Implementation of a Weight Loss Program for Latino Outpatients with Severe Mental Illness

Mangurian, Christina; Chaudhry, Simriti; Capitelli, Lucia; Amiel, Jonathan; Rosario, Felicia; Jackson, Carlos T.; Newcomer, John W.; Cournos, Francine; Essock, Susan M.; Barrett, Diane M.; Devlin, Michael J.

doi:10.1007/s10597-012-9506-1

Cited by 10 publications

(20 citation statements)

References 39 publications

(45 reference statements)

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“…Only one study included non–English-speaking participants and culturally adapted the lifestyle intervention to fit the needs of a small group of Spanish-speaking Hispanic patients (26). Aside from Weber and colleagues' study (26), we know of one other quasi-experimental study that was recently completed that also adapted a lifestyle intervention for Hispanic outpatients with serious mental illness (48). More work in this area is clearly needed given the prevalence of racial and ethnic health disparities in the United States (49).…”

Section: Discussionmentioning

confidence: 99%

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Cabassa¹,

Ezell²,

Lewis‐Fernández³

2010

151

116

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Objective The promotion of healthy lifestyles among persons with serious mental illness is an integral part of their recovery. The aims of this systematic literature review were to rate the methodological quality of lifestyle intervention outcome studies for persons with serious mental illness, summarize intervention strategies, examine physical health outcomes, and evaluate the inclusion of racial and ethnic minority groups in these studies. Methods Electronic bibliographic database searches were performed to locate studies conducted in the United States. Articles written in English and published in peer-reviewed journals between 1980 and 2009 were included. The authors used a standardized instrument to rate studies' methodological quality. Results Twenty-three articles were reviewed. Based on studies' methodological quality, three levels of evidence were found: single-group reports, quasi-experimental studies, and randomized controlled trials. Most interventions used behavioral techniques to improve dietary habits and increase physical activity. Twelve studies reported significant improvements in either weight loss or metabolic syndrome risk factors associated with receiving a lifestyle intervention. Persons from racial and ethnic minority groups were underrepresented, especially Hispanics and Asian Americans. Only one study included non–English-speaking participants. Conclusions Lifestyle interventions adapted to persons with serious mental illness show promise in reducing weight loss and some risk factors for metabolic syndrome. The under-representation of persons from racial or ethnic minority groups in this literature limits its generalizability. Implications for research and practice are discussed.

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Section: Discussionmentioning

confidence: 99%

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Cabassa¹,

Ezell²,

Lewis‐Fernández³

2010

151

116

View full text Add to dashboard Cite

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“…67,68,70 A large VA study (N = 22,014) found that adherence to oral hypoglycemic medications was actually better among diabetes patients with schizophrenia than patients without schizophrenia (57 % vs. 48 %, p < 0.001). 71 Additionally, people with schizophrenia attend weight loss programs if these are provided, [72][73][74] although whether their attendance rates are comparable to those without SMI has not been studied.…”

Section: Management Of Type 2 Diabetes and Other Cardiovascular Diseamentioning

confidence: 99%

Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review

et al. 2016

Self Cite

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Close to 19 million US adults have severe mental illnesses (SMI), and they die, on average, 25 years earlier than the general population, most often from cardiovascular disease (CVD). Many of the antipsychotic medications used to treat SMI contribute to CVD risk by increasing risk for obesity, type 2 diabetes, dyslipidemia, and hypertension. Based on compelling evidence, the American Diabetes Association and the American Psychiatric Association developed guidelines for metabolic screening and monitoring during use of these medications. In this manuscript, we have reviewed the evidence on diabetes and other CVD risk screening, prevalence, and management among populations with SMI. We also review differences in screening among subpopulations with SMI (e.g., racial/ethnic minorities, women, and children). We found that despite national guidelines for screening for diabetes and other cardiovascular risk factors, up to 70 % of people taking antipsychotics remain unscreened and untreated. Based on estimates that 20 % of the 19 million US adults with SMI have diabetes and 70 % of them are not screened; it is likely that over 2 million Americans with SMI have unidentified diabetes. Given that undiagnosed diabetes costs over $4,000 per person, this failure to identify diabetes among people with SMI represents a missed opportunity to prevent morbidity and translates to over $8 billion in annual preventable costs to our healthcare system. Given the high burden of disease and significant evidence of suboptimal medical care received by people with SMI, we propose several clinical and policy recommendations to improve diabetes and other CVD risk screening and care for this highly vulnerable population. These recommendations include reducing antipsychotic medication dose or switching antipsychotic medications, enhancing smoking cessation efforts, sharing electronic health records between physical and mental health care systems, and promoting integration of care.KEY WORDS: mental illness; diabetes; integration of care.

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“…For interested participants, RAs will conduct a face-to-face screening interview to determine study eligibility, and for those eligible, obtain informed consent. Eligibility criteria (Table 1 ) are similar to the ones used in previous weight loss trials [ 27 , 28 ] and are broad in order to capture a sample that resembles racially/ethnically diverse people with SMI served by supportive housing agencies. RAs will then conduct baseline interviews face-to-face with eligible participants at their site within a week of recruitment.…”

Section: Methodsmentioning

confidence: 99%

“…More research has been done recently, but only in clinical settings. A study tested the acceptability and feasibility of a weight loss program among 43 Latino patients with SMI in an outpatient clinic [ 28 ], and the ACHIEVE trial sample was 38 % black. More work is needed given the growth of the national racial/ethnic minority population and the persistent health disparities they face.…”

Section: Introductionmentioning

confidence: 99%

Peer-led healthy lifestyle program in supportive housing: study protocol for a randomized controlled trial

Cabassa

Stefancic

O'Hara

et al. 2015

Trials

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BackgroundThe risk for obesity is twice as high in people with serious mental illness (SMI) compared to the general population. Racial and ethnic minority status contribute additional health risks. The aim of this study is to describe the protocol of a Hybrid Trial Type 1 design that will test the effectiveness and examine the implementation of a peer-led healthy lifestyle intervention in supportive housing agencies serving diverse clients with serious mental illness who are overweight or obese.MethodsThe Hybrid Trial Type 1 design will combine a randomized effectiveness trial with a mixed-methods implementation study. The effectiveness trial will test the health impacts of a peer-led healthy lifestyle intervention versus usual care in supportive housing agencies. The healthy lifestyle intervention is derived from the Group Lifestyle Balanced Program, lasts 12 months, and will be delivered by trained peer specialists. Repeated assessments will be conducted at baseline and at 6, 12, and 18 months post randomization. A mixed-methods (e.g., structured interviews, focus groups, surveys) implementation study will be conducted to examine multi-level implementation factors and processes that can inform the use of the healthy lifestyle intervention in routine practice, using data from agency directors, program managers, staff, and peer specialists before, during, and after the implementation of the effectiveness trial.DiscussionThis paper describes the use of a hybrid research design that blends effectiveness trial methodologies and implementation science rarely used when studying the physical health of people with SMI and can serve as a model for integrating implementation science and health disparities research. Rigorously testing effectiveness and exploring the implementation process are both necessary steps to establish the evidence for large-scale delivery of peer-led healthy lifestyle intervention to improve the physical health of racial/ethnic minorities with SMI.Trial registrationwww.clinicaltrials.gov; NCT02175641, registered 24 June 2014

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Implementation of a Weight Loss Program for Latino Outpatients with Severe Mental Illness

Cited by 10 publications

References 39 publications

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review

Peer-led healthy lifestyle program in supportive housing: study protocol for a randomized controlled trial

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