Identifying Physical Health Concerns of People With a Mental Health Condition: An RCT.

Abstract

PhysiCards have been co-designed to support an interactive, person-led approach to help people with mental health conditions identify and respond to cardiovascular disease and other physical health concerns. This study aimed to test the effectiveness of PhysiCards in assisting people accessing support from a community-managed mental health organization to identify and take action to address cardiovascular disease and other physical health concerns. This study was a parallel-group RCT. Participants (aged ≥18 years; N=154) were people accessing Flourish Australia services in New South Wales, Australia. Participants were randomly allocated to a control (physical health concerns discussed in line with usual support) or intervention condition (usual care and offered PhysiCards) delivered in a single session. Main outcome measures were assessed through support worker records of allocation delivery and participant self-report telephone surveys at baseline and 1-week and 4-month follow-ups (September 2022 to January 2024). Analysis was conducted in 2025. Primary outcomes were identifying at least 1 concern participants wanted support for that was a physical health concern, cardiovascular disease prevention concern, new (i.e., not previously raised with a health professional) physical health concern, and new cardiovascular disease prevention concern. Secondary outcomes included discussing a concern with a health professional, confidence to raise concerns, and acceptability of PhysiCards. The intervention group participants were significantly more likely to identify that they wanted support for a physical health concern (OR=16.7; 95% CI=5.14, 54.24, p<0.001), cardiovascular disease-related concern (OR=7.89, 95% CI=2.91, 21.39, p<0.001), and new health concern (OR=7.40, 95% CI=2.28, 24.05, p<0.001). PhysiCards were rated as highly acceptable. There was no significant difference in discussing concerns with a health professional or confidence in raising concerns. PhysiCards were effective in supporting people to identify cardiovascular disease and other physical health concerns. Future research is needed to consider additional strategies to enhance their impact on care seeking.