Adults with serious mental illness (SMI) have a 20 percent reduced life expectancy and disproportionately greater prevalence of medical comorbidity associated with high rates of obesity, sedentary lifestyle, and poor dietary and health behaviors. This is a application for a randomized controlled trial evaluating the effectiveness of a novel health promotion and fitness intervention (In SHAPE) specially tailored for, and pilot tested among persons with SMI. Study participants will include 200 adults with SMI stratified by diagnostic group (n=100 schizophrenia-spectrum disorders and n=100 mood disorders) and randomized to either: a) In SHAPE, consisting of a personal fitness assessment and development of diet and exercise goals, weekly meetings with a health mentor, monthly group sessions on diet and weight management, a YMCA membership, an incentive program, and group educational and motivational sessions;or b) a health club membership and educational materials (HCME). In SHAPE participants will receive a one-year intensive program (weekly contact with a health mentor), followed by a 6-month maintenance phase (bi-weekly meetings tapering to monthly meetings with a health mentor), with assessments conducted at baseline, 3, 6,12 and 18 months. This study will address the following 3 specific aims:
Aim 1) To compare the effectiveness of In SHAPE and HCME with respect to physical fitness outcomes, including: (a) engagement in regular exercise and dietary change and (b) indicators of physical fitness, including performance on the 6-minute walk test, decreased waist circumference, and decreased BMI;
Aim 2 : To compare the effectiveness of In SHAPE and HCME with respect to mental health outcomes, including negative symptoms, depressive symptoms, and self-efficacy;
and Aim 3) To explore the effectiveness of In SHAPE and HCME with respect to psychosocial functioning, health status, and acute service use, as well as the effects of selected demographic, clinical, and health behavior variables on primary outcomes. If found to be effective, the In SHAPE program could provide a model for improving fitness, dietary behaviors, and mental health outcomes for this vulnerable and at-risk population within public sector mental health settings. The potential downstream impact on morbidity and mortality has public health implications for large numbers of persons with SMI.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
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Niederehe, George T
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Dartmouth College
Schools of Medicine
United States
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Naslund, John A; Aschbrenner, Kelly A; Pratt, Sarah I et al. (2017) Association Between Cardiovascular Risk and Depressive Symptoms Among People With Serious Mental Illness. J Nerv Ment Dis 205:634-640
Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A et al. (2017) Health Promotion for Young Adults With Serious Mental Illness. Psychiatr Serv 68:137-143
Naslund, John A; Whiteman, Karen L; McHugo, Gregory J et al. (2017) Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis. Gen Hosp Psychiatry 47:83-102
Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A et al. (2016) Lifestyle Intervention for People With Severe Obesity and Serious Mental Illness. Am J Prev Med 50:145-53
Batsis, J A; Germain, C M; Vásquez, E et al. (2016) Prevalence of weakness and its relationship with limitations based on the Foundations for the National Institutes for Health project: data from the Health and Retirement Study. Eur J Clin Nutr 70:1168-1173
Jimenez, Daniel E; Burrows, Kimberly; Aschbrenner, Kelly et al. (2016) Health behavior change benefits: Perspectives of Latinos with serious mental illness. Transcult Psychiatry 53:313-29
Liu, Stephen K; Montgomery, Justin; Yan, Yu et al. (2016) Association Between Hospital Admission Risk Profile Score and Skilled Nursing or Acute Rehabilitation Facility Discharges in Hospitalized Older Adults. J Am Geriatr Soc 64:2095-2100
Batsis, J A; Mackenzie, T A; Bartels, S J et al. (2016) Diagnostic accuracy of body mass index to identify obesity in older adults: NHANES 1999-2004. Int J Obes (Lond) 40:761-7
Batsis, John A; Mackenzie, Todd A; Lopez-Jimenez, Francisco et al. (2015) Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004. Nutr Res 35:1031-9
Aschbrenner, Kelly A; Brunette, Mary F; McElvery, Raleigh et al. (2015) Cigarette smoking and interest in quitting among overweight and obese adults with serious mental illness enrolled in a fitness intervention. J Nerv Ment Dis 203:473-6

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