TITLE:
“Well-Track”: Fitbit Based Physical Activity and Sleep Hygiene Intervention for Early Intervention in Psychosis (EIP) and At-Risk Mental State (ARMS) Service Patients
AUTHORS:
Chris Griffiths, Ksenija da Silva, Sue Jugon, Harmony Jiang, Rowena Rogers, Thomas Althorpe, Josephine Davis, Andrea Morris, Neil Redding, Kate Walker, Marlene Kelbrick
KEYWORDS:
Fitbit, Tracker, Psychosis, Exercise, Insomnia, Wearables, Activity
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.13 No.4,
September
13,
2023
ABSTRACT: Background: Compared to the general population, people who are
at a high risk of or experience severe mental illness (SMI) such as psychosis,
are more likely to have low levels of physical activity, high levels of
sedentary behaviour, and sleep problems. Intervention: The Well-Track
intervention comprises a wearable activity and sleep tracker (Fitbit); one
session with mental health service staff providing physical activity and sleep
hygiene advice; a brief motivational interview; completing a goal setting
workbook; and one or two further engagement, feedback and discussion sessions. Participants: Twenty-four participants using an early intervention in psychosis (EIP) or
at-risk mental state (ARMS) service completed an eight-week, three session
intervention (14 males and 10 females), with an age range of 18 - 61, and average age of 27.75 years. Methods: An open-label patient cohort design with no
control group. Pre-intervention, 4-week and 8-week intervention assessments
using participant self-report measures: Patient Health Questionnaire (PHQ-9)
(depression), Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS), and
Sleep Conditioning Index (SCI); and clinician
measurement of body weight. Results: Mean scores showed a
significant improvement in PHQ-9 from 9.29 (SD 5.89) to 5.58 (SD 3.68) at 4 weeks and to 5.83 (SD 4.40) at 8 weeks, with large effect
sizes. For those who met a diagnosis of depression at baseline, at 4 week
follow-up seven participants (26%) experienced remission and nine (33%)
reliable improvement, and at 8 week follow-up four (21%) experienced remission
and seven (37%) reliable improvement. WEMWBS scores significantly improved,
from 44.04 (SD 9.44) to 48.54 (SD 8.71) at 4 weeks and to 48.67 (SD 8.76) at 8 weeks, with large effect sizes. Body weight did not change
significantly, remaining unchanged at 4 weeks and reduced from a mean of 82.8
kg (baseline) to 80.15 kg at 8 weeks, a reduction of 2.65 kg. Conclusion: Well-Track was integrated
into an EIP and ARMS service and was found to be beneficial in terms of
wellbeing, depression, sleep, and preventing weight gain (either as a two or
three engagement point intervention). Well-Track could be delivered through EIP
and ARMS services to promote healthy lifestyle behaviours.