Effects of the Health-Awareness-Strengthening Lifestyle Program in a Randomized Trial of Young Adults with an At-Risk Mental State
Abstract
:1. Introduction
2. Methods
2.1. Research Design
2.2. Study Participants
2.3. Sample Characteristics
2.4. Data Collection
2.5. Health-Awareness-Strengthening Lifestyle Program
2.6. Instruments and Measurements
2.6.1. Demographic Inventory
2.6.2. Chinese Version of the Schizotypal Personality Questionnaire-Brief
2.6.3. Chinese Mandarin State and Trait Anxiety Inventory Form Y
2.6.4. Health-Promoting Lifestyle Profile–Short Form
2.6.5. World Health Organization Quality of Life-Brief Taiwan Version
2.6.6. 3-Month Physical Activity Checklist
2.6.7. Physical Assessments
2.7. Data Analysis
2.8. Identifying Information and Ethical Considerations
3. Results
3.1. Study Variables
3.2. Effects of the HASL Program in Post-test
3.3. Effects of the HASL Program in Differences between Pre- and Post-Test Analysis (T1–T0)
3.4. Prolonged Effects of the HASL Program
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Session | Dimensions | Definitions * | Prevention Strategies |
---|---|---|---|
1 | Exercise | Engaging in sports and leisure activities | Counseling: Establishing role model Encouraging sharing of previous sports experience Providing mechanisms linking exercise and stress management Tools: Health education manual on benefits of sports and the obstacles to overcome, as well as exercise journal |
Stress Management | Using relaxation techniques for stress management | Counseling: Advising time management and planning Encouraging the use of regular moderate aerobic exercise as the stress management ability Training of crisis management and response capabilities Tools: Stress management manuals | |
Interpersonal Support | Developing social support systems and intimate relationships, encouraging sharing of ideas and spending time with friends and family, etc. | Counseling: Discussing the establishment of social network Training communication skills Strengthening mutual communication Encouraging the sharing of interpersonal difficulties and solution strategies | |
2 | Nutrition | Balancing daily diet and food choice | Counseling: Encouraging sharing of balanced nutritional intake Tools: Nutrition manuals, nutrition knowledge triangle, and nutrition journal |
3 | Self-Actualization | Maximizing individual abilities and potentials, including purpose in life, self-appreciation, positive thinking, etc. | Counseling: Encouraging sharing of personal vision, planning, and performance in academic and living, etc. Tools: Journal |
Health Responsibility | Paying attention to health condition, seeking professional assistance if needed, and attending health lesson | Counseling: Encouraging sharing of health responsibility issues Establishing a health responsibility role model Tools: Mental health related manuals, emotional self-assessment booklet, and journal |
Pre-Test | Post-Test | |||||||
---|---|---|---|---|---|---|---|---|
Control (n = 46) | Experimental (n = 46) | t | p | Control (n = 46) | Experimental (n = 46) | t | p | |
Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | |||||
Health Promotion Lifestyles | 52.9 (9.4) | 54.9 (7.8) | −1.1 | 0.2586 | 53.8 (8.4) | 58.5 (7.8) | −2.7 | 0.0075 |
Self-Actualization | 9.7 (2.5) | 9.6 (2.1) | 0.0 | 0.9638 | 9.6 (2.6) | 10.5 (2.1) | −1.7 | 0.0897 |
Health Responsibility | 7.0 (2.7) | 7.1 (1.9) | −0.3 | 0.7538 | 7.3 (2.3) | 7.9 (2.1) | −1.3 | 0.2010 |
Exercise | 7.9 (2.0) | 7.8 (2.1) | 0.3 | 0.7996 | 7.7 (2.2) | 8.4 (2.1) | −1.5 | 0.1397 |
Nutrition | 9.0 (2.4) | 10.4 (1.9) | −3.1 | 0.0028 | 9.4 (2.3) | 10.9 (2.0) | −3.2 | 0.0017 |
Interpersonal Support | 10.2 (2.8) | 10.2 (2.5) | 0.0 | 1.0000 | 10.3 (2.5) | 10.6 (2.1) | −0.7 | 0.5134 |
Stress Management | 9.1 (2.0) | 9.7 (2.1) | −1.5 | 0.1347 | 9.5 (1.9) | 10.3 (2.1) | −1.8 | 0.0694 |
State Anxiety | 47.9 (6.7) | 47.7 (8.8) | 0.1 | 0.8834 | 47.7 (9.5) | 42.5 (7.7) | 2.8 | 0.0060 |
Trait Anxiety | 56.6 (5.6) | 55.7 (7.4) | 0.7 | 0.5079 | 56.0 (7.0) | 52.0 (7.0) | 2.7 | 0.0093 |
Schizotypal Personality | 11.0 (4.5) | 11.4 (3.8) | −0.5 | 0.6158 | 10.3 (4.6) | 9.9 (4.0) | 0.4 | 0.6686 |
Cognitive−Perceptual Deficits | 3.7 (1.9) | 3.5 (1.4) | 0.4 | 0.6612 | 3.5 (1.6) | 3.0 (1.6) | 1.3 | 0.1821 |
Interpersonal Deficits | 5.0 (2.3) | 5.5 (2.1) | −1.0 | 0.3440 | 4.6 (2.4) | 4.8 (2.2) | −0.4 | 0.6795 |
Disorganization | 2.3 (1.8) | 2.4 (1.7) | −0.4 | 0.6782 | 2.1 (1.8) | 2.0 (1.8) | 0.4 | 0.7081 |
Quality of Life | 53.9 (7.5) | 56.0 (7.1) | −1.2 | 0.2165 | 55.0 (8.8) | 59.3 (7.3) | −2.3 | 0.0230 |
Physical | 12.6 (2.2) | 12.8 (2.0) | −0.3 | 0.7582 | 13.2 (2.4) | 13.4 (2.3) | −0.5 | 0.6067 |
Psychological | 10.7 (2.4) | 11.3 (2.0) | −1.3 | 0.2045 | 10.9 (2.5) | 12.1 (2.3) | −2.3 | 0.0237 |
Social | 11.7 (2.3) | 12.4 (1.9) | −1.3 | 0.2019 | 12.3 (2.7) | 12.9 (1.8) | −1.3 | 0.2060 |
Environmental | 13.4 (1.9) | 13.4 (1.9) | 0.0 | 1.0000 | 13.6 (2.1) | 14.2 (1.9) | −1.4 | 0.1726 |
Physical Assessments | ||||||||
Systolic Blood Pressure | 115.7 (15.7) | 111.7 (16.1) | 1.2 | 0.2383 | 118.6 (19.6) | 111.8 (15.9) | 1.8 | 0.0805 |
Diastolic Blood Pressure | 74.0 (10.6) | 70.2 (9.8) | 1.8 | 0.0765 | 75.3 (10.8) | 72.9 (10.9) | 1.0 | 0.3145 |
Body Mass Index | 22.5 (4.7) | 22.5 (4.0) | 0.0 | 0.9658 | 22.5 (4.8) | 22.6 (4.0) | −0.1 | 0.9419 |
Waist/Hip Ratio | 0.79 (0.06) | 0.77 (0.08) | 1.0 | 0.5384 | 0.80 (0.09) | 0.78 (0.07) | 1.3 | 0.2293 |
Physical Exercises | 68.4 (94.9) | 50.5 (95.6) | 0.9 | 0.3695 | 105.1 (121.1) | 94.0 (119.8) | 0.4 | 0.6682 |
Control (n = 46) | Experimental (n = 46) | t | p | |
---|---|---|---|---|
Mean (SD) | Mean (SD) | |||
Health Promotion Lifestyles | 0.83 (6.82) | 3.61 (7.32) | −1.8 | 0.0699 |
Self-Actualization | −0.02 (1.44) | 0.83 (2.11) | −2.2 | 0.0291 |
Health Responsibility | 0.26 (1.52) | 0.76 (1.78) | −1.4 | 0.1622 |
Exercise | −0.17 (1.92) | 0.57 (2.00) | −1.7 | 0.0841 |
Nutrition | 0.21 (1.88) | 0.48 (1.72) | −0.7 | 0.4938 |
Interpersonal Support | 0.17 (1.82) | 0.39 (1.77) | −0.6 | 0.5589 |
Stress Management | 0.38 (1.86) | 0.59 (1.97) | −0.5 | 0.6165 |
State Anxiety | −0.38 (8.70) | −5.13 (6.30) | 2.9 | 0.0048 |
Trait Anxiety | −0.40 (4.28) | −3.72 (5.39) | 3.2 | 0.0021 |
Schizotypal Personality | −0.69 (3.13) | −1.52 (2.87) | 1.3 | 0.1966 |
Cognitive–Perceptual Deficits | −0.24 (1.65) | −0.48 (1.38) | 0.7 | 0.4593 |
Interpersonal Deficits | −0.38 (1.50) | −0.61 (1.69) | 0.7 | 0.5073 |
Disorganization | −0.07 (1.11) | −0.43 (1.56) | 1.3 | 0.2089 |
Quality of Life | 0.56 (4.69) | 2.98 (6.06) | −1.9 | 0.0616 |
Physical | 0.52 (1.36) | 0.65 (2.03) | −0.4 | 0.7253 |
Psychological | 0.14 (1.49) | 0.77 (1.92) | −1.7 | 0.0934 |
Social | 0.35 (2.32) | 0.44 (1.52) | −0.2 | 0.8397 |
Environmental | 0.19 (1.58) | 0.82 (2.06) | −1.6 | 0.1153 |
Physical Assessments | ||||
Systolic Blood Pressure | 3.31 (12.52) | 0.22 (9.67) | 1.3 | 0.1997 |
Diastolic Blood Pressure | 1.38 (8.81) | 3.02 (8.33) | −0.9 | 0.3742 |
Body Mass Index | 0.10 (0.71) | −0.01 (1.15) | 0.5 | 0.6034 |
Waist/Hip Ratio | 0.01 (0.06) | 0.01 (0.05) | 0.5 | 0.5968 |
Physical Exercises | 46.03 (92.26) | 43.52 (124.11) | 0.1 | 0.9152 |
T0 (n = 46) | T1 (n = 46) | T2 (n = 42) | T3 (n = 38) | p | |||
---|---|---|---|---|---|---|---|
Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | T1 vs. T0 | T2 vs. T0 | T3 vs. T0 | |
Health Promotion Lifestyles | 54.9 (7.8) | 58.5 (7.8) | 57.3 (8.1) | 56.6 (9.8) | 0.0007 | 0.0584 | 0.1610 |
Self-Actualization | 9.6 (2.1) | 10.5 (2.1) | 10.1 (2.1) | 9.8 (2.2) | 0.0073 | 0.0491 | 0.4144 |
Health Responsibility | 7.1 (1.9) | 7.9 (2.1) | 7.5 (1.8) | 7.4 (2.0) | 0.0034 | 0.2591 | 0.4290 |
Exercise | 7.8 (2.1) | 8.4 (2.1) | 8.0 (2.2) | 8.2 (2.1) | 0.0522 | 0.6554 | 0.4158 |
Nutrition | 10.4 (1.9) | 10.9 (2.0) | 11.0 (2.2) | 10.9 (2.1) | 0.0569 | 0.1148 | 0.2357 |
Interpersonal Support | 10.2 (2.5) | 10.6 (2.1) | 10.5 (2.5) | 10.3 (2.3) | 0.1295 | 0.3160 | 0.6366 |
Stress Management | 9.7 (2.1) | 10.3 (2.1) | 10.2 (1.8) | 10.1 (2.3) | 0.0413 | 0.0782 | 0.1006 |
State Anxiety | 47.7 (8.8) | 42.5 (7.7) | 46.0 (8.4) | 45.6 (9.2) | <0.0001 | 0.2657 | 0.2201 |
Trait Anxiety | 55.7 (7.4) | 52.0 (7.0) | 51.8 (7.6) | 52.2 (8.3) | <0.0001 | <0.0001 | <0.0001 |
Schizotypal Personality | 11.4 (3.8) | 9.9 (4.0) | 10.1 (4.3) | 10.2 (4.5) | 0.0003 | 0.0092 | 0.0030 |
Cognitive–Perceptual Deficits | 3.5 (1.4) | 3.0 (1.6) | 3.1 (1.9) | 3.2 (1.8) | 0.0173 | 0.1374 | 0.2905 |
Interpersonal Deficits | 5.5 (2.1) | 4.8 (2.2) | 4.8 (2.1) | 5.1 (2.4) | 0.0137 | 0.0151 | 0.0050 |
Disorganization | 2.4 (1.7) | 2.0 (1.8) | 2.2 (1.7) | 1.9 (1.5) | 0.0558 | 0.0870 | 0.0023 |
Quality of Life | 56.0 (7.1) | 59.3 (7.3) | 58.2 (7.4) | 58.4 (9.1) | 0.0019 | 0.0308 | 0.0115 |
Physical | 12.8 (2.0) | 13.4 (2.3) | 13.5 (2.6) | 13.7 (2.3) | 0.0293 | 0.0258 | 0.0032 |
Psychological | 11.3 (2.0) | 12.1 (2.3) | 11.7 (2.4) | 11.8 (2.7) | 0.0060 | 0.3133 | 0.1493 |
Social | 12.4 (1.9) | 12.9 (1.8) | 12.9 (1.8) | 12.7 (2.5) | 0.0471 | 0.0489 | 0.2025 |
Environmental | 13.4 (1.9) | 14.2 (1.9) | 13.8 (2.1) | 14.1 (1.7) | 0.0083 | 0.1534 | 0.0131 |
Physical Assessments | |||||||
Systolic BP | 111.7 (16.1) | 111.8 (15.9) | 114.1 (16.5) | 113.5 (17.7) | 0.8858 | 0.4731 | 0.2516 |
Diastolic BP | 70.2 (9.8) | 72.9 (10.9) | 72.7 (11.2) | 73.2 (11.5) | 0.0176 | 0.1590 | 0.0536 |
Body Mass Index | 22.5 (4.0) | 22.6 (4.0) | 22.5 (4.1) | 22.8 (4.8) | 0.9655 | 0.6323 | 0.0844 |
Waist/Hip Ratio | 0.77 (0.08) | 0.78 (0.07) | 0.80 (0.07) | 0.78 (0.08) | 0.4068 | 0.0190 | 0.0784 |
Physical Exercises | 50.5 (95.6) | 94.0 (119.8) | 115.3 (191.7) | 113.8 (181.1) | 0.0162 | 0.0173 | 0.0209 |
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Tsai, C.-L.; Lin, Y.-W.; Hsu, H.-C.; Lou, M.-L.; Lane, H.-Y.; Tu, C.-H.; Ma, W.-F. Effects of the Health-Awareness-Strengthening Lifestyle Program in a Randomized Trial of Young Adults with an At-Risk Mental State. Int. J. Environ. Res. Public Health 2021, 18, 1959. https://doi.org/10.3390/ijerph18041959
Tsai C-L, Lin Y-W, Hsu H-C, Lou M-L, Lane H-Y, Tu C-H, Ma W-F. Effects of the Health-Awareness-Strengthening Lifestyle Program in a Randomized Trial of Young Adults with an At-Risk Mental State. International Journal of Environmental Research and Public Health. 2021; 18(4):1959. https://doi.org/10.3390/ijerph18041959
Chicago/Turabian StyleTsai, Ching-Lun, Ya-Wen Lin, Hsing-Chi Hsu, Mei-Ling Lou, Hsien-Yuan Lane, Cheng-Hao Tu, and Wei-Fen Ma. 2021. "Effects of the Health-Awareness-Strengthening Lifestyle Program in a Randomized Trial of Young Adults with an At-Risk Mental State" International Journal of Environmental Research and Public Health 18, no. 4: 1959. https://doi.org/10.3390/ijerph18041959