Eligible studies were of interventions which targeted lifestyle factors associated with diabetes self-care (such as problem-solving skills, education classes, diet, or exercise) for people with a medical diagnosis of type II diabetes combined with schizophrenia or schizoaffective disorder. Eligible studies had to report outcomes of glycated haemoglobin (HbA1c) levels, fasting blood glucose levels, body mass index, or weight loss. Studies that did not exclusively recruit people with schizophrenia or schizoaffective disorder were considered for inclusion.
Half of the included studies recruited participants from psychiatric hospital inpatient settings, and half were in outpatient mental health settings. Inpatient interventions consisted of information about the importance of exercise, enhancing motivation through classes and providing exercise facilities. The outpatient intervention involved weekly sessions providing diet, exercise and other diabetes self-care advice. Interventions took into account the challenges of decreased cognitive ability and reduced motivation in this population by gradually introducing new topics, using memory aids and providing minimal text to simplify messages. The mean age of participants ranged from 44 to 53 years. All studies were conducted in the USA.
Two reviewers independently selected studies for inclusion; disagreements were resolved by discussion with a third reviewer.