| Individuals with serious mental illness, including schizophrenia, schizoaffective disorder, major depressive disorder, or bipolar disorder, experience dramatically reduced life expectancy compared to the general population. Alarmingly high obesity rates, elevated risk of chronic medical conditions, and poor cardiovascular health contribute to this early mortality disparity. Debilitating mental health symptoms, societal stigma, and socioeconomic disadvantage such as homelessness, unemployment, and poverty have further devastating consequences on the health, functioning, and wellbeing of people with serious mental illness. Addressing this early mortality disparity represents a major public health priority. In this Thesis, six studies were completed. These studies examined health promotion efforts for people with serious mental illness and explored opportunities to support interventions using emerging digital technologies. In Study 1, a systematic review and meta-analysis of randomized trials of lifestyle interventions demonstrated that longer duration interventions contributed to greater weight loss among people with serious mental illness. In Study 2, participation in a 12-month lifestyle intervention contributed to improved fitness and reduction in cardiovascular risk, which were associated with fewer depressive symptoms among overweight and obese adults with serious mental illness. In Study 3 the role of health behavior models for informing digital technology interventions for individuals with mental illness was examined. In Study 4, achieving higher average daily step count using wearable activity tracking devices was associated with improved fitness among adults with serious mental illness enrolled in a 6-month lifestyle intervention. In Study 5, greater interaction within a secret Facebook group as part of a lifestyle intervention appeared to contribute to greater weight loss among adults with serious mental illness. And, in Study 6 social media users who self-identified as having a mental illness were surveyed and expressed interest in accessing health promotion programs online and on popular social media platforms. Together, these six studies offer valuable insights for advancing the development, evaluation, and implementation of health promotion programs supported with digital technology for individuals with serious mental illness. |
