Co-development of the ‘Move More’ toolkit: A theoretically informed resource to support physical activity promotion and participation within secure psychiatric care

Physical activity improves physical and mental health outcomes for individuals in inpatient psychiatric settings. However, psychiatric inpatients remain a seldom-heard population in research concerning their care. This study reports on the co-development of a theoretically informed physical activity toolkit, a set of resources and guidance to support physical activity engagement within an inpatient psychiatric setting. A behavioural analysis was conducted with 10 patients and 11 staff in a secure psychiatric hospital. Individual interviews and group discussions, guided by the COM-B model, identified barriers to physical activity. Participants proposed solutions and toolkit content. The academic team then selected intervention functions and behaviour change techniques using the Behaviour Change Wheel, aligning these with toolkit content. The resulting resource, titled the ‘Move More’ toolkit, was developed and produced. Applying the COM-B model to interview transcripts, we identified several subthemes reflecting the capability, opportunity and motivation components of the model. Three intervention functions – education, training, and enablement were selected, alongside six behaviour change techniques: restructuring the social environment, instructions on performing behaviour, social support, demonstration of behaviour, self-monitoring, and information about health consequences. The final toolkit includes four sections: education on PA benefits, preparing for activity (e.g., suitable clothing), ward-based activity examples, and self-monitoring tools. This study provides a practical example of how coproduction can be integrated with the BCW to develop a physical activity toolkit for use within an inpatient psychiatric setting. Future research will evaluate the feasibility implementing this toolkit within the inpatient setting. • A novel approach to intervention development in inpatient psychiatric care. • The COM-B model and Behaviour Change Wheel guided ‘toolkit’ development. • Coproduction plus behaviour change theory offers a viable approach to intervention development.