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Implementation of a Fitness and Nutrition Program for Adults with Serious Mental Illness
Dissertation

Implementation of a Fitness and Nutrition Program for Adults with Serious Mental Illness

Kerrigan Kruse
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
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Abstract

Background: Individuals experiencing serious mental illness (SMI) have approximately twice the risk of developing metabolic syndrome and premature mortality compared to the general population. This disparity is linked to sedentary lifestyles, poor nutrition, and the metabolic effects of psychotropic medications. Assertive Community Treatment (ACT) programs provide intensive psychiatric services but have historically lacked interventions to address physical wellness. Purpose: The purpose of this project was to implement a fitness and nutrition program within an ACT team at an academic medical center in the Midwest of the US to promote healthy lifestyles for adults with SMI. Methods: Utilizing the Iowa Model, and Iowa Implementation for Sustainability Framework, a 26-week intervention was provided. Individualized strategies included weekly sessions with a health mentor focused on physical activity and nutritional goal setting, guided exercise, nutritional education, meal preparation support, and assistance with overcoming social determinants of health barriers such as transportation and access to healthy foods. Outcomes measured included body mass index (BMI), functional fitness capacity assessed by the six-minute walk test (6MWT), and program participation. Findings: The intervention was offered to 67 adults with SMI and twelve adults participated (18%). After intervention, median BMI decreased by 4.5% and median functional fitness capacity improved with a 25.2% (81-meter) increase in 6MWT distance from baseline. Discussion: Despite limited participation, this project demonstrated that the integration of fitness and nutrition program for adults with SMI within an ACT team is a feasible intervention that can lead to significant improvements in functional fitness capacity and BMI. By embedding health promotion programs into psychiatric care, this initiative supports a holistic approach that addresses both physical and mental health needs in a population experiencing disproportionate health disparities
Assertive community Treatment Serious Mental Illness Fitness Nutrition Diet Therapy Exercise Therapy

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