This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Overweight and obesity are highly prevalent among people with severe mental illness (SMI); these conditions in the SMI likely contribute substantially to hypertension, diabetes mellitus, coronary disease, and early mortality. Through increased appetite and other possible mechanisms, most atypical antipsychotics cause weight gain. Yet, given their effectiveness and fewer neurologic side effects, these medications will likely remain a mainstay of pharmacotherapy for persons with SMI in the foreseeable future. At the same time, weight gain may play a role in non-adherence to antipsychotics. Effective behavioral weight loss interventions exist for the general population; however, they are probably not appropriate for people with SMI, who have special needs. Healthy lifestyle interventions for people with SMI are urgently needed. Psychiatric rehabilitation programs provide a unique context for testing nutrition and exercise interventions through their emphasis on skills building in a supportive environment. ACHIEVE is a pre-post intervention study that will pilot test a multifaceted nutrition and exercise intervention for clients with SMI participating in a psychiatric rehabilitation program. The client population is urban and predominantly African American. Our starting point will be a state-of-the art behavioral lifestyle intervention implemented in the Trial of Non-pharmacologic Interventions in the Elderly (TONE) that accomplished substantial weight loss in the general population. We will modify appropriately and enhance the intervention for this SMI population, and integrate it into a rehabilitation conceptual model. The intervention will include elements of: 1) individual and group nutrition and physical activity education and counseling; 2) an on-site group exercise class and 3) healthy modification of on-site meals and snacks. The primary outcomes to be measured at six months are: a) weight loss and b) level of moderate physical activity measured by accelerometry. Secondary outcomes will be: a) quality of life; b) health status; and, c) depression symptom level. Process outcomes will be: a) self-efficacy and b) participation in the intervention. Other outcomes will be the change in fasting serum glucose, insulin, lipids and CRP. The goals will be to have clients achieve a 10 pound weight loss and participate in 30 minutes of moderate intensity physical activity five times a week. Reflecting a client-centered focus, two sequential cohorts of 25 participants will complete the six month intervention, allowing for interim client feedback and subsequent intervention modification between cohorts. This study will provide important pilot data for future work to improve healthy lifestyle behaviors and reduce chronic medical illness in people with severe mental illness. Use of the GCRC is requested to cover the cost of the proposed serum measures.

National Institute of Health (NIH)
National Center for Research Resources (NCRR)
General Clinical Research Centers Program (M01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRR1-CR-1 (01))
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Johns Hopkins University
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Al-Sofiani, Mohammed E; Yanek, Lisa R; Faraday, Nauder et al. (2018) Diabetes and Platelet Response to Low-Dose Aspirin. J Clin Endocrinol Metab 103:4599-4608
Grover, Surbhi; Desir, Fidel; Jing, Yuezhou et al. (2018) Reduced Cancer Survival Among Adults With HIV and AIDS-Defining Illnesses Despite No Difference in Cancer Stage at Diagnosis. J Acquir Immune Defic Syndr 79:421-429
Grams, Morgan E; Sang, Yingying; Ballew, Shoshana H et al. (2018) Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate. Kidney Int 93:1442-1451
Yanik, Elizabeth L; Hernández-Ramírez, Raúl U; Qin, Li et al. (2018) Brief Report: Cutaneous Melanoma Risk Among People With HIV in the United States and Canada. J Acquir Immune Defic Syndr 78:499-504
Aboud, Katherine S; Barquero, Laura A; Cutting, Laurie E (2018) Prefrontal mediation of the reading network predicts intervention response in dyslexia. Cortex 101:96-106
Kattan, Meyer; Bacharier, Leonard B; O'Connor, George T et al. (2018) Spirometry and Impulse Oscillometry in Preschool Children: Acceptability and Relationship to Maternal Smoking in Pregnancy. J Allergy Clin Immunol Pract 6:1596-1603.e6
Altekruse, Sean F; Shiels, Meredith S; Modur, Sharada P et al. (2018) Cancer burden attributable to cigarette smoking among HIV-infected people in North America. AIDS 32:513-521
Salemi, Parissa; Skalamera Olson, Julie M; Dickson, Lauren E et al. (2018) Ossifications in Albright Hereditary Osteodystrophy: Role of Genotype, Inheritance, Sex, Age, Hormonal Status, and BMI. J Clin Endocrinol Metab 103:158-168
Robert Braši?, James; Mari, Zoltan; Lerner, Alicja et al. (2018) Remission of Gilles de la Tourette Syndrome after Heat-Induced Dehydration. Int J Phys Med Rehabil 6:
Altman, Matthew C; Whalen, Elizabeth; Togias, Alkis et al. (2018) Allergen-induced activation of natural killer cells represents an early-life immune response in the development of allergic asthma. J Allergy Clin Immunol 142:1856-1866

Showing the most recent 10 out of 1014 publications