Data_Sheet_1_Determinants of Physical Health Self-Management Behaviours in Adults With Serious Mental Illness: A Systematic Review.doc

Behavioural interventions can support the adoption of healthier lifestyles and improve physical health outcomes, but it is unclear what factors might drive success of such interventions in people with serious mental illness (SMI). We systematically identified and reviewed evidence of the association between determinants of physical health self-management behaviours in adults with SMI. Data about American Association of Diabetes Educator's Self-Care Behaviours (AADE-7) were mapped against the novel Mechanisms of Action (MoA) framework. Twenty-eight studies were included in the review, reporting evidence on 104 determinant-behaviour links. Beliefs about capabilities and beliefs about consequences were the most important determinants of behaviour, especially for being physically active and healthy eating. There was some evidence that emotion and environmental context and resources played a role in determining reducing risks, being active, and taking medications. We found very limited evidence associated with problem solving, and no study assessed links between MoAs and healthy coping. Although the review predominantly identified evidence about associations from cross-sectional studies that lacked validated and objective measures of self-management behaviours, these findings can facilitate the identification of behaviour change techniques with hypothesised links to determinants to support self-management in people with SMI.
Systematic Review Registration: PROSPERO, registration CRD42018099553.

行为干预可助力个体养成更健康的生活方式，并改善躯体健康结局，但目前尚不明确，在严重精神疾病（Serious Mental Illness, SMI）患者群体中，哪些因素可推动此类干预取得成功。本研究系统检索并梳理了针对成年严重精神疾病患者的躯体健康自我管理行为相关决定因素间关联的证据。研究将美国糖尿病教育者协会自我护理行为量表（American Association of Diabetes Educator's Self-Care Behaviours, AADE-7）相关数据，与全新的作用机制（Mechanisms of Action, MoA）框架进行了映射匹配。本次综述共纳入28项研究，共报道了104项决定因素-行为关联的相关证据。能力信念与结果信念是影响行为的最为关键的决定因素，在体育锻炼与健康饮食行为中尤为显著。现有部分证据表明，情绪、环境情境与资源在风险规避、体育锻炼及服药行为的决定过程中发挥了一定作用。本研究发现，与问题解决相关的证据极为有限，且尚无研究评估作用机制与健康应对行为间的关联。尽管本次综述纳入的关联证据主要来自横断面研究，且这些研究未采用经过验证的客观手段对自我管理行为进行测评，但本研究结果仍可助力识别与决定因素存在假设性关联的行为改变技术，从而为严重精神疾病患者的自我管理提供支持。系统综述注册信息：PROSPERO，注册编号CRD42018099553。