Health Promotion and Fitness for Younger and Older Adults With SMI

患有严重精神疾病(SMI)的成年人预期寿命缩短20%，而且不成比例 与肥胖率高、久坐不动的生活方式和贫穷相关的医疗合并症患病率更高 饮食和健康行为。这是一项评估疗效的随机对照试验的建议。 一种新的健康促进和健身干预措施(形状)，专门为 患有SMI的人。研究参与者包括200名患有SMI的成年人，按诊断组分层(n=100 精神分裂症谱系障碍和n=100个情绪障碍)，并随机分为：a)形状， 包括个人健康评估和制定饮食和锻炼目标，每周会议 有一位健康导师，每月举行饮食和体重管理小组会议，基督教青年会成员，以及 奖励计划，以及团体教育和激励会议；或b)健身俱乐部会员资格和 教育材料(HCME)。在SHAPE中，参与者将获得为期一年的强化计划(每周 与健康导师联系)，然后是6个月的维护阶段(两周一次的会议逐渐减少到 每月与健康导师会面)，在基线、3个月、6个月、12个月和18个月进行评估。 本研究将针对以下三个具体目标进行研究：目的1)比较不同治疗方法的疗效 在身体健康结果方面，包括：(A)参加定期运动和 饮食变化和(B)身体健康指标，包括6分钟步行测试的表现， 减少腰围，降低BMI；目标2：比较塑形和塑形的效果 在精神健康结果方面，包括阴性症状、抑郁症状和 自我效能感；以及目的3)探讨形式主义和人格化倾向对心理社会的影响 功能、健康状况和急性服务使用，以及选定的人口、临床和 健康行为变量对主要结果的影响。 如果被发现是有效的，In Shape计划可以为改善健康、饮食提供一个模式 公共精神卫生部门弱势和高危人群的行为和心理健康结果 运行状况设置。对发病率和死亡率的潜在下游影响对公共卫生有影响 适用于大量患有SMI的人。

Adults with serious mental illness (SMI) have a 20% reduced life expectancy and disproportionately greater prevalence of medical comorbidity associated with high rates of obesity, sedentary lifestyle, and poor dietary and health behaviors. This is a proposal for a randomized controlled trial evaluating the effectiveness of a novel health promotion and fitness intervention (In SHAPE) specially tailored for, and pilot tested among persons with SMI. Study participants will include 200 adults with SMI stratified by diagnostic group (n=100 schizophrenia-spectrum disorders and n=100 mood disorders) and randomized to either: a) In SHAPE, consisting of a personal fitness assessment and development of diet and exercise goals, weekly meetings with a health mentor, monthly group sessions on diet and weight management, a YMCA membership, an incentive program, and group educational and motivational sessions; or b) a health club membership and educational materials (HCME). In SHAPE participants will receive a one-year intensive program (weekly contact with a health mentor), followed by a 6-month maintenance phase (bi-weekly meetings tapering to monthly meetings with a health mentor), with assessments conducted at baseline, 3, 6,12 and 18 months. This study will address the following 3 specific aims: Aim 1) To compare the effectiveness of In SHAPE and HCME with respect to physical fitness outcomes, including: (a) engagement in regular exercise and dietary change and (b) indicators of physical fitness, including performance on the 6-minute walk test, decreased waist circumference, and decreased BMI; Aim 2: To compare the effectiveness of In SHAPE and HCME with respect to mental health outcomes, including negative symptoms, depressive symptoms, and self-efficacy; and Aim 3) To explore the effectiveness of In SHAPE and HCME with respect to psychosocial functioning, health status, and acute service use, as well as the effects of selected demographic, clinical, and health behavior variables on primary outcomes. If found to be effective, the In SHAPE program could provide a model for improving fitness, dietary behaviors, and mental health outcomes for this vulnerable and at-risk population within public sector mental health settings. The potential downstream impact on morbidity and mortality has public health implications for large numbers of persons with SMI.