and hinders physical activity. A previous study by this team (“Getting more physically active: finding out what helps and hinders”; REC reference 21/WA/0285), in which we spoke in depth to 51 people with psychosis, staff and carers, indicates that the thoughts people have about themselves, the world and others impact upon the physical activity they do. It is therefore important that we develop ways of assessing problematic thoughts, which can later be targeted in treatment. The next step is to develop four questionnaires: 1) Reasons to be active 2) Reasons to be less active 3) Reasons to stand 4) Reasons to sit The items making up each of these questionnaires have come from i) interviews and focus groups with people who have psychosis, informal carers and staff ii) a lived experience advisory panel. The questionnaires will be tested to check that they measure what we intend them to measure (validity) and are reliable. We will also remove unnecessary items which will shorten the questionnaires. The data from the questionnaires will not only help to create a clinically useful measure that can be used by many different health professionals, but the results will also give indications about how thoughts about physical activity relate to other experiences that people have (for example, how low mood might relate to our thoughts about activity). Over 600 patients with diagnoses of psychosis will be invited to answer a pack of questionnaires (approximately 30-45 minutes), and provide some brief demographic information (e.g. age, gender, ethnicity etc.). Roughly half (300-500) participants will be invited to answer questions in pack 1 including the two new questionnaires relating to thoughts about exercise. The other half will be invited to answer questions in pack 2 including the two new questionnaires relating to thoughts about sitting. After completing the first pack a subgroup of around 100 participants will be asked to repeat two of the measures one week after initial participation, for test-retest analysis. Once people have participated they may wish to take part in the study again by completing the other pack of questionnaires. In this case they will ask the researcher if this is possible in their area. A large number of participants are required to assess validity and reliability. We will therefore recruit participants via the Clinical Research Network (CRN), which has research assistants based in NHS Trusts nationwide. The study is funded by the National Institute of Health Research. Participants will be reimbursed £10, or an equivalent value shopping voucher, for each pack of questionnaires they complete (ie up to three times). Recruiting via the CRN is a method which has been successfully used by our research group, with no risks identified.Summary of Results
: Background Better treatments are needed to help patients diagnosed with psychosis to be more physically active and to spend less time sitting (sedentary behaviour). Thoughts are likely to be important in blocking and promoting movement. Our aim was to identify the thoughts that are likely to affect physical inactivity or sedentary behaviour in patients with psychosis in order to develop future research and treatment development.Methods
Lists of thoughts relating to physical activity (46 thoughts promoting it and 103 thoughts blocking it) and thoughts relating to sedentary behaviour (105 promoting it and 51 blocking it) were developed with lived experience advisors and given to patients with diagnoses of psychosis, aged 16 years or older, using secondary care mental health services in 43 National Health Service (NHS) providers in England and Wales. Questionnaires were developed using a statistical technique called factor analysis. Two existing questionnaires (the International Physical Activity Questionnaire-Short form and the Sedentary Behaviour Questionnaire) were used to see how the new questionnaires about thoughts related to measures of how much movement patients report that they are doing.Results
917 participants took part between 6th March, 2023 to 19th February, 2024. 563 patients completed the physical activity lists and 523 patients completed the sedentary behaviour lists, with 169 patients completing both questionnaires. 620 (67.6%) patients were men and 286 (31.2%) patients were women. 592 (64.6%) patients were White, 83 (9.1%) were mixed or multiple ethnic origin, 85 (9.3%) were Asian, 133 (14.5%) were Black, 4 (0.4%) were Arab, and 20 (2.2%) were other ethnic groups or preferred not to say. The average age was 42.9 years.
The Oxford Physical Activity Cognition (OPAC) (Promoting and Blocking) scales included eight groups of issues: positive feelings with exercise, anticipation of reward, responsibility to others, negative social appraisal, physical health, hearing voices, preoccupation, and negative feelings towards exercise. The Oxford Sedentary Cognitions Assessments (OSCA) (Promoting and Blocking) included eleven groups of issues: purpose, poor physical health, defeatist beliefs, unaware of time passing, low mood, television, sitting to steady mind, purpose, anticipation of reward, responsibility to others, and motivation from others.
Statistical analyses showed that the new questionnaires were strong. They related to the other questionnaires that measured movement, but not very strongly.Making sense of the results
There are lots of thoughts that drive movement for patients with psychosis. Some of the thoughts are similar for physical activity and sedentary behaviour, and some are more specific to only physical activity or only sedentary behaviour. The thoughts that seem to be important could be good targets for future treatments to increase movement. The next step is to find out whether we can change the thoughts and if so, whether this leads to more movement.REC name
West of Scotland REC 4
REC reference
23/WS/0010
Date of REC Opinion
2 Feb 2023
REC opinion
Further Information Favourable Opinion