Get Moving and Get Well: A Behavioral Activation Program for Veterans with SMI

行动起来并康复：针对 SMI 退伍军人的行为激活计划

• 批准号: 8597121
• 负责人: Kristen M Viverito
• 金额: --
• 依托单位: CENTRAL ARKANSAS VETERANS HLTHCARE SYS
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-10-01 至 2014-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8597121
• 关键词: Address; Adoption; Analysis of Variance; Attention; Behavioral; Chi-Square Tests; Consult; Control Groups; Data; Development; Diagnosis; Dimensions; Educational process of instructing; Effectiveness; Emotional; Enrollment; Evaluation; Exercise; Fostering; Future; General Population; Goals; Health; Health Promotion; Health behavior; Healthcare; Home environment; Individual; Intervention; Investigator-Initiated Research; Lead; Life; Measures; Medical Records; Mental Health; Mental health promotion; Methods; Moods; Morbidity - disease rate; Outcome Measure; Participant; Pattern; Persuasive Communication; Physical activity; Pilot Projects; Population; Positive Reinforcements; Prevention; Randomized; Recovery; Reporting; Research Proposals; Self Efficacy; Testing; Time; United States Substance Abuse and Mental Health Services Administration; Veterans; Vulnerable Populations; Weight maintenance regimen; avoidance behavior; behavior measurement; cohort; design; experience; improved; interest; intervention effect; mortality; novel; nutrition; physical conditioning; programs; psychiatric rehabilitation; reinforced behavior; response; sedentary; severe mental illness; smoking cessation; social; social cognitive theory; social model; trend

DESCRIPTION (provided by applicant): Anticipated Impacts on Veteran's Healthcare: Individuals with serious mental illness (SMI) have greater physical illness morbidity and mortality than the general population, but typically do not enroll in nor complete health promotion interventions. This pilot study will provide preliminary evaluation of a low- demand physical activity intervention that may be acceptable to Veterans with SMI and lead to improved health in this medically vulnerable population. Project Background: The relatively high rates of morbidity and mortality found among individuals with SMI have led to prioritization by Mental Health QUERI, and other groups, of prevention and health promotion in addition to improved coordination of physical health care for this population. Although promising health promotion interventions have been developed, they are intensive and none seem to successfully address the challenge of improving reach and enrollment while minimizing attrition. We propose to conduct a pilot evaluation of a novel low-demand intervention that may be an acceptable introduction to health promotion, the Get Moving and Get Well! (GMGW) program. Participants in the current version of GMGW have described benefits beyond those expected. We believe a 12-week GMGW program may be an effective and relatively low- demand intervention to promote self-efficacy and physical health in Veterans with SMI through increasing Veteran behavioral activation. Project Objectives: The objectives of the proposed study are to: (a) determine the effects of participation in the 12-week GMGW program on a measure of behavioral activation; (b) determine the effects of GMGW on measures of self-efficacy, physical activity, general physical and mental health, and mood; and (c) determine the effects of participation in the class on measures of intent to engage and actual engagement in more intensive physical health programs. Project Methods: In order to inform a future full scale study, we will complete the development of a 12-week manualized GMGW class, assess its acceptability, feasibility and time burden, and evaluate effects of the intervention on key outcome measures. To achieve the aims of the study, we will randomly assign 30 participants to either GMGW or an attention control condition. Participants will complete baseline measures investigating behavioral activation, self-efficacy, physical activity, physical and emotional health, mood, and intent to engage in health promotion activities before beginning the class. These measures will be repeated at the end of the 12-week class, along with questions investigating the acceptability of the interventions. A chart review will investigat actual engagement in health promotion interventions. We will be looking for the emergence of trends for differences in expected directions and response patterns within and between groups that will inform us about effect sizes for the measures and permit a power analysis for the full scale trial. We plan to use repeated measures analysis of variance, controlling for any variables that differ significantly between the intervention and control groups, to test the hypothesis that GMGW participants will have greater improvements on the measures at the end of the 12-week intervention than the control participants. Finally, we will also compare the number of participants who have evidence of participation in new health promotion activities in their medical record using a chi-square test of equal proportions.

描述（由申请人提供）： 对退伍军人医疗保健的预期影响：患有严重精神疾病（SMI）的个人比一般人群有更高的身体疾病发病率和死亡率，但通常不参加也不完成健康促进干预。这项试点研究将提供一个低需求的身体活动干预的初步评估，可能是可接受的退伍军人与精神分裂症，并导致改善健康，在这个医学脆弱的人口。项目背景：重度精神障碍患者的发病率和死亡率相对较高，因此，精神卫生调查组和其他团体将预防和促进健康作为优先事项，并改善对这一人群的身体保健协调。虽然已经制定了有前途的健康促进干预措施，但这些措施都是密集的，似乎没有一项措施能够成功地解决在最大限度地减少自然减员的同时提高覆盖面和入学率的挑战。我们建议对一种新的低需求干预进行试点评估，这种干预可能是健康促进的一种可接受的介绍，即“动起来，好起来！”（GMGW）计划。目前版本的GMGW的参与者描述了超出预期的好处。我们认为，12周的GMGW计划可能是一种有效的和相对低需求的干预，以促进自我效能和身体健康的退伍军人与SMI通过增加退伍军人的行为激活。项目目标：拟议研究的目的是：（a）确定参与12周GMGW计划对行为激活措施的影响;（B）确定GMGW对自我效能、体力活动、一般身心健康和情绪措施的影响;以及（c）确定参与课堂对参与更密集的身体健康计划的意图和实际参与的措施的影响。项目方法：为了告知未来的全面研究，我们将完成12周手动GMGW类的开发，评估其可接受性，可行性和时间负担，并评估干预措施对关键结果指标的影响。为了实现研究的目的，我们将随机分配30名参与者到GMGW或注意力控制条件中。参与者将完成基线测量，调查行为激活，自我效能，身体活动，身体和情绪健康，情绪，以及在开始上课前参与健康促进活动的意图。这些措施将在12周的课程结束时重复，沿着调查干预措施可接受性的问题。图表审查将评估实际参与健康促进干预措施的情况。我们将寻找组内和组间预期方向和反应模式差异的趋势，这将告知我们措施的效应量，并允许对全规模试验进行功效分析。我们计划使用重复测量方差分析，控制干预组和对照组之间存在显著差异的任何变量，以检验GMGW参与者在12周干预结束时比对照组参与者在测量方面有更大改善的假设。最后，我们亦会采用等比例的卡方检验，比较在医疗纪录中有参与新健康促进活动证据的参与者人数。