The Design and Evaluation of a Digital Physical Activity Intervention for Individuals With Severe Mental Illness in an Irish Mental Health Residential Setting

Active Ease is a co-designed digital-physical activity web-based application developed for individuals with severe mental illness (SMI) in Irish mental health residential settings. The platform was adapted from the Move More Toolkit (Anthony et al., 2024), originally developed at Loughborough University, and informed by Public and Patient Involvement (PPI) feedback from service users and clinicians. Active Ease includes an educational homepage and a range of physical activities with guided visual demonstrations, including videos and images.

The intervention was underpinned by the Capability, Opportunity, Motivation - Behaviour (COM-B) model and evaluated using the RE-AIM framework. A clustered randomised controlled trial design was employed across three Irish mental health residential houses. Two houses were randomly assigned as intervention houses and one as a control.

The intervention was delivered across two consecutive phases. Phase One involved a 10-week researcher-led pilot in which the researcher served as a digital navigator, supporting service users in engaging with Active Ease individually or in groups. Following co-design interviews with service users and clinicians, iterative refinements were made to Active Ease for Phase Two. Phase Two lasted six weeks and shifted its focus to empowering clinicians to independently facilitate service users' engagement in physical activity, with the researcher adopting a facilitative role. Environmental adaptations introduced in Phase Two included screen mirroring Active Ease to communal televisions and placement of visual aids and a guidebook within the residential settings.

Follow-up data were collected at +12 weeks post-Phase Two to evaluate the maintenance of Active Ease engagement and early indicators of sustainability. Qualitative data were analysed using reflexive thematic analysis informed by Braun and Clarke (2019), with findings mapped onto the RE-AIM framework.

Inclusion criteria

• Aged 19+
• Have an SMI of schizophrenia, bipolar disorder, or psychosis.
• A service user within one of three HSE mental health residential houses. Capacity to understand the research and consent to the research (Assisted Decision-Making (Capacity) Act 2015).
• Approved by their clinician.

Exclusion criteria

• No SMI diagnosis
• Acute psychiatric episode at the time of recruitment
• Service users who are unwell/ distressed