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

体力活动可降低患有严重精神疾病的成人的心脏代谢风险（PARCS 研究）

• 批准号: 10431329
• 负责人: Gina Besenyi
• 金额: $ 23.71万
• 依托单位: KANSAS STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-23 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10431329
• 关键词: Adherence; Administrator; Adult; Aerobic Exercise; Age; American; Antipsychotic Agents; Body fat; CCL18 gene; Chronic Disease; Clinical; Communities; Community Mental Health Services; Data; Diabetes Mellitus; Dissemination and Implementation; Effectiveness; Effectiveness of Interventions; Evidence based intervention; Exercise; Face; Focus Groups; Foundations; Future; General Population; Goals; Health Personnel; Health behavior outcomes; Health care facility; Healthcare Systems; Heart Diseases; Intervention; Interview; Lead; Life; Light; Link; Major Depressive Disorder; Measures; Mediation; Medicaid; Medicare; Mental Health; Mental Health Services; Mental disorders; Mission; Modeling; Moods; Morbidity - disease rate; National Institute of Mental Health; Obesity; Outcome; Participant; Peer Group; Personality; Persons; Physical Fitness; Physical activity; Population; Process; Protocols documentation; Provider; Public Health; Quality of life; Recommendation; Recovery; Research; Research Personnel; Resources; Risk Factors; Schizophrenia; Self Efficacy; Services; Social support; Specialist; Stress; Stretching; Technology; Testing; Training; United States National Institutes of Health; Walking; acceptability and feasibility; active control; base; behavior change; behavioral health; cardiometabolic risk; cardiometabolism; cardiovascular risk factor; depressive symptoms; effectiveness evaluation; effectiveness testing; effectiveness trial; evidence base; exercise intervention; experience; feasibility testing; fitbit; fitness; health disparity; improved; innovation; moderate-to-vigorous physical activity; modifiable risk; mortality; novel; novel strategies; peer; physical inactivity; post intervention; primary outcome; programs; psychologic; satisfaction; scale up; secondary outcome; severe mental illness; social; social cognitive theory; social disparities; strength training; system-level barriers; waist circumference

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.

项目摘要/摘要 数十年来，患有严重精神疾病（SMI）的成年人的生活被缩短了。包括心脏在内的慢性病 疾病是一个基本原因。与一般的成年人相比 人口。可修改的危险因素（例如身体上的不活动，健身差）更为普遍，并且更早地表现出来 在患有SMI的人的生命中。体育活动（PA）可以减少SMI人群中的心脏代谢风险。 但是，SMI患者符合PA建议的可能性较小。认证的同行专家 （CPSS）是具有生活心理健康恢复经验的受过训练的人，是一种快速增长的心理健康 劳动力部门由Medicare偿还。 CPS包括PA的健康目标，并提供可持续性 心理健康服务中PA干预的交付机制。但是，有效的PA治疗交付和 可持续性仍然具有挑战性。具有创新性，可扩展性，基于证据的PA干预措施 需要SMI。公园是免费的，无处不在的空间。公园提供身体，心理和社会 与改善健康行为和结果有关的好处。包括我们在内的研究都有相关的公园访问 并用于更大的PA，社会支持，情绪和生活质量（QOL）以及肥胖，压力，发病率和 死亡。 2-37室外PA与增加的享受，满意度和长期PA依从性有关，33 支持其用于行为改变的用途，尤其是在SMI的人中。尽管基于公园的PA益处，但34个很少 基于公园的干预措施已严格测试。没有人专注于SMI人群。我们的长期 目标是最大化循证PA干预措施的影响范围和临床影响 通过使用现有的心理健康服务和 社区公园。 PARCS研究是一项基于证据的公园PA干预措施，纳入成人的CPS 与smi。改编自先前的练习方案，并以社会认知理论（SCT）为基础 研究将测试为12周的公园PA干预（60分钟CPS LED，3天/周），而主动控制 当前的同行组服务。该提案的目的是：1）测试 基于公园的PA干预措施纳入了SMI（主要）2A）的成年人的CPS，以评估 SCT行动机制的干预（PA自我效能感，目标设定和PA社会支持以及2B） 测试干预措施对PA分钟的初步有效性，以及SMI成年人（次要）的适应性。 这种新颖的方法旨在通过 利用现有资源（CPS服务，公园）降低SMI成年人的心脏代谢风险。 探索性措施包括体内脂肪百分比，腰围，QOL和抑郁症状。我们的团队 跨学科共同研究人员和社区行为卫生设施的忠实团队具有专业知识和 实现拟议研究目标的资源。使用心理健康服务，我们将完善我们的 方法并为将来的大规模有效性测试提供证据。