# The role of public and patient involvement in designing a web-based, physical activity application for individuals with severe mental illness

## TL;DR

This paper explores how involving people with severe mental illness and clinicians helped design a web-based physical activity app tailored to their needs.

## Contribution

The study introduces a novel approach of using Public and Patient Involvement to co-design a digital physical activity tool for individuals with severe mental illness.

## Key findings

- Involving individuals with severe mental illness and clinicians led to design preferences like more visuals and suitable terminology.
- Key design features included multiple activity options and intensities, while excluding timers and login features.
- The process highlighted the importance of user feedback in creating accessible and effective digital health tools.

## Abstract

Individuals with severe mental illness (SMI) engage in less physical activity (PA) and experience an earlier mortality rate than the general population. PA offers individuals with SMI multiple benefits, improving their physical and mental health. However, barriers are present that minimise the engagement of individuals with SMI in PA, including SMI symptoms, a lack of motivation, a lack of support and a lack of PA knowledge. Digital tools incorporated in PA interventions can assist in minimising these barriers and act as a long-term PA support for the SMI population. A gap remains in the literature on incorporating the voices of those with a lived experience of SMI in developing a long-term digital PA intervention. This project utilised a Public and Patient Involvement (PPI) approach in designing a digital web-based PA application for the SMI population in an Irish mental health residential setting, understanding SMI perspectives and influencing the design. The objective of this paper is to explore (i) the PPI process, and (ii) the impact of PPI.

A local clinical psychologist was contacted to assist in identifying suitable contributors. Two individuals with a lived experience of a SMI living in an Irish mental health residential setting and two clinicians (i.e., stakeholder representation) working within these settings were identified. The individuals with a lived experience of a SMI and the clinicians were separated, and each group contributed to separate discussions. Each group participated in two discussions, sharing their ideas and views on the design of the web-based PA application. Each contributor provided insightful feedback on the design and development of the web-based PA application. Key highlights of the discussions involved the need for the web-based application to include more visuals in comparison to writing, suitable terminology, multiple PA options, multiple intensities, font type, layout design and the exclusion of a timer and a login feature.

Based on the valuable feedback from the contributors, the web-based application was designed accordingly to address the needs and preferences of individuals with a lived experience of SMI and their clinicians working in the Irish mental health residential setting.

The online version contains supplementary material available at 10.1186/s40900-025-00735-x.

Individuals with severe mental illness often face barriers when trying to engage in physical activity. This can be due to symptoms of their mental illness, a lack of support or a lack of motivation. Adding a digital tool to a physical activity intervention for people with severe mental illness can help reduce these barriers and increase their physical activity. Using Public and Patient Involvement in research can improve the quality of the digital physical activity tool. By incorporating the voices of individuals with severe mental illness, this project can design a suitable digital physical activity tool that meets their needs, increasing their physical activity and long-term use. This project used Public and Patient Involvement to design a web-based physical activity application for people with a severe mental illness living in an Irish mental health residential setting. This paper will explore (i) the Public and Patient Involvement Process, and (ii) the Impact of Public and Patient Involvement.

A clinical psychologist helped find appropriate individuals willing to give their opinions and views on the design. These individuals included two people living in an Irish mental health residential setting with a lived experience of a SMI and two clinicians working within these settings. The individuals with SMI and the clinicians were separated into two groups. The groups participated in two discussions each. These individuals provided useful feedback on what elements to include and/or exclude in the design of the web-based PA application. Their valuable feedback helped shape the appropriate design of the web-based PA application and create this to suit the needs and preferences of the SMI population.

The online version contains supplementary material available at 10.1186/s40900-025-00735-x.