Peer-Led Healthy Lifestyle Program in Supportive Housing

描述（由申请人提供）：本申请响应RFA-MH-14-060。本研究的总体目标是测试的有效性，并检查实施同伴为主导的健康生活方式干预（同伴GLB）的支持性住房机构服务于不同的客户与严重精神疾病（SMI）谁是超重或肥胖。与普通人群相比，SMI患者患肥胖症的风险是普通人群的两倍。少数民族血统带来了额外的风险。与患有SMI的非拉丁裔白人相比，患有SMI的非裔美国人和拉丁裔人患肥胖和心血管疾病的风险更高。来自糖尿病预防计划的群体生活方式平衡（GLB）是一种既定的健康生活方式干预，在一般人群中有效，可实现临床显著的体重减轻（e5%体重减轻）。我们的目标是提高GLB在这项研究中的覆盖面：1）通过在支持性住房机构提供这种干预措施，使人们的家门口; 2）使用同行专家（前客户与生活经验的SMI）作为促进者，以解决经济和人员需求;和3）确定实施因素，可以促进在社区环境中使用这种干预措施。我们建议使用混合1型随机对照试验设计，以测试的有效性对等GLB与家庭护理在支持性住房机构，并检查多层次的实施因素。同行GLB持续12个月，将由住房机构的同行专家提供。将在基线和随机化后6、12和18个月进行重复评估。为了检查同行GLB的实施情况，我们将进行一项背景因素的混合方法研究，在我们的试验实施之前和试验招募结束后，从住房机构的董事、项目经理、工作人员和同行专家那里收集数据。

DESCRIPTION (provided by applicant): This application responds to RFA-MH-14-060. The overall goals of this study are to test the effectiveness and examine the implementation of a peer-led healthy lifestyle intervention (Peer GLB) in supportive housing agencies serving diverse clients with serious mental illness (SMI) who are overweight or obese. The risk for obesity is twice as high in people with SMI compared to the general population. Minority origin contributes additional risk. Compared to non-Latino Whites with SMI, African Americans and Latinos with SMI are at higher risk of obesity and cardiovascular disease. The Group Lifestyle Balance (GLB) derived from the Diabetes Prevention Program is an established healthy lifestyle intervention that is efficacious in the general population for achieving clinically significant weiht loss (e5% weight loss). We aim to improve the reach of GLB in this study by: 1) bringing this intervention to people's doorsteps through its delivery in supportive housing agencies; 2) using peer specialists (former clients with lived experience of SMI) as facilitators to address economic and staffing demands; and 3) identifying implementation factors that can foster the use of this intervention in community settings. We propose to use a Hybrid Type 1 randomized controlled trial design to test the effectiveness of Peer GLB vs. Usual Care in supportive housing agencies and examine multi-level implementation factors. Peer GLB lasts 12 months and will be delivered by peer specialists in the housing agencies. Repeated assessments will be at baseline and at 6, 12, and 18 months post-randomization. To examine Peer GLB's implementation, we will conduct a mixed-methods study of contextual factors, collecting data from housing agencies' directors, program managers, staff, and peer specialists before the implementation of our trial and after recruitment for the trial has ended.