The lives of adults with serious mental illness (SMI) are cut short by decades. Chronic illnesses including heart
disease are a fundamental cause. Adults with SMI have high cardiometabolic risk compared to the general
population. Modifiable risk factors (e.g., physical inactivity, poor fitness) are more prevalent and manifest earlier
in the lifecourse in those with SMI. Physical activity (PA) can reduce cardiometabolic risk in SMI populations.
Yet, persons with SMI are significantly less likely to meet PA recommendations. Certified peer specialists
(CPSs), trained persons with lived mental health recovery experience, are a rapidly growing mental health
workforce sector reimbursed by Medicare. CPSs include PA among their wellness goals and offer a sustainable
delivery mechanism for PA interventions within mental health services. Yet, effective PA treatment delivery and
sustainability remain challenging. Innovative, scalable, evidence-based PA interventions for people with
SMI are needed. Parks are free, ubiquitous spaces for PA. Parks offer physical, psychological, and social
benefits linked with improved health behaviors and outcomes. Studies, including ours, have related park access
and use to greater PA, social support, mood, and quality of life (QOL), and less obesity, stress, morbidity and
mortality. 2-37 Outdoor PA is associated with increased enjoyment, satisfaction, and long-term PA adherence, 33
supporting its use for behavior change, especially among those with SMI. Despite park-based PA benefits,34 few
park-based interventions have been tested rigorously. None have focused on SMI populations. Our long-term
goal is to maximize the reach and clinical impact of evidence-based PA interventions to reduce
cardiometabolic risk among SMI populations through use of existing mental health services and
community parks. The PARCS Study is an evidence-based park PA intervention incorporating CPSs in adults
with SMI. Adapted from previous exercise protocols, and grounded in Social Cognitive Theory (SCT) the PARCS
Study will test a 12-week park-based PA intervention (60 min CPS-led, 3 days/week) vs a active control, as part
of current peer group services. The aims of this proposal are: 1) To test the feasibility and acceptability of the
park-based PA intervention incorporating CPSs in adults with SMI (primary), 2a) to assess the effectiveness of
the intervention on SCT mechanisms of action (PA self-efficacy, goal setting, and PA social support, and 2b) to
test the preliminary effectiveness of the intervention on minutes of PA, and fitness in adults with SMI (secondary).
This novel approach aims to establish a sustainable, scalable, and reimbursable intervention model by
leveraging existing resources (CPS services, parks) to reduce cardiometabolic risk in adults with SMI.
Exploratory measures include percent body fat, waist circumference, QOL, and depressive symptoms. Our team
committed team of interdisciplinary co-investigators and community behavioral health facilities has expertise and
resources to achieve the goals of the proposed study. Working with mental health services, we will refine our
approach and generate evidence for future large-scale effectiveness testing.