Keeping the Body Mind: A lifestyle intervention for young people with first episode psychosis

A cluster-controlled trial will be conducted across early psychosis programs at two sites, one active site in which the intervention will be delivered, and one site that will act as a usual care control. Participants will be young FEP clients. The lifestyle intervention involves a 12-week program consisting of both dietetic and exercise physiology based interventions. The specific program each participant receives is individualised using best practice principles from both disciplines, and aimed at increasing physical activity and improving dietary choices and nutritional understanding. In addition to lifestyle interventions, young people referred to the KBIM project will be assessed for suitability for pharmacological interventions, such as medication switching, metformin and statins. Health coaching Health coaching will be provided by the CNC who will oversee both the diet and exercise interventions and provide a motivational framework to assist clients with adherence. Specifically the CNC will utilize goal identification and structured motivational interviewing involving four-core components 1.expressing empathy 2. Developing discrepancy 3. Rolling with resistance 4. Supporting self-efficacy. Diet Dietetic consultations will be offered on a weekly basis focusing on nutritional adequacy and energy balance in order to ensure requirements for key nutrients are met while promoting weight loss or the attenuation of weight gain. A diet history or 24-hour nutritional recall will be conducted during each consultation using non-leading questions. The diet history or 24-hour recall aims to obtain an accurate description of all food and drink consumed in the last day, and will be used for comparison against Australian Guide to Healthy Eating Food Group recommendations for nutritional adequacy. Weekly 2-hour cooking classes will also be facilitated in conjunction with an occupational therapist or case worker. Exercise The American College of Sports Medicine aerobic and resistance training guidelines will be used to guide exercise programming within the KBIM project. Whilst these public health recommendations will be used to structure the exercise prescriptions, the exercise physiologist will tailor individual programmes to cater for variations in motivation, time and access to services. Clients involved in the KBIM lifestyle intervention will have access to a supervised gym within the community health centre up to four days per week. The duration of each session and total sessions per week is varied and dependent upon engagement with individual clients.