S16-3: An International Consensus on the Most Effective, Impactful, and Feasible Strategies for Physical Activity Implementation in Inpatient Services. A Nominal Group Technique

Abstract

Purpose: Physical activity (PA) offers numerous physical and psychological health benefits for individuals with severe mental illness. Despite its benefits, PA is not routinely integrated into inpatient mental health services. We aimed to present an international consensus and establish priorities for the most effective, impactful, and feasible implementation strategies which can lead to the routine integration of PA services into inpatient mental health services. Methods: Insights were gathered from 13 international stakeholders with experience of designing, implementing and delivering PA interventions in inpatient mental health settings using the Nominal Groups Technique (NGT). Stakeholders included: academic researchers (n = 6), a representative from the charity sector (n = 1), a clinical psychologist (n = 1), a senior manager in sport and exercise therapy (n = 1), a physical activity and mental health nurse (n = 1), sport and exercise therapists (n = 2), and a clinical exercise physiologist and researcher (n = 1). The NGT process followed five steps: opening statement, silent idea generation, round-robin recording of ideas, group discussion, and voting to rank strategies based on their perceived effectiveness, impact, and feasibility. Results: Thirty-three consolidated strategies were generated and organised into three broad categories: leadership and policy, staffing, and PA delivery. Within these categories, the strategies ranked most effective and impactful were leadership and organisational top-down commitment, providing PA infrastructure, the capacity to facilitate consistent access to opportunities, building workforce capacity, and creating a positive day-to-day PA culture. The most feasible strategies included protecting PA time within patients’ timetables, collection and utilisation of patient feedback, ongoing services evaluations, the characteristics of the PA provider, co-design of PA programmes with patients, and PA language. Conclusion: Findings emphasise the need for a multi-level implementation approach. Strategies that rely on organisational resources and leadership were considered as more effective and impactful, whereas those that operated independently of wider systemic and organisational barriers were found to be more feasible. There is a need for increased collaboration across research and practice to test, refine, and discover effective implementation strategies. Support/Funding Source: No funding supported this work. Keywords: Implementation, physical activity, mental illness, secure settings, expert consensus