Authors (including presenting author) :
Eric CK WONG(1), Francez SY LEUNG(1), Anita SF CHAN(1), June YW CHAO(1), Eileena MC CHUI(2), Phyllis KL CHAN(2)
Affiliation :
(1) Occupational Therapy Department, Queen Mary Hospital (2) Department of Psychiatry, Queen Mary Hospital
Introduction :
Over 80% of people with severe mental illnesses (SMI) are overweight or obese, which contributes to the decrease of 25 years of life expectancy and 3 times of mortality rate comparing to the average of global population. Sedentary lifestyle, unhealthy diets and side effect of medication are accounting for the growing problem. Psychiatric Adult Day Hospital of Queen Mary Hospital, Phoenix Clubhouse is a rehabilitation service adopting the “Clubhouse Model”. Its’ physical wellness program aims at increasing members’ awareness on their health and to encourage healthy lifestyle. The program is specifically designed in addressing the behavioral component of people with SMI.
Objectives :
To apply the COM-B Model (consisting of capability, opportunity and motivation and behavioral- change wheel) to illustrate how Phoenix Clubhouse facilitate the change of healthy lifestyle of Clubhouse members (people with SMI). To review the health status after joining the physical wellness program.
Methodology :
The physical wellness program was run by Health Ambassadors including staff and members. It incorporated into the COM-B model to induce lifestyle behavioral changes. To increase members’ capability, information on advantages of healthy lifestyle including regular exercise and healthy diet were provided regularly. To provide more opportunities for members to engage in healthy lifestyle, regular sports activities and healthy meals were provided and fitness equipment was installed. Healthy snacks and drinks could be purchased in Environmental Protection and Tuck Shop Unit. ‘Buddy system’ was introduced to enhance modelling and provide psychological support. To increase motivation of change, personal recovery plans were discussed with members. Staff were volunteered to develop peer exercise groups. Fitness equipment usage ranking evaluated members’ exercise habit to provide encouragement and modelling behavior. A health survey was conducted annually to evaluate the health status of Clubhouse members including body weight, fat percentage, BMI score, subjective quality of life, exercise and eating habit and their satisfaction on these habits. Among a total of 107 members, health statuses of 25 members with 5 years tracing data were evaluated.
Result & Outcome :
The key factors for encouraging healthy lifestyle were explored. The technique for improving the motivation and capability of members including regular recovery goal settings and review, modelling, psychoeducation and social and environmental support system, such as “buddying up”, fitness activities, healthy meals and so on. Among 25 members, 60% of Clubhouse members showed improvement or maintenance in exercise habit. 56 % of them showed decrease or maintenance in fat percentage. Around 40% members showed increase in subjective quality of life, exercise and diet satisfaction. The past five-year experience of physical wellness program in Phoenix Clubhouse has slowed down the continuous weight gain of the members. Another observation was found that fitness equipment usage was peaked after the health survey was conducted, possible motivating effect of annual health survey was proposed.
