Improving dietary and physical activity practices in group homes serving residents with severe mental illness

People with severe mental illness (SMI) are at least 50% more likely to be overweight for various reasons, including poor nutrition, sedentary lifestyles, and side effects of antipsychotic medications.

Among residents with SMI who live in group homes, we examined (1) factors that affected the motivations of both group home operators and residents around improvement of residents' diet and physical activity, (2) how operators and residents viewed responsibility for maintaining good health in group homes, and (3) strategies from operators and residents for improving diet and exercise.

The research team conducted 6 focus groups-3 with group home operators and 3 with residents, using a community-based participatory research (CBPR) process and qualitative data analysis.

Both group home operators and residents discussed conflicting feelings about foods they know as healthy and foods they prefer to eat. Operators attributed barriers to better health to the perceived negative attitudes of residents and providers, lack of communication with health care providers, and poor working relationships with the state licensing body that protects individual rights on lifestyle choices. Residents reported barriers of their own negative attitudes, limited menu options, lack of organized activities, existing health problems, and side effects of medications.

Residents and operators had concrete suggestions for changes they could make individually, as well as recommendations for systemic changes to support healthier lifestyles. These recommendations provide a basis for designing an urgently needed pilot intervention program to address the current epidemic of obesity and diabetes in people with SMI residing in group homes.