Co-development of the ‘Move More’ Toolkit: A Theoretically Informed Resource to Support Physical Activity Promotion and Participation within Secure Psychiatric Care

Introduction: Physical activity (PA) is effective in improving physical and mental health outcomes of individuals within secure psychiatric care. However, psychiatric inpatients remain a seldomly heard population in research involving their care. This project reports on the co-development of a theoretically informed PA toolkit to promote physical activity within an inpatient setting.Methods: A behavioural analysis was conducted with 10 patients and 11 staff within a secure psychiatric hospital. Qualitative interviews and group discussions guided by the COM-B model were conducted to identify barriers to physical activity. Based on identified barriers, participant led solutions and suggestions for toolkit content were identified. The academic team selected intervention functions and behaviour change techniques from the behaviour change wheel (BCW) which were subsequently aligned with toolkit content. A final toolkit titled the ‘Move More’ toolkit was developed and produced.Results: Applying the COM-B model to interview transcripts, we identified six key subthemes reflecting the capability, opportunity and motivation components of the model. Using the BCW, we selected three intervention functions (education, training and enablement) and six behaviour change techniques ( restructing the social environment, instructions on performing behaviour, social support, demonstration of behaviour, self-monitoring of behaviour and information about health consequences). Incorporating these components, the final toolkit consisted of four sections: education on the benefits of physical activity engagement, ways to prepare for physical activity (e.g., selecting appropriate clothing), examples of activities that patients could engage in within a ward environment, and self-monitoring tools including a PA planner.Significance: The toolkit was developed using principles of co-production and guided by the BCW. This approach presents a key contribution to literature by demonstrating how principles of co-production can be employed with the BCW in a complex, often hard to reach population. This may represent a valuable approach to develop targeted and effective health interventions within psychiatric populations.