“One Size Doesn’t Fit All”: Design Considerations for an Exercise Program to Improve Physical Function in Older Veterans with Serious Mental Illness

Julia Browne (), Whitney L. Mills, Courtney T. Lopez, Noah S. Philip, Katherine S. Hall, Alexander S. Young, Kate M. Guthrie and Wen-Chih Wu
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Julia Browne: Center of Innovation on Transformative Health Systems Research to Improve Veteran Equity and Independence (THRIVE COIN), VA Providence Healthcare System, Providence, RI 02908, USA
Whitney L. Mills: Center of Innovation on Transformative Health Systems Research to Improve Veteran Equity and Independence (THRIVE COIN), VA Providence Healthcare System, Providence, RI 02908, USA
Courtney T. Lopez: VA Providence Healthcare System, Providence, RI 02908, USA
Noah S. Philip: VA Providence Healthcare System, Providence, RI 02908, USA
Katherine S. Hall: Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC 27705, USA
Alexander S. Young: Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles, Los Angeles, CA 90073, USA
Kate M. Guthrie: Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
Wen-Chih Wu: Center of Innovation on Transformative Health Systems Research to Improve Veteran Equity and Independence (THRIVE COIN), VA Providence Healthcare System, Providence, RI 02908, USA

IJERPH, 2025, vol. 22, issue 2, 1-14

Abstract: Older adults with serious mental illness (SMI) (i.e., schizophrenia, schizoaffective disorder, bipolar disorder) have compromised physical function that adversely affects their quality of life. Exercise is an effective intervention to improve function in older persons; however, older people with SMI experience barriers to exercise engagement. This study sought to obtain feedback on an exercise program in development for older people with SMI that comprised home-based exercise delivery, individualized exercise prescription, and motivational health coaching calls. Individual interviews and focus groups were conducted with older Veterans with SMI ( n = 3) and clinical staff serving this population (directors: n = 3; clinicians: n = 15, k = 3) to elicit feedback on the perceived feasibility and acceptability of the preliminary program and recommendations for modifications to the program. Rapid analysis was used to summarize transcripts of audio-recorded interviews and focus groups. Results indicated a strong perceived feasibility and acceptability of the preliminary intervention because of how the individualized exercise prescription component (i.e., exercise plan) would be personalized to the Veteran’s preferences and abilities. Clinical staff participants expressed concerns about how the lack of real-time supervision would negatively affect exercise completion. Participants recommended tailoring the home-based exercise delivery and motivational health coaching calls components to each Veteran’s unique context.

Keywords: physical activity; intervention development; schizophrenia; bipolar disorder; qualitative; rapid analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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