Wednesday, December 17, 2014

Health Coaching Intervention Effective for Obesity in Those With Serious Mental Illness, Study Finds

A health coaching intervention for obesity appears to be effective in achieving and sustaining clinically significant reductions in cardiovascular risk for overweight and obese individuals with serious mental illness.

That’s the finding of a replication trial of the In SHAPE program in the report “Pragmatic Replication Trial of Health Promotion Coaching for Obesity in Serious Mental Illness and Maintenance of Outcomes,” published in AJP in Advance.

In SHAPE is a 12-month program consisting of individual weekly meetings in the community with a health-promotion coach, a fitness club (YMCA) membership, and nutrition education adapted for people with serious mental illness that was found in a previous study to contribute to clinically significant reduction in cardiovascular risk in overweight or obese adults with serious mental illness.

In the new study, Stephen Bartels, M.D., of the Department of Psychiatry and the Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth and colleagues randomly assigned 210 individuals with serious mental illness and a body mass index greater than 25 receiving services in three community mental health organizations either to the 12-month In SHAPE program or to fitness club membership alone. The primary outcome measures were weight and cardiorespiratory fitness (as measured with the 6-minute walk test) assessed at baseline and at 3, 6, 9, 12, and 18 months.

At 12 months, the In SHAPE group had greater reduction in weight and improved fitness compared with the fitness club membership group. Primary outcomes were maintained at 18 months. Approximately half of the In SHAPE group achieved clinically significant cardiovascular risk reduction, defined by a weight loss greater than 5 percent or an increase of greater than 50 meters on the 6-minute walk test.

“By comparing In SHAPE to an active comparison condition (a fitness club membership), we were able to test the specific contribution of having a health-promotion coach,” the researchers stated. “Having a health-promotion coach was associated with more than two-and-a-half times the mean amount of fitness club attendance, which in turn was associated with greater weight loss and improved fitness.”

For more on this subject, see the Psychiatric News article, "Health Mentors Prove Valuable For Those With Serious Mental Illness."

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