A qualitative study of individuals with first episode psychosis’ experience of taking part in an online remote exercise and lifestyle (REAL) intervention

Background Given the physical health disparities associated with mental illness, targeted lifestyle interventions are required to reduce the risk of cardiometabolic disease. In addition to its physical health benefits, physical activity has been linked to positive mental well-being and increased confidence. Digital technology is increasingly used to promote fitness, lifestyle and physical health among the general population. However, using digital technology to promote physical health within mental healthcare requires a nuanced understanding of the factors which affect their adoption and implementation. Objectives Using a qualitative design, the study explored participants’ experiences of engaging with a digital remote group-based exercise intervention as part of a feasibility trial. Methods Participants, young adults aged 18–35 currently receiving care for first episode psychosis from early intervention services, who consented to participate in an eight-week feasibility study were invited to an online semi-structured interviews were analysed using reflexive thematic analysis to explore their experiences. The remote exercise and lifestyle (REAL) intervention included the provision of wearable sensors (Fitbits) and participating in twice-weekly live zoom sessions, using pre-existing exercise videos. Results Fourteen of the 31 participants enrolled in the REAL intervention consented to interviews. Four main themes were developed: (i) Acceptability and usability of the REAL intervention, (ii) Physical activity and beyond: impact on lifestyle, wellbeing, and connection, (iii) Technology as a facilitator for engagement and behaviour change; and (iv) Navigating visibility and privacy in digital spaces. Participants found the online intervention engaging and accessible. Participants reported improvements to their confidence, self-esteem, mental wellbeing, lifestyle behaviours, as well as increasing their physical activity. Conclusion This study suggests the acceptability of a digital health intervention consisting of twice-weekly online sessions, using pre-existing exercise videos, for young people with first episode psychosis, with the potential to promote benefits to psychological wellbeing and functioning. Findings highlight the importance of flexible design, participant-led outcomes, and integration into routine mental health care. Clinical trial number Not applicable. Trial registration This study was prospectively registered with the ISRCTN registry (ISRCTN12893459) on the 20/04/2023.