City Research Online

Abstract

Background
People diagnosed with severe mental illness (SMI) die around 15–20 years prematurely compared with people without these conditions, partially to a 50% increased risk of developing Cardiovascular disease (CVD). Treatment and diagnosis rates of CVD and metabolic disease (together called Cardiometabolic disease) are lower in people diagnosed with SMI, at a considerable cost to individuals and their families, health services, and society. Previous trials have shown that Behaviour change interventions to reduce cardiometabolic risk, when delivered alone, produce modest results at best. PEGASUS aims to co-design a peer-led group intervention with lived experience and which includes social integration and peer support along with behaviour change to reduce cardiometabolic risk in people diagnosed with SMI.

Methods
This is a multi-site single arm mixed methods study based in three National Health Service (NHS) Mental Health Trusts in England, aiming to test the feasibility of the PEGASUS intervention and its future evaluation in a large-scale randomised controlled trial. Over six months, participants aged 18–75, with a diagnosis of SMI and enhanced Cardiovascular disease risk will attend ten fortnightly support groups led by a peer support worker and a health care professional, focusing on physical health, both general and specific to those diagnosed with SMI. Additionally, there are four one-to-one sessions with a peer support worker and a booster session three months after the intervention has ended. Biometric, accelerometer, behavioural and psychometric questionnaire data will be collected at baseline, three months, and six months, accompanied by qualitative interview and focus group data at three and six months. The feasibility and acceptability of each measure will also be measured. Quantitative data will be analysed using STATA and qualitative data will be analysed with NVivo using rapid framework analysis.

Discussion
This study will determine the feasibility and acceptability of a peer-led group programme to reduce Cardiovascular disease risk in people diagnosed with SMI. The results will inform the PEGASUS randomised controlled trial.

Publication Type:	Article
Additional Information:	©The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher Keywords:	Cardiovascular disease, Cardiometabolic disease, Severe Mental Illness, Behaviour change, Feasibility study, Metabolic syndrome, Schizophrenia, Bipolar disorder, Psychosis, Co-production, Peer support
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RC Internal medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:	Symplectic Administrator

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