Scaling a behavioral weight-loss intervention for individuals with serious mental illness using the enhanced replicating effective programs framework: A preconditions phase proof-of-concept study

Kimberly A Gudzune; Gerald J Jerome; Arlene T Dalcin; Ruiyi Gao; Elizabeth Mace; Tyler Fink; Eva Minahan; Christina Yuan; Anping Xie; Stacy Goldsholl; Joseph V Gennusa; Gail L Daumit

doi:10.1002/osp4.690

Scaling a behavioral weight-loss intervention for individuals with serious mental illness using the enhanced replicating effective programs framework: A preconditions phase proof-of-concept study

Obes Sci Pract. 2023 Jul 7;9(6):618-630. doi: 10.1002/osp4.690. eCollection 2023 Dec.

Authors

Kimberly A Gudzune^{1

2

3}, Gerald J Jerome^{1

4}, Arlene T Dalcin^{1

2}, Ruiyi Gao¹, Elizabeth Mace¹, Tyler Fink¹, Eva Minahan¹, Christina Yuan^{3

5}, Anping Xie^{5

6}, Stacy Goldsholl¹, Joseph V Gennusa¹, Gail L Daumit^{1

2

3}

Affiliations

¹ Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.
² Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Medical Institution Baltimore Maryland USA.
³ Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.
⁴ Department of Kinesiology Towson University Towson Maryland USA.
⁵ Armstrong Institute for Patient Safety and Quality Johns Hopkins University School of Medicine Baltimore Maryland USA.
⁶ Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.

Abstract

Background: Given the obesity's high prevalence among individuals with serious mental illness (SMI), translating weight-loss interventions with demonstrated effectiveness is needed. This study describes the initial translation phase of such an intervention using the Enhanced Replicating Effective Programs (REP) Framework for delivery by mental health program staff.

Methods: The Achieving Healthy Lifestyles in Psychiatric Rehabilitation (Achieving Healthy Lifestyles in Psychiatric Rehabilitation) trial intervention was preliminarily adapted to create the ACHIEVE-Dissemination (ACHIEVE-D) curriculum. A treatment-only study was conducted to rapidly evaluate the curriculum using a mixed-methods approach including surveys and focus groups. A study coach delivered an abbreviated curriculum to individuals with SMI from a single psychiatric program. Among all participants with SMI (n = 17), outcomes were attendance and satisfaction; 14 participated in a focus group. The program staff observed curriculum delivery and participated in a focus group (n = 3).

Results: Overall, 23 group sessions were delivered. Median attendance was 78.6% across participants with SMI; 92.9% would recommend ACHIEVE-D to others. The staff found the curriculum acceptable, particularly its structured nature, inclusion of weight management and exercise, and integrated goal setting and tracking. These improvements recommended by participants and/or staff were to assess participant readiness-to-change prior to enrollment, change the frequency of weigh-ins, and train staff coaches on anticipated challenges (e.g., exercise engagement, weight fluctuations).

Conclusions: During this first REP phase, individuals with SMI and program staff were satisfied with ACHIEVE-D. Additional refinements will aid future implementation and improve participant experience.

Keywords: community mental health centers; implementation science; weight reduction programs.

Grants and funding

P50 MH115842/MH/NIMH NIH HHS/United States