Web-Based Weight Management for Individuals with Mental Illness

针对精神疾病患者的基于网络的体重管理

基本信息

批准号：
8084142
负责人：
Alexander S. Young
金额：
$ 22.94万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2013-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8084142
关键词：
Accounting Address Adverse effects Behavioral Body Weight decreased Caring Cessation of life Chronic Disease Client Clinic Cognitive Cognitive Therapy Cognitive deficits Communities Community Mental Health Centers Computer Assisted Computer Systems Computers Control Groups County Development Diet Diet Habits Disadvantaged Education Educational Materials Educational process of instructing Effectiveness Epidemic Evidence based intervention Evidence based practice Future Guidelines Health Health Care Costs Health Personnel Individual Internet Intervention Interview Learning Life Expectancy Life Style Location Los Angeles Measures Medical Medical center Mental Health Mental disorders Meta-Analysis Methods Modification Monitor Motivation National Institute of Mental Health Obesity Online Systems Outcome Overweight Pamphlets Participant Persons Pharmaceutical Preparations Phase Physical activity Population Postdoctoral Fellow Process Quality of life Randomized Randomized Controlled Trials Readiness Research Research Design Research Personnel Risk Sampling Schizophrenia Self Efficacy Self Management Site System Techniques Technology Testing Time Training Transportation Travel United States Variant Visit Weight Weight Gain base clinical care community based care comparison group computerized cost design diet and exercise evidence base improved innovation meetings mental health center nutrition education pilot trial preference premature programs prototype psychoeducational intervention psychosocial public health relevance routine care rural area severe mental illness social success treatment as usual treatment center treatment program uptake urban area waist circumference weight loss intervention

项目摘要

DESCRIPTION (provided by applicant): Obesity and physical inactivity have reached epidemic proportions, resulting in increased rates of chronic disease, premature death, and substantial health care costs. Excess weight is even more prevalent in populations with serious mental illnesses (SMI), in part due to medication- induced weight gain and social disadvantage. Since individuals with SMI often have cognitive deficits, specialized approaches are required to help people manage their weight. Researchers have found that specialized in-person interventions focused on diet and activity can help individuals with SMI manage their weight. However, these evidence-based practices have not been widely disseminated. Barriers to the use of these interventions include reluctance of individuals to participate in groups, difficulty finding transportation for frequent visits to clinics, a shortage of trained clinicians, and inadequate clinician time to provide the interventions. It is likely that these barriers can be addressed with a web-based weight intervention that is tailored for individuals with SMI. Specialized web-based approaches have been studied and found to be effective in this population, and can deliver content that is intensive and engaging with minimal requirements for clinician time. Objectives: The investigators on this proposal recently developed a prototype web-based system, called "Help-MI" (Health eLearning for Persons with Mental Illness), that provides limited diet education to individuals with SMI. The current project extends and evaluates this Help-MI system. The project's objectives are to: 1) build on the Help-MI prototype to develop a comprehensive web-based system that delivers an evidence-based weight management program that is focused on diet and activity, and that meets the needs of individuals with SMI; 2) evaluate the effectiveness, in individuals with SMI, of Help-MI compared with a control group; and, 3) characterize, from the perspective of individuals with SMI, the strengths, weaknesses, and barriers to the use of Help-MI. Methods: This is a randomized, controlled trial of 90 individuals with SMI at a community mental health center who are overweight and prescribed medications that have weight gain as a common side-effect. Participants are assigned to Help-MI or a comparison group. Research assessments occur at baseline, 3, and 6 months. Changes in outcomes are compared over time between the two groups. Significance: By losing weight, individuals with mental illness can decrease their risk for medical problems, and improve their quality of life and life expectancy. A web-based system that helps individuals lose weight could be feasible to disseminate broadly at medical centers, clinics, and community based programs in both rural and urban areas. PUBLIC HEALTH RELEVANCE: Obesity and physical inactivity have become serious problems for individuals with mental illness, resulting in increased rates of chronic disease, premature death, and substantial health care costs. Although in-person psychoeducational interventions help individuals with mental illness manage their weight, these interventions are often not used because they require frequent travel to treatment programs and substantial time from clinicians. This project addresses these barriers by developing and evaluating the effectiveness of a web-based computer system that is focused on diet and exercise education, and designed to help individuals with mental illness manage their weight.

描述（由申请人提供）：肥胖和身体不活动已经达到了流行比例，导致慢性疾病，过早死亡和实质性医疗保健成本增加。在患有严重精神疾病（SMI）的人群中，体重更加普遍，部分原因是药物诱发的体重增加和社会劣势。由于患有SMI的人通常会有认知缺陷，因此需要采用专门的方法来帮助人们管理自己的体重。研究人员发现，专门针对饮食和活动的专门面对面干预措施可以帮助患有SMI的人来管理自己的体重。但是，这些基于证据的做法尚未被广泛传播。使用这些干预措施的障碍包括个人不愿参加小组，很难找到经常去诊所的运输，训练有素的临床医生短缺以及临床医生不足的时间来提供干预措施。这些障碍很可能可以使用基于网络的重量干预来解决，该干预措施是针对SMI的人量身定制的。已经对基于Web的专业方法进行了研究，并发现在该人群中有效，并且可以提供密集且对临床医生时间的需求最少的内容。目的：该提案的调查人员最近开发了一个基于Web的原型系统，称为“ Help-Mi”（针对精神疾病患者的健康电子学习），该系统为SMI的人提供了有限的饮食教育。当前的项目扩展并评估了此帮助MI系统。该项目的目标是：1）建立在Help-MI原型上，以开发一个基于Web的全面系统，该系统提供了一个基于证据的体重管理计划，该计划专注于饮食和活动，并满足SMI的个人的需求； 2）与对照组相比，评估SMI的个体的有效性； 3）从具有SMI的个体的角度来看，其优势，劣势和使用帮助MI的障碍。方法：这是一项在社区心理健康中心的90名患者的随机，对照试验，他们超重和处方药，其体重增加作为常见的副作用。参与者被指定为帮助MI或比较组。研究评估在基线，3和6个月进行。在两组之间比较结果的变化。意义：通过减肥，精神疾病的人可以减少其医疗问题的风险，并提高其生活质量和预期寿命。一个基于网络的系统，可以帮助个人减肥，可以在农村和城市地区的医疗中心，诊所和社区计划中广泛传播。公共卫生相关性：肥胖和身体上的不活动已成为精神疾病患者的严重问题，导致慢性疾病，过早死亡和实质性医疗保健成本增加。尽管面对面的心理教育干预措施可以帮助患有精神疾病的人管理体重，但这些干预措施通常不使用，因为它们需要频繁旅行去治疗计划和临床医生大量时间。该项目通过开发和评估侧重于饮食和运动教育的基于Web的计算机系统的有效性来解决这些障碍，并旨在帮助患有精神疾病的人管理体重。