Web-Based Weight Management for Individuals with Mental Illness

针对精神疾病患者的基于网络的体重管理

• 批准号: 7875624
• 负责人: Alexander S. Young
• 金额: $ 25.03万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7875624
• 关键词: Accounting; Address; Adverse effects; Behavioral; Body Weight decreased; Caring; Cessation of life; Chronic Disease; Client; Clinic; Cognitive; Cognitive deficits; Communities; Community Mental Health Centers; Computer Assisted; Computer Systems; Computers; Control Groups; County; Development; Diet; Diet Habits; Disadvantaged; Education; Educational Materials; Educational process of instructing; Effectiveness; Epidemic; Evidence based intervention; Evidence based practice; Future; Guidelines; Health; Health Care Costs; Health Personnel; Individual; Internet; Intervention; Interview; Learning; Life Expectancy; Life Style; Location; Los Angeles; Measures; Medical; Medical center; Mental Health; Mental disorders; Meta-Analysis; Methods; Modification; Monitor; Motivation; National Institute of Mental Health; Obesity; Online Systems; Outcome; Overweight; Pamphlets; Participant; Persons; Pharmaceutical Preparations; Phase; Physical activity; Population; Postdoctoral Fellow; Process; Quality of life; Randomized; Randomized Controlled Trials; Readiness; Research; Research Design; Research Personnel; Risk; Rural; Sampling; Schizophrenia; Self Efficacy; Self Management; Site; System; Techniques; Technology; Testing; Time; Training; Transportation; Travel; United States; Variant; Visit; Weight; Weight Gain; base; clinical care; community based care; comparison group; computerized; cost; design; diet and exercise; evidence base; improved; innovation; meetings; mental health center; nutrition education; pilot trial; preference; premature; programs; prototype; psychoeducational intervention; psychosocial; public health relevance; routine care; severe mental illness; social; success; treatment as usual; treatment center; treatment program; uptake; urban area; waist circumference; weight loss intervention

DESCRIPTION (provided by applicant): Obesity and physical inactivity have reached epidemic proportions, resulting in increased rates of chronic disease, premature death, and substantial health care costs. Excess weight is even more prevalent in populations with serious mental illnesses (SMI), in part due to medication- induced weight gain and social disadvantage. Since individuals with SMI often have cognitive deficits, specialized approaches are required to help people manage their weight. Researchers have found that specialized in-person interventions focused on diet and activity can help individuals with SMI manage their weight. However, these evidence-based practices have not been widely disseminated. Barriers to the use of these interventions include reluctance of individuals to participate in groups, difficulty finding transportation for frequent visits to clinics, a shortage of trained clinicians, and inadequate clinician time to provide the interventions. It is likely that these barriers can be addressed with a web-based weight intervention that is tailored for individuals with SMI. Specialized web-based approaches have been studied and found to be effective in this population, and can deliver content that is intensive and engaging with minimal requirements for clinician time. Objectives: The investigators on this proposal recently developed a prototype web-based system, called "Help-MI" (Health eLearning for Persons with Mental Illness), that provides limited diet education to individuals with SMI. The current project extends and evaluates this Help-MI system. The project's objectives are to: 1) build on the Help-MI prototype to develop a comprehensive web-based system that delivers an evidence-based weight management program that is focused on diet and activity, and that meets the needs of individuals with SMI; 2) evaluate the effectiveness, in individuals with SMI, of Help-MI compared with a control group; and, 3) characterize, from the perspective of individuals with SMI, the strengths, weaknesses, and barriers to the use of Help-MI. Methods: This is a randomized, controlled trial of 90 individuals with SMI at a community mental health center who are overweight and prescribed medications that have weight gain as a common side-effect. Participants are assigned to Help-MI or a comparison group. Research assessments occur at baseline, 3, and 6 months. Changes in outcomes are compared over time between the two groups. Significance: By losing weight, individuals with mental illness can decrease their risk for medical problems, and improve their quality of life and life expectancy. A web-based system that helps individuals lose weight could be feasible to disseminate broadly at medical centers, clinics, and community based programs in both rural and urban areas. PUBLIC HEALTH RELEVANCE: Obesity and physical inactivity have become serious problems for individuals with mental illness, resulting in increased rates of chronic disease, premature death, and substantial health care costs. Although in-person psychoeducational interventions help individuals with mental illness manage their weight, these interventions are often not used because they require frequent travel to treatment programs and substantial time from clinicians. This project addresses these barriers by developing and evaluating the effectiveness of a web-based computer system that is focused on diet and exercise education, and designed to help individuals with mental illness manage their weight.

描述（由申请人提供）：肥胖和缺乏身体活动已达到流行病的比例，导致慢性病，过早死亡和大量医疗保健费用的增加。超重在患有严重精神疾病（SMI）的人群中更为普遍，部分原因是药物引起的体重增加和社会劣势。由于患有SMI的人通常有认知缺陷，因此需要专门的方法来帮助人们管理体重。研究人员发现，专注于饮食和活动的专业亲自干预可以帮助SMI患者管理体重。然而，这些基于证据的做法尚未得到广泛传播。使用这些干预措施的障碍包括个人不愿意参加团体，难以找到频繁访问诊所的交通工具，训练有素的临床医生短缺，以及临床医生提供干预措施的时间不足。这些障碍很可能可以通过为SMI患者量身定制的基于网络的体重干预来解决。专门的基于网络的方法已经过研究，发现在这一人群中是有效的，并且可以提供密集的内容，并且对临床医生的时间要求最低。 目的：这项提案的研究人员最近开发了一个基于网络的原型系统，称为“帮助-MI”（精神疾病患者的健康电子学习），为SMI患者提供有限的饮食教育。目前的项目扩展和评估这个帮助MI系统。该项目的目标是：1）建立在Help-MI原型的基础上，开发一个全面的基于网络的系统，提供一个基于证据的体重管理计划，重点是饮食和活动，并满足SMI患者的需求; 2）评估Help-MI与对照组相比在SMI患者中的有效性; 3）从SMI患者的角度，描述使用Help-MI的优势、劣势和障碍。 研究方法：这是一项随机对照试验，在社区精神卫生中心有90名患有SMI的人，他们超重，并处方了体重增加作为常见副作用的药物。参与者被分配到Help-MI或对照组。研究评估在基线、3个月和6个月时进行。比较两组之间随时间的结果变化。 重要性：通过减肥，患有精神疾病的人可以降低他们出现医疗问题的风险，提高他们的生活质量和预期寿命。一个基于网络的系统，帮助个人减肥可能是可行的，在医疗中心，诊所和社区为基础的项目在农村和城市地区广泛传播。 公共卫生关系：肥胖和缺乏身体活动已成为精神疾病患者的严重问题，导致慢性病、过早死亡和大量医疗保健费用的增加。虽然面对面的心理教育干预可以帮助精神疾病患者管理他们的体重，但这些干预措施通常不被使用，因为它们需要频繁前往治疗计划和临床医生的大量时间。该项目通过开发和评估基于网络的计算机系统的有效性来解决这些障碍，该系统专注于饮食和运动教育，旨在帮助精神疾病患者管理体重。