Physical Activity to Reduce Cardiometabolic Risk in Adults with Serious Mental Illness (PARCS Study)

项目摘要/摘要 患有严重精神疾病(SMI)的成年人的生命被缩短了几十年。包括心脏病在内的慢性疾病 疾病是根本原因。与普通人群相比，患有重度心肌梗死的成年人心脏代谢风险更高 人口。可改变的危险因素(例如，缺乏体力活动、身体状况不佳)更为普遍且更早显现。 在那些患有SMI的人的生活过程中。体力活动(PA)可以降低SMI人群的心脏代谢风险。 然而，患有SMI的人明显不太可能满足PA的建议。经过认证的同行专家 (CPSS)，训练有素的有心理健康恢复经验的人，是一种快速增长的心理健康 由联邦医疗保险报销的劳动力部门。CPSS将PA纳入其健康目标，并提供可持续的 精神卫生服务中PA干预的交付机制。然而，有效的PA治疗提供和 可持续发展仍然具有挑战性。创新、可扩展、基于证据的PA干预措施，适用于患有以下疾病的人 SMI是必需的。公园对宾夕法尼亚州来说是免费的、无处不在的空间。公园提供生理、心理和社交方面的帮助 与改善健康行为和结果相关的好处。研究，包括我们的研究，都有相关的公园通道 并使用更多的PA、社会支持、情绪和生活质量(QOL)，以及较少的肥胖、压力、发病率和 死亡率。2-37户外PA与更多的快乐、满足感和长期的PA坚持有关，33 支持使用它来改变行为，特别是在那些患有SMI的人中。尽管以公园为基础的PA受益，但34人很少 以公园为基础的干预措施经过了严格的测试。没有一家公司专注于SMI人群。我们的长期合作 目标是最大限度地扩大循证PA干预的范围和临床影响，以减少 通过使用现有的精神卫生服务和精神卫生服务在重度精神障碍人群中的心脏代谢风险 社区公园。PARCS研究是一项基于证据的公园PA干预，在成年人中加入了CPSS 与SMI合作。改编自以前的练习方案，并以社会认知理论(SCT)为基础 这项研究将测试为期12周的以公园为基础的PA干预(60分钟CPS主导，每周3天)与积极对照，作为一部分 当前的同级组服务。这项建议的目的是：1)测试项目的可行性和可接受性 以公园为基础的PA干预结合CPSS对患有SMI的成年人(初级)，2a)评估 SCT作用机制(PA自我效能感、目标设定、PA社会支持和2b)的干预 测试干预对成人SMI(次级)的PA分钟数和适合度的初步效果。 这一新方法旨在通过以下方式建立可持续、可扩展和可报销的干预模式 利用现有资源(CPS服务、公园)降低患有SMI的成年人的心脏代谢风险。 探索性测量包括体脂百分比、腰围、生活质量和抑郁症状。我们的团队 致力于跨学科合作调查的团队和社区行为健康机构拥有专业知识和 资源，以实现拟议研究的目标。与精神健康服务机构合作，我们将完善我们的 为未来的大规模有效性测试提供方法和证据。

Project Summary/Abstract The lives of adults with serious mental illness (SMI) are cut short by decades. Chronic illnesses including heart disease are a fundamental cause. Adults with SMI have high cardiometabolic risk compared to the general population. Modifiable risk factors (e.g., physical inactivity, poor fitness) are more prevalent and manifest earlier in the lifecourse in those with SMI. Physical activity (PA) can reduce cardiometabolic risk in SMI populations. Yet, persons with SMI are significantly less likely to meet PA recommendations. Certified peer specialists (CPSs), trained persons with lived mental health recovery experience, are a rapidly growing mental health workforce sector reimbursed by Medicare. CPSs include PA among their wellness goals and offer a sustainable delivery mechanism for PA interventions within mental health services. Yet, effective PA treatment delivery and sustainability remain challenging. Innovative, scalable, evidence-based PA interventions for people with SMI are needed. Parks are free, ubiquitous spaces for PA. Parks offer physical, psychological, and social benefits linked with improved health behaviors and outcomes. Studies, including ours, have related park access and use to greater PA, social support, mood, and quality of life (QOL), and less obesity, stress, morbidity and mortality. 2-37 Outdoor PA is associated with increased enjoyment, satisfaction, and long-term PA adherence, 33 supporting its use for behavior change, especially among those with SMI. Despite park-based PA benefits,34 few park-based interventions have been tested rigorously. None have focused on SMI populations. Our long-term goal is to maximize the reach and clinical impact of evidence-based PA interventions to reduce cardiometabolic risk among SMI populations through use of existing mental health services and community parks. The PARCS Study is an evidence-based park PA intervention incorporating CPSs in adults with SMI. Adapted from previous exercise protocols, and grounded in Social Cognitive Theory (SCT) the PARCS Study will test a 12-week park-based PA intervention (60 min CPS-led, 3 days/week) vs a active control, as part of current peer group services. The aims of this proposal are: 1) To test the feasibility and acceptability of the park-based PA intervention incorporating CPSs in adults with SMI (primary), 2a) to assess the effectiveness of the intervention on SCT mechanisms of action (PA self-efficacy, goal setting, and PA social support, and 2b) to test the preliminary effectiveness of the intervention on minutes of PA, and fitness in adults with SMI (secondary). This novel approach aims to establish a sustainable, scalable, and reimbursable intervention model by leveraging existing resources (CPS services, parks) to reduce cardiometabolic risk in adults with SMI. Exploratory measures include percent body fat, waist circumference, QOL, and depressive symptoms. Our team committed team of interdisciplinary co-investigators and community behavioral health facilities has expertise and resources to achieve the goals of the proposed study. Working with mental health services, we will refine our approach and generate evidence for future large-scale effectiveness testing.