Improving Fitness and Health among People with Serious Mental Illness: A Promising Approach
ARLINGTON, Va. (August 1, 2013) — Participation in a fitness and nutrition intervention involving a fitness mentor resulted in significant improvements in cardiovascular health among overweight adults with serious mental illness. The research is presented in the August issue of Psychiatric Services, a publication of the American Psychiatric Association.
In a one-year randomized controlled trial, participants were provided a one-year fitness club membership and paired with a health mentor who provided weekly fitness coaching and nutrition counseling through a program called In SHAPE. The health mentors conducted a comprehensive lifestyle and fitness evaluation and developed personalized fitness plans using shared goal setting. During the year, the mentors met with participants once a week for 45-60 minutes at a local fitness club and provided fitness coaching and support. A control group was given a free gym membership and education but no mentoring. Study participants included 133 overweight or obese adults with serious mental illness.
Compared to the control group, more than twice as many In SHAPE participants achieved improvement s in cardiorespiratory fitness, and they achieved these early in the year and maintained them through the 12-month follow-up. In SHAPE participants had three times greater fitness club attendance, twice as much participation in physical exercise, greater engagement in vigorous physical activity, and improvement in diet.
Among In SHAPE participants, nearly half (49%) achieved either clinically significant increased fitness or weight loss (5% or greater), and 24% achieved both. There were no differences in weight and BMI between the 2 groups. However, almost one-third of participants from both groups achieved clinically significant weight loss.
The study authors, led by Stephen Bartels, MD, MS, with the Geisel School of Medicine at Dartmouth, note that “These findings suggest that a mentoring approach can be effective in rapidly reducing cardiovascular mortality risk for overweight and obese individuals with serious mental illness by significantly improving fitness.” They concluded that the fitness mentor may help to overcome motivational challenges and low self-efficacy often experienced by people with serious mental illness. A follow-up study will be looking at the financial implications of the mentor program.
The research was supported by grants from the Centers for Disease Control and Prevention (CDC) and from the National Institute of Mental Health (NIMH).
Psychiatric Services features new column on integrated care
Also in the August issue of the journal is the introduction of a new Integrated Care column, edited by Benjamin G. Druss, M.D., M.P.H., of the Rollins School of Public Health at Emory University. The Affordable Care Act is moving the U.S. health system toward greater integration of primary and behavioral health care and this column will focus on initiatives to promote integration. In the inaugural column, Margaret A. Swarbrick, Ph.D., describes the growing role of peer wellness specialists in integrated care teams.
The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at www.psychiatry.org.
Source: American Psychiatric Association Press Releases, August 2013