A randomised controlled feasibility trial of an intervention to increase activity and reduce sedentary behaviour in people with severe mental illness: Walking fOR Health (WORtH) Study: Feasibility RCT WORtH

Suzanne McDonough; Maurice Dillon; Catherine McDonough; Judith McAuley; Mary Clarke; Claire Murphy; Mike Clarke; Duana McArdle; Ailsa Niven; Iseult Wilson; Mark Tully; Marie Murphy; J. Williams; Sara Howes

A randomised controlled feasibility trial of an intervention to increase activity and reduce sedentary behaviour in people with severe mental illness: Walking fOR Health (WORtH) Study: Feasibility RCT WORtH

Suzanne McDonough^*
, Maurice Dillon
, Catherine McDonough
, Judith McAuley
, Mary Clarke
, Claire Murphy
, Mike Clarke
, Duana McArdle
, Ailsa Niven
, Iseult Wilson
, Mark Tully
, Marie Murphy
, J. Williams
, Sara Howes

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: People with severe mental illness (SMI) engage in less physical activity (PA) and more people with SMI. sedentary behaviour (SB) than the general population, contributing to poorer physical health outcomes in this population. Therefore, the aim of this study was to evaluate the feasibility of a multi-component behaviour change intervention called WORtH, delivered by community mental health teams, aimed at increasing PA and reducing SB compared with a one-off education session in people with SMI.

Design: Feasibility randomised controlled trial.

Setting: Study recruitment and intervention delivery took place within four community mental health teams in United Kingdom and Ireland.

Participants: Eligible participants had a diagnosis of a severe mental illness and no contraindications to participating in physical activity. Fifty-four participants (25 male:29 female; mean age 51.6 years) were recruited.

Interventions: Participants were randomised to the 13-week WORtH intervention, comprising education, activity tracking and health coaching, or an education-only control.

Primary and secondary outcome measures: Feasibility outcomes included recruitment, retention, adherence and acceptability. Clinical outcomes included device-measured (Axivity AX3) and self-reported PA and SB, body anthropometry, physical function and mental wellbeing.

Results: This feasibility study met 90% target recruitment and 94% of participants provided follow-up data. Adherence to allocated intervention and engagement with all core intervention components was >80%. Qualitative feedback indicated high levels of satisfaction. Valid device measured moderate-vigorous PA (MVPA), the intended primary outcome for a definitive trial, was obtained from 90% participants at baseline and 75% participants at post-intervention. Point estimates indicated a mean increase of 8.6 minutes/day of MVPA in the intervention group and of 1.0 minute/day in the control group.

Conclusions: The results of this study support the feasibility of the WORtH intervention in adults with SMI, and findings will be used to optimise the design of a definitive RCT.

Original language	English
Number of pages	109
Journal	BMJ Open
Publication status	Accepted - 31 Mar 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Mental health
chronic disease
clinical trial
public health
wearable devices
wearable electronic devices

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McDonough, S., Dillon, M., McDonough, C., McAuley, J., Clarke, M., Murphy, C., Clarke, M., McArdle, D., Niven, A., Wilson, I., Tully, M., Murphy, M., Williams, J., & Howes, S. (Accepted/In press). A randomised controlled feasibility trial of an intervention to increase activity and reduce sedentary behaviour in people with severe mental illness: Walking fOR Health (WORtH) Study: Feasibility RCT WORtH. BMJ Open.

@article{1bf043727fd4475689a0e1cac85be60b,

title = "A randomised controlled feasibility trial of an intervention to increase activity and reduce sedentary behaviour in people with severe mental illness: Walking fOR Health (WORtH) Study: Feasibility RCT WORtH",

abstract = "Objective: People with severe mental illness (SMI) engage in less physical activity (PA) and more people with SMI. sedentary behaviour (SB) than the general population, contributing to poorer physical health outcomes in this population. Therefore, the aim of this study was to evaluate the feasibility of a multi-component behaviour change intervention called WORtH, delivered by community mental health teams, aimed at increasing PA and reducing SB compared with a one-off education session in people with SMI. Design: Feasibility randomised controlled trial. Setting: Study recruitment and intervention delivery took place within four community mental health teams in United Kingdom and Ireland. Participants: Eligible participants had a diagnosis of a severe mental illness and no contraindications to participating in physical activity. Fifty-four participants (25 male:29 female; mean age 51.6 years) were recruited. Interventions: Participants were randomised to the 13-week WORtH intervention, comprising education, activity tracking and health coaching, or an education-only control. Primary and secondary outcome measures: Feasibility outcomes included recruitment, retention, adherence and acceptability. Clinical outcomes included device-measured (Axivity AX3) and self-reported PA and SB, body anthropometry, physical function and mental wellbeing. Results: This feasibility study met 90\% target recruitment and 94\% of participants provided follow-up data. Adherence to allocated intervention and engagement with all core intervention components was >80\%. Qualitative feedback indicated high levels of satisfaction. Valid device measured moderate-vigorous PA (MVPA), the intended primary outcome for a definitive trial, was obtained from 90\% participants at baseline and 75\% participants at post-intervention. Point estimates indicated a mean increase of 8.6 minutes/day of MVPA in the intervention group and of 1.0 minute/day in the control group. Conclusions: The results of this study support the feasibility of the WORtH intervention in adults with SMI, and findings will be used to optimise the design of a definitive RCT. ",

keywords = "Mental health, chronic disease, clinical trial, public health, wearable devices, wearable electronic devices",

author = "Suzanne McDonough and Maurice Dillon and Catherine McDonough and Judith McAuley and Mary Clarke and Claire Murphy and Mike Clarke and Duana McArdle and Ailsa Niven and Iseult Wilson and Mark Tully and Marie Murphy and J. Williams and Sara Howes",

year = "2026",

month = mar,

day = "31",

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journal = "BMJ Open",

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McDonough, S, Dillon, M, McDonough, C, McAuley, J, Clarke, M, Murphy, C, Clarke, M, McArdle, D, Niven, A, Wilson, I, Tully, M, Murphy, M, Williams, J & Howes, S 2026, 'A randomised controlled feasibility trial of an intervention to increase activity and reduce sedentary behaviour in people with severe mental illness: Walking fOR Health (WORtH) Study: Feasibility RCT WORtH', BMJ Open.

TY - JOUR

T1 - A randomised controlled feasibility trial of an intervention to increase activity and reduce sedentary behaviour in people with severe mental illness: Walking fOR Health (WORtH) Study: Feasibility RCT WORtH

AU - McDonough, Suzanne

AU - Dillon, Maurice

AU - McDonough, Catherine

AU - McAuley, Judith

AU - Clarke, Mary

AU - Murphy, Claire

AU - Clarke, Mike

AU - McArdle, Duana

AU - Niven, Ailsa

AU - Wilson, Iseult

AU - Tully, Mark

AU - Murphy, Marie

AU - Williams, J.

AU - Howes, Sara

PY - 2026/3/31

Y1 - 2026/3/31

N2 - Objective: People with severe mental illness (SMI) engage in less physical activity (PA) and more people with SMI. sedentary behaviour (SB) than the general population, contributing to poorer physical health outcomes in this population. Therefore, the aim of this study was to evaluate the feasibility of a multi-component behaviour change intervention called WORtH, delivered by community mental health teams, aimed at increasing PA and reducing SB compared with a one-off education session in people with SMI. Design: Feasibility randomised controlled trial. Setting: Study recruitment and intervention delivery took place within four community mental health teams in United Kingdom and Ireland. Participants: Eligible participants had a diagnosis of a severe mental illness and no contraindications to participating in physical activity. Fifty-four participants (25 male:29 female; mean age 51.6 years) were recruited. Interventions: Participants were randomised to the 13-week WORtH intervention, comprising education, activity tracking and health coaching, or an education-only control. Primary and secondary outcome measures: Feasibility outcomes included recruitment, retention, adherence and acceptability. Clinical outcomes included device-measured (Axivity AX3) and self-reported PA and SB, body anthropometry, physical function and mental wellbeing. Results: This feasibility study met 90% target recruitment and 94% of participants provided follow-up data. Adherence to allocated intervention and engagement with all core intervention components was >80%. Qualitative feedback indicated high levels of satisfaction. Valid device measured moderate-vigorous PA (MVPA), the intended primary outcome for a definitive trial, was obtained from 90% participants at baseline and 75% participants at post-intervention. Point estimates indicated a mean increase of 8.6 minutes/day of MVPA in the intervention group and of 1.0 minute/day in the control group. Conclusions: The results of this study support the feasibility of the WORtH intervention in adults with SMI, and findings will be used to optimise the design of a definitive RCT.

AB - Objective: People with severe mental illness (SMI) engage in less physical activity (PA) and more people with SMI. sedentary behaviour (SB) than the general population, contributing to poorer physical health outcomes in this population. Therefore, the aim of this study was to evaluate the feasibility of a multi-component behaviour change intervention called WORtH, delivered by community mental health teams, aimed at increasing PA and reducing SB compared with a one-off education session in people with SMI. Design: Feasibility randomised controlled trial. Setting: Study recruitment and intervention delivery took place within four community mental health teams in United Kingdom and Ireland. Participants: Eligible participants had a diagnosis of a severe mental illness and no contraindications to participating in physical activity. Fifty-four participants (25 male:29 female; mean age 51.6 years) were recruited. Interventions: Participants were randomised to the 13-week WORtH intervention, comprising education, activity tracking and health coaching, or an education-only control. Primary and secondary outcome measures: Feasibility outcomes included recruitment, retention, adherence and acceptability. Clinical outcomes included device-measured (Axivity AX3) and self-reported PA and SB, body anthropometry, physical function and mental wellbeing. Results: This feasibility study met 90% target recruitment and 94% of participants provided follow-up data. Adherence to allocated intervention and engagement with all core intervention components was >80%. Qualitative feedback indicated high levels of satisfaction. Valid device measured moderate-vigorous PA (MVPA), the intended primary outcome for a definitive trial, was obtained from 90% participants at baseline and 75% participants at post-intervention. Point estimates indicated a mean increase of 8.6 minutes/day of MVPA in the intervention group and of 1.0 minute/day in the control group. Conclusions: The results of this study support the feasibility of the WORtH intervention in adults with SMI, and findings will be used to optimise the design of a definitive RCT.

KW - Mental health

KW - chronic disease

KW - clinical trial

KW - public health

KW - wearable devices

KW - wearable electronic devices

M3 - Article

SN - 2044-6055

JO - BMJ Open

JF - BMJ Open

ER -