What should be included in an educational programme for non-health professional exercise instructors in charge of community-based exercise targeting young adults in antipsychotic treatment – A focus group study of stakeholder perspectives

Background Exercise plays a crucial role in addressing the increased cardiometabolic morbidity and premature mortality in people with schizophrenia. When delivered in community-based settings, exercise may also reduce loneliness, while promoting overall physical active behaviours. Skilled instructors are essential to deliver effective community-based exercise; however, knowledge about their roles and required training is lacking. We investigated stakeholders’ perspectives on components needed for an educational programme for non-health professional exercise instructors delivering community-based exercise targeting young adults in antipsychotic treatment.

Methods We conducted six focus groups comprising a total of 30 individuals representing five different stakeholder groups, namely clinical staff within mental health, physiotherapists, exercise instructors, young adults in antipsychotic treatment, and relatives to young adults in antipsychotic treatment. Data were analysed using qualitative content analysis, as described by Graneheim and Lundman.

Results The analysis identified three categories: (i) acknowledging mental illness, (ii) applying a resource-oriented approach, and (iii) promoting exercise as a shared activity, and one overarching theme: instructors as guardians of an inclusive culture.

Conclusions An educational programme for exercise instructors delivering community-based exercise to young adults in antipsychotic treatment should focus on securing an inclusive culture that embraces an anti-stigmatising approach. Results of the current study informed the development of an educational programme consisting of an instructor manual, a one-day educational programme for instructors, and a continuous exchange of experiences between instructors.