Examining the feasibility of a peer-delivered healthy lifestyle intervention to reduce cardiovascular and cancer disease risk for people living with a severe mental illness.

INTERVENTION: The proposed project will be conducted as a randomised controlled pilot study. In addition to completing assessments, and receiving pamphlets and standard care, participants randomised to the intervention will be immediately engaged in the peer delivered Better Health Choices telephone intervention. Better Health Choices was developed to target the specific needs and barriers facing people with Schizophrenia and other severe mental illnesses and aims to help participants decrease their smoking, increase their intake of fruit and vegetables (F&V), and reduce their sedentary behaviour. It incorporates clear health messages, well‐established behavioural strategies and can be tailored to the personal goals of each participant. Better Health Choices consists of 8 telephone sessions delivered by trained peer workers over a maximum of 11 weeks. Session 1 will be of 45‐60 minutes duration, and consists of feedback from the baseline assessment regarding smoking, activity, screen time, F&V intake and alcohol use with motivational interviewing employed to assist clients in identifying goals for change. A box of F&V will be delivered between sessions 1 and 2 to assist initiation of behaviour change in F&V intake. Sessions 2‐8 will be conducted over 15‐30 minutes and consist of motivational interviewing, education, and goal setting focused on smoking, F&V consumption, and screen use. Adherence to the intervention will be monitored through a log of telephone sessions. Where clinically appropriate, smokers will be encouraged to access their general practitioner for nicotine replacement therapy (subsidised by the MBS). CONDITION: Cancer Cardiovascular Disease Severe Mental Illness PRIMARY OUTCOME: Number of cigarettes/day as assessed by the Timeline Followback Method. SECONDARY OUTCOME: Fruit & vegetable consumption as assessed by the fruit & vegetable subscales of the Australian Recommended Food Score (ARFS) diet quality index. Leisure screen time assessed using Marshall Sedentary questions targeting television viewing and use of computers and other screens at home. Minutes spent per day of walking, moderate and vigorous physical activity, assessed using the International Physical Activity Questionnaire (IPAQ). Participant satisfactions as assessed by the Client Satisfaction Questionnaire‐8. Quality of life assessed using the WHO‐8 Quality of Life Scale. Readiness to quit smoking assessed using the Smoking Stages of Change (Short Form). Smoking point prevalence abstinence assessed by 7‐day smoking point prevalence abstinence self‐reported by participants and using the Timeline Followback Method. Smoking quit attempts. Participants are asked to report the number of serious quit attempts made since the previous assessment. The following explanation is read to participants to describe serious quit attempts: "By serious attempt I mean you decided that you would try to make sure you never smoked again. Please include any attempt that you are currently making and please include any successful attempt made since we last spoke". Substance use assessed using the Timeline Follow Back Tool (TLFB). Symptom distress as assessed by the Kessler‐10. Use of Nicotine Replacement Therapy assessed by self‐reports. INCLUSION CRITERIA: (i) registration as a consumer of Neami services; (ii) currently living with a severe mental illness (e.g. schizophrenia, bipolar disorder); (iii) age =18 years or older; (iv) identification of a health related goal.