Young adults with serious mental illness (SMI) who are overweight or obese experienced similar weight loss and cardiorespiratory fitness improvements after participating in a 12-month group intervention as those who received one-on-one mobile health (mHealth) coaching for 12 months, a report in Psychiatric Services in Advance has found.
The findings suggest that “mHealth coaching may be a more scalable approach for addressing modifiable cardiometabolic risk factors among young adults with serious mental illness,” wrote Stephen J. Bartels, M.D., M.S., of Massachusetts General Hospital and colleagues.
The study involved 150 adults with SMI aged 18 to 35 years with a body mass index ≥25 kg/m2 who were receiving services at four community mental health centers in the northeastern United States. The participants were randomly assigned to one of two groups:
- PeerFIT: Participants in the PeerFIT group were invited to twice-weekly one-hour group meetings in person for six months followed by weekly exercise sessions for six months. They also received wearable activity trackers (Fitbits) and were encouraged to participate in a private Facebook group, where they could access information about healthy lifestyles and interact with others in the group. PeerFIT participants received weekly text messages (three to five texts per week) from the coach, encouraging healthy behaviors and monitoring of weight and physical activity.
- BEAT: Participants in the BEAT mHealth group attended an in-person orientation during which they received a scale and Fitbit and were taught to weigh and track their daily step count regularly. A coach subsequently delivered five monthly 30-minute telephone calls, during which participants were reminded to monitor weight and daily step counts, detect changes in weight and physical activity, identify and reduce barriers to achieving healthy changes, and recognize and celebrate their success. BEAT participants received three to five text messages per week with reminders and encouragement about monitoring weight and physical activity.
All participants were assessed at the start of the study as well as six and 12 months later. (Participants received $50 for completing each assessment.) The primary outcome was the proportion of participants who achieved cardiovascular disease risk reduction—defined as either weight loss of 5% from baseline or an increase of >50 m on the six-minute walk test, an objective measure of functional exercise capacity—from baseline to 6 and 12 months.
“Participants in both groups achieved clinically significant weight loss, [cardiorespiratory fitness] improvements, and [cardiovascular disease] risk reduction from baseline to 6 and 12 months,” Bartels and colleagues wrote. “At 6 months, more than half of the participants in both groups were at or below their baseline weight: 52% of PeerFIT participants and 58% of BEAT participants. Similar rates of weight-gain prevention were found at the 12-month follow-up: 50% of PeerFIT participants compared with 54% of BEAT participants were at or below their baseline weight.”
For related information, see the Psychiatric Services article “Participant Experiences With a Peer-Led Healthy Lifestyle Intervention for People With Serious Mental Illness.”