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

描述(由申请人提供)： 对退伍军人医疗保健的预期影响：严重精神疾病(SMI)患者的身体疾病发病率和死亡率高于普通人群，但通常不参加或完成健康促进干预。这项试点研究将提供对低需求体力活动干预的初步评估，该干预可能为患有SMI的退伍军人接受，并导致改善这一医学脆弱人群的健康。项目背景：SMI患者的发病率和死亡率相对较高，这使得精神卫生研究所和其他群体除了改善对这一人群的身体健康护理的协调外，还将预防和健康促进列为优先事项。虽然已经制定了有希望的健康促进干预措施，但这些干预措施是密集的，似乎没有一个成功地解决了在最大限度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措施进行试点评估，该干预措施可能是健康促进的一个可接受的介绍，即动起来，好起来！(GMGW)计划。当前版本的GMGW的参与者描述了超出预期的好处。我们认为，为期12周的GMGW计划可能是一种有效的、相对低需求的干预措施，通过增加退伍军人的行为激活来促进患有SMI的退伍军人的自我效能和身体健康。项目目标：拟议研究的目标是：(A)确定参加为期12周的GMGW计划对行为激活的测量的影响；(B)确定GMGW对自我效能、身体活动、一般身心健康和情绪的测量的影响；以及(C)确定参加课堂对参与更密集的身体健康计划的意向和实际参与的测量的影响。项目方法：为了给未来的全面研究提供信息，我们将完成为期12周的GMGW班级的开发，评估其可接受性、可行性和时间负担，并评估干预对关键结果指标的影响。为了达到研究的目的，我们将随机将30名参与者分配到GMGW或注意力控制条件下。学员将在课程开始前完成基线测量，调查行为激活、自我效能、体力活动、身体和情绪健康、情绪和参与健康促进活动的意图。这些措施将在为期12周的课程结束时重复，同时还将调查干预措施的可接受性。图表审查将调查健康促进干预措施的实际参与情况。我们将在小组内部和小组之间寻找预期方向和反应模式差异的趋势出现，这将使我们了解这些措施的效果大小，并允许进行全面试验的力量分析。我们计划使用重复测量的方差分析，控制干预组和控制组之间显著不同的任何变量，以检验GMGW参与者在12周干预结束时的测量结果将比对照参与者有更大改善的假设。最后，我们还将使用等比例的卡方检验来比较在其医疗记录中有参与新的健康促进活动的证据的参与者的数量。

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.