Development of a multicomponent lifestyle modification intervention package (LMIP) for persons with schizophrenia in India

Abstract

Background

Providing patients with individualized lifestyle intervention is essential, especially for persons with schizophrenia (PwS), to reduce co-morbid physical health problems. The aim of the study is to develop a multicomponent, individually tailored lifestyle modification intervention package (LMIP) for PwS in a tertiary level mental health center, India.

Methods

The lifestyle intervention package was developed in 7 stages. The stages included: defining the purpose and reviewing the literature for identifying specific interventions for the Asian population, expert consultation, preparation of an intervention package draft, and validation by experts from various disciplines. Expansion of the intervention package was based on the existing theories from the chronic care model and pilot tested for the feasibility and practicability of the intervention. Revisions were made based on the pilot study and experts’ suggestions, and finalization of the intervention package.

Results

The final lifestyle intervention package consisted of psychoeducation, criteria for metabolic syndrome, WHO classification for obesity, dietary modification includes healthy eating behaviours, dietary choices for metabolic syndrome, exercise guidelines and appropriate physical exercises for metabolic syndrome. Further, the intervention package was refined and finalized based on pilot testing in 5 subjects with their caregivers.

Conclusion

The LMIP was designed to be delivered by a mental health professional through comprehensive 40–45 min sessions, integrated into both inpatient care and routine follow up visits. This package employed a robust strategy aimed at achieving possible widest impact on the physical well-being of persons with schizophrenia, particularly by addressing modifiable lifestyle risk factors contributing to metabolic syndrome.