Clinical Trial of Wellness Training

Chafetz, Linda; White, Mary C.; Collins-Bride, Gerri; Cooper, Bruce A.; Nickens, John

doi:10.1097/nmd.0b013e31817738de

Cited by 36 publications

(21 citation statements)

References 55 publications

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“…Intervention formats featured individual sessions (29) and group sessions (16,17,19,21,23,26–28,31–34,36,37), with some integrating both approaches (20,22,24,25,38). Interventions were delivered by a range of staff, including registered nurses, exercise physiologists, registered dieticians, trained fitness instructors, case managers, and master's- and doctoral-level health care practitioners.…”

Section: Resultsmentioning

confidence: 99%

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Cabassa¹,

Ezell²,

Lewis‐Fernández³

2010

Psychiatric Services

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Objective The promotion of healthy lifestyles among persons with serious mental illness is an integral part of their recovery. The aims of this systematic literature review were to rate the methodological quality of lifestyle intervention outcome studies for persons with serious mental illness, summarize intervention strategies, examine physical health outcomes, and evaluate the inclusion of racial and ethnic minority groups in these studies. Methods Electronic bibliographic database searches were performed to locate studies conducted in the United States. Articles written in English and published in peer-reviewed journals between 1980 and 2009 were included. The authors used a standardized instrument to rate studies' methodological quality. Results Twenty-three articles were reviewed. Based on studies' methodological quality, three levels of evidence were found: single-group reports, quasi-experimental studies, and randomized controlled trials. Most interventions used behavioral techniques to improve dietary habits and increase physical activity. Twelve studies reported significant improvements in either weight loss or metabolic syndrome risk factors associated with receiving a lifestyle intervention. Persons from racial and ethnic minority groups were underrepresented, especially Hispanics and Asian Americans. Only one study included non–English-speaking participants. Conclusions Lifestyle interventions adapted to persons with serious mental illness show promise in reducing weight loss and some risk factors for metabolic syndrome. The under-representation of persons from racial or ethnic minority groups in this literature limits its generalizability. Implications for research and practice are discussed.

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Section: Resultsmentioning

confidence: 99%

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Cabassa¹,

Ezell²,

Lewis‐Fernández³

2010

Psychiatric Services

View full text Add to dashboard Cite

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“…People with serious mental illness such as schizophrenia have higher levels of cardiovascular disease [6,7], metabolic disease [8], diabetes [9,10], and respiratory illness [11,12]. Although genetics may have a role in the physical health problems of these patients, lifestyle and environmental factors such as smoking, obesity, poor diet, and low levels of physical activity play a prominent part [13].…”

Section: Introductionmentioning

confidence: 99%

Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis

et al. 2014

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BackgroundIndividuals with serious mental illness are at a higher risk of physical ill health. Mortality rates are at least twice those of the general population with higher levels of cardiovascular disease, metabolic disease, diabetes, and respiratory illness. Although genetics may have a role in the physical health problems of these patients, lifestyle and environmental factors such as levels of smoking, obesity, poor diet, and low levels of physical activity also play a prominent part.MethodsWe conducted a systematic review and meta-analysis of randomised controlled trials comparing the effect of exercise interventions on individuals with serious mental illness.Searches were made in Ovid MEDLINE, Embase, CINAHL, PsycINFO, Biological Abstracts on Ovid, and The Cochrane Library (January 2009, repeated January 2013) through to February 2013.ResultsEight RCTs were identified in the systematic search. Six compared exercise versus usual care. One study assessed the effect of a cycling programme versus muscle strengthening and toning exercises. The final study compared the effect of adding specific exercise advice and motivational skills to a simple walking programme. The review found that exercise improved levels of exercise activity (n = 13, standard mean difference [SMD] 1.81, CI 0.44 to 3.18, p = 0.01). No beneficial effect was found on negative (n = 84, SMD = -0.54, CI -1.79 to 0.71, p = 0.40) or positive symptoms of schizophrenia (n = 84, SMD = -1.66, CI -3.78 to 0.45, p = 0.12). No change was found on body mass index compared with usual care (n = 151, SMD = -0.24, CI -0.56 to 0.08, p = 0.14), or body weight (n = 77, SMD = 0.13, CI -0.32 to 0.58, p = 0.57). No beneficial effect was found on anxiety and depressive symptoms (n = 94, SMD = -0.26, CI -0.91 to 0.39, p = 0.43), or quality of life in respect of physical and mental domains.ConclusionsThis systematic review showed that exercise therapies can lead to a modest increase in levels of exercise activity but overall there was no noticeable change for symptoms of mental health, body mass index, and body weight.

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“…Even though the samples of the remaining studies were more evenly distributed among multiple racial and ethnic groups, only one study sample had more than 10% Latino participants (27), and only one study provided data on the percentage of Asian participants (28), indicating limited information on how health self-management interventions affect outcomes across racial-ethnic groups. It should be noted, however, that several studies did not provide detailed racial-ethnic information about the sample, instead grouping numerous racial and ethnic groups into a single “other” category and thus limiting conclusions.…”

Section: Resultsmentioning

confidence: 99%

“…The other eight studies modified existing models. Four studies tested modified versions of the Chronic Disease Self-Management Program (22,26,33,34), three studies were based on the Life Goals Program and Collaborative Care Model (23,24,35,36)—one in conjunction with the Diabetes Awareness and Rehabilitation Training intervention (35,37)—and one study tested basic primary care services plus wellness training, an adaptation of the Moller-Murphy Symptom Management Assessment Tool (28,38). All but one of the 14 studies (25) used manualized or workbook-directed training programs.…”

Section: Resultsmentioning

confidence: 99%

“…The interventions were delivered by nursing staff in seven of the studies (23,25,28–32), three studies exclusively used mental health peers (26,27,33), three studies used peers combined with a mental health specialist or nurse (22,34,35), and one study used a master's-level health specialist (24). Duration of participant training in self-management skills varied widely, from four weeks (23) to six months (27) or up to 12 months (25,28–30,32), and two models included booster sessions beyond 12 months (24,29,30).…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Self-Management Health Care Models for Individuals With Serious Mental Illnesses

Kelly¹,

Fenwick²,

Barr³

et al. 2014

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Objective The general medical health of individuals with serious mental illnesses is compromised relative to those without serious mental illnesses. To address this health disparity, numerous integrated care strategies are being employed from the system level to the level of individual patients. However, self-management of health care, a strategy considered an integral aspect of typical care, has been infrequently included in interventions for this population. Despite reservations about the capacity of those with serious mental illnesses to self-manage health care, a subset of new interventions focused on general medical health in this population has tested whether models including self-management strategies have empirical support. To understand whether these models are supported, the authors reviewed the evidence for self-management models. Methods This systematic review examined collaborative and integrated care models that include self-management components for individuals with serious mental illnesses. Results Across the 14 studies identified in this review, promising evidence was found that individuals with serious mental health issues can collaborate with health professionals or be trained to self-manage their health and health care. The evidence supports the use of mental health peers or professional staff to implement health care interventions. However, the substantial heterogeneity in study design, types of training, and examined outcomes limited conclusions about the comparative effectiveness of existing studies. Conclusions This review found preliminary support that self-management interventions targeting the general medical health of those with serious mental illnesses are efficacious, but future work is needed to determine what elements of training or skills lead to the most salient changes.

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Clinical Trial of Wellness Training

Cited by 36 publications

References 55 publications

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

Exercise therapy in adults with serious mental illness: a systematic review and meta-analysis

A Systematic Review of Self-Management Health Care Models for Individuals With Serious Mental Illnesses

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