Motivation and adherence to exercise in college students with schizophrenia

Abstract

The purpose of this study was to explore and define the behavioral and thought processes that affect exercise engagement and adherence in college students with schizophrenia. A mixed methods approach was proposed utilizing an online survey followed by semi structured interviews. The online survey used was the Exercise Benefits and Barriers Scale (EBBS) Adult Version and the semi structured interview questions were produced by the researcher. The potential participants for this study were students who were 18 years of age or older and registered with the Disability Resources and Services Department at Temple University. The participants were also to have already experienced their first episode of psychosis (FEP). The online survey yielded no completed questionnaires. The online survey consisted of the 43 question EBBS Adult version and a basic demographic questionnaire. The EBBS utilized a 4-point Likert scale ranging from ‘strongly disagree’ to ‘strongly agree.’ At the end of the survey, an optional question was added if participants wanted to take part in a semi-structured interview. The semi-structured interview also yielded no participants. Interviews were designed to develop a more in depth understanding of personal schizophrenia symptoms, how well symptoms are managed by the individual, and how exercise plays a role in their management. Interviews were to be transcribed verbatim and coded using transcendental phenomenology theory to explore the phenomenon of exercise adherence and non-adherence. Considering the lack of responses, social stigma surrounding mental illness could be a contributing factor. Discrimination surrounding mental illness has been shown to lower quality of life for individuals with a mental illness, increase unemployment rates, and increase anxiety and depression rates. Another potential contributing factor to low survey completion rate was the length of the EBBS. The population diagnosed with schizophrenia could benefit from research involving a six month exercise implementation. The EBBS or a shortened modified version could be utilized in pre and post testing along with exercise testing in the pre and post form analyzing the five areas of physical fitness. Semi-structured interviews would be beneficial to do prior, during, and at the end of the exercise intervention to acquire a well rounded view of the perceptions of exercise engagement. A follow up survey and interview would be completed after two months to examine continued or discontinued exercise engagement and the associated reasons. A case study or narrative research would be a second beneficial study. One or two participants who currently engage in exercise and are considered in the maintenance stage of behavior change would be followed and interviewed over the course of a year or longer. It would be valuable to examine a participant who is currently engaged in exercise since this is a phenomenon in this population. A qualitative research approach would give better insight into how these individuals perceive exercise, exercise barriers, or current and past exercise motivators. This in turn can better mold future research designs and exercise implementations to address the exercise motivation obstacle in people with schizophrenia.