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Table 4 Feedback from user groups (Leicester)

From: Reducing weight gain in people with schizophrenia, schizoaffective disorder, and first episode psychosis: describing the process of developing the STructured lifestyle Education for People With SchizophrEnia (STEPWISE) intervention

Groups

No. of users

Conducted by:

Emergent themes

User group 1

n = 11

n = 4

o Transport: a free bus pass or taxi provided enable/motivate people to attend appointments/sessions, particularly if people are feeling unwell or down.

o Duration of a session should not exceed 2 h. Long sessions could cause anxiety, be difficult for people on injections, put them off coming

o Sessions should start in the afternoon, around 1:00pm or 2:00pm.

o Regular breaks are important for concentration

o Would be OK bringing a friend or support worker with them to a session, but not family member.

o Barriers to attending sessions: tiredness, depression, feeling isolated or down, bad weather, football match, or something interesting on TV.

o Availability of free food/drinks a big motivator. People with schizophrenia do not cook for themselves when they feel down.

o Entertainment at the venue is a good motivator, e.g. to play pool.

o Call reminders as people forget about appointments. Text or phone OK.

o Feedback after the sessions, but a phone call, not a form to fill in.

o Many comments on resources, e.g., people are not aware of the amount of sugar in fizzy drinks, which are easy to take especially when people are unwell.

o Beer is harder to change—people with schizophrenia can be addicted to alcohol.

o Health messages given should depend on the individual

User group 2

1× developer; 1× independent interviewer

2× developers; 1× independent interviewer

o Methods suggested to avoid weight gain: eat food low in calories; have someone to cook for them; carry a bottle of water with them; carry little snacks with them; drink tea at night; use mp3 player to motivate them to walk; have access to recommended information on daily allowances, etc.

o People with schizophrenia have no control over craving.

o Upsetting events can overwhelm and lead to over eating

o Tablets that cause sleepiness can de-motivate to stay physically active.

o Do not like the idea of food diaries—a hassle to complete and would probably forget about it.

o Exercise seen as good motivator to overcome depression—not about losing weight, but about becoming fitter

o Give reward for weight loss, e.g., going away on holiday

o It can be hard to take in information and make a change in diet

o People did not like the word ‘group’—people with schizophrenia would not attend—replace with ‘drop-in’.

o Sessions need to be in a routine, as change is stressful when you have schizophrenia

o If people are attending a session for more than one reason, e.g., they are coming to a drop in to get support for weight management, there will be a free lunch and drinks, and there it is possible to play pool and other games at the venue—more are likely to attend.