Promoting Healthy Lifestyle Behaviors to Address Obesity Related Complications of African Americans with Severe Mental Illness Using Peer Navigators

 描述（由申请人提供）：肥胖是导致严重精神疾病患者早期死亡的许多共病健康状况的重要风险因素。在患有严重精神疾病的非裔美国人中，体重问题和肥胖问题更严重。与消费者咨询委员会（CAB）一起进行基于社区的参与性研究（CBPR），我们将与患有严重精神疾病的非洲裔美国人进行混合方法研究，以更好地了解问题的性质和可能的解决方案。虽然在适应认知行为减肥策略方面已经取得了一些成功（例如，饮食和锻炼），研究表明，这种策略可能对非洲裔美国人来说是无声的。因此，CAB和社区联盟将专门考虑适应他们社区中的同龄人的认知行为减肥策略。饮食和锻炼计划在低收入社区尤其困难，这些社区的特点是食物和活动沙漠。CAB和社区联盟将在适应过程中考虑这一挑战。由NIMHD和PCARI资助的早期CBPR表明，当由同行导航员补充时，有色人种的医疗保健结果得到了增强，这些导航员是来自相同种族背景的受过专门训练的服务提供者，具有类似的行为健康挑战历史。同伴导航员将帮助项目参与者在这些社区实现饮食和锻炼目标。这项研究代表了Heartland Health Outreach（HHO）和NIMH资助的伊利诺伊理工学院坚持和自决中心之间的合作关系。最终的随机对照试验将有三个条件（最终取决于CBPR反馈）：照常治疗（TAU，即综合护理），TAU加行为减肥干预，或TAU，减肥干预，与同行导航。影响将在基线、6个月、12个月和18个月进行评估，检查体重变化、健康行为、身心健康、恢复和生活质量。研究结果将促进知识和服务，以减少肥胖和患有严重精神疾病的非裔美国人的共病健康状况的种族差异。

 DESCRIPTION (provided by applicant): Obesity is a significant risk factor for many comorbid health conditions contributing to earlier deaths of people with severe mental illnesses. Weight problems and obesity are even worse among African Americans with severe mental illnesses. Doing community- based participatory research (CBPR) with a consumer advisory board (CAB), we will conduct mixed methods research with African Americans with severe mental illness to better understand the nature of the problem and possible solutions. While some success has been found in adapting cognitive-behavior weight loss strategies (e.g., diet and exercise) for people with severe mental illnesses, research suggests such strategies may be muted for African Americans. Hence, the CAB and Community Coalition will specifically consider adaptations to cognitive behavior weight loss strategies for peers in their community. Diet and exercise programs are especially difficult in low income communities marked by food and activity deserts. The CAB and Community Coalition will consider this challenge in their adaptation. Earlier CBPR funded by NIMHD and PCORI has shown healthcare outcomes for people of color are enhanced when complemented by peer navigators, specially trained service providers from the same ethnic background with a history of similar behavioral health challenges. Peer navigators will help program participants achieve diet and exercise goals in these communities. This study represents a partnership between Heartland Health Outreach (HHO), and the NIMH-funded Center on Adherence and Self-Determination at the Illinois Institute of Technology. The ultimate, randomized controlled trial will have three conditions (depending ultimately on CBPR feedback): treatment as usual (TAU which is integrated care), TAU plus behavioral weight loss intervention, or TAU, the weight loss intervention, with peer navigators. Impact will be assessed baseline, 6, 12, and 18 months examining weight change, health behavior, physical and mental health, recovery, and quality of life. Findings will advance knowledge and services to reduce racial disparities in obesity and comorbid health conditions for African Americans with severe mental illnesses.