Web-Based Weight Management for Individuals With Mental Illness
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss, Schizophrenia, Psychiatric |
| Therapuetic Areas: | Endocrinology, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/5/2014 |
| Start Date: | August 2011 |
| End Date: | June 2013 |
| Contact: | Dawn Glover, MA |
| Email: | dawnglover@ucla.edu |
| Phone: | 310-478-3711 |
Obesity and physical inactivity have become serious problems for individuals with mental
illness, resulting in increased rates of chronic disease, premature death, and substantial
health care costs. Although in-person psychoeducational interventions help individuals with
mental illness manage their weight, these interventions are often not used because they
require frequent travel to treatment programs and substantial time from clinicians. This
project addresses these barriers by developing and evaluating the effectiveness of an
web-based computer system that is focused on diet and exercise education, and designed to
help individuals with mental illness manage their weight.
illness, resulting in increased rates of chronic disease, premature death, and substantial
health care costs. Although in-person psychoeducational interventions help individuals with
mental illness manage their weight, these interventions are often not used because they
require frequent travel to treatment programs and substantial time from clinicians. This
project addresses these barriers by developing and evaluating the effectiveness of an
web-based computer system that is focused on diet and exercise education, and designed to
help individuals with mental illness manage their weight.
Background/Rationale: Obesity and physical inactivity have reached epidemic proportions,
resulting in increased rates of chronic disease, premature death, and substantial health
care costs. Excess weight is even more prevalent in populations with serious mental
illnesses (SMI), in part due to medication-induced weight gain and social disadvantage.
Since individuals with SMI often have cognitive deficits, specialized approaches are
required to help people manage their weight. Researchers have found that specialized
in-person interventions focused on diet and activity can help individuals with SMI manage
their weight. However, these evidence-based practices have not been widely disseminated.
Barriers to the use of these interventions include reluctance of individuals to participate
in groups, difficulty finding transportation for frequent visits to clinics, a shortage of
trained clinicians, and inadequate clinician time to provide the interventions. It is
likely that these barriers can be addressed with a web-based weight intervention that is
tailored for individuals with SMI. Specialized web-based approaches have been studied and
found to be effective in this population, and can deliver content that is intensive and
engaging with minimal requirements for clinician time.
Objectives: The investigators on this proposal previously developed a prototype web-based
system that provides limited diet education to individuals with SMI. The current project
extends and evaluates this system. The project's objectives are to: 1) build on the
prototype to develop "eWellness," a comprehensive web-based system that delivers an
evidence-based weight management program focused on diet and activity, and that meets the
needs of individuals with SMI; 2) evaluate the effectiveness, in individuals with SMI, of an
eWellness program compared with a control group; and, 3) characterize, from the perspective
of individuals with SMI, the strengths, weaknesses, and barriers to the use of eWellness.
Methods: This is a randomized, controlled trial of 90 individuals with SMI at a community
mental health center who are overweight and prescribed medications that have weight gain as
a common side-effect. Participants are assigned to the eWellness program or a comparison
group. Research assessments occur at baseline, 3, and 6 months. Changes in outcomes are
compared over time between the two groups.
Significance: By losing weight, individuals with mental illness can decrease their risk for
medical problems, and improve their quality of life and life expectancy. A web-based system
that helps individuals lose weight could be feasible to disseminate broadly at medical
centers, clinics, and community based programs in both rural and urban areas.
resulting in increased rates of chronic disease, premature death, and substantial health
care costs. Excess weight is even more prevalent in populations with serious mental
illnesses (SMI), in part due to medication-induced weight gain and social disadvantage.
Since individuals with SMI often have cognitive deficits, specialized approaches are
required to help people manage their weight. Researchers have found that specialized
in-person interventions focused on diet and activity can help individuals with SMI manage
their weight. However, these evidence-based practices have not been widely disseminated.
Barriers to the use of these interventions include reluctance of individuals to participate
in groups, difficulty finding transportation for frequent visits to clinics, a shortage of
trained clinicians, and inadequate clinician time to provide the interventions. It is
likely that these barriers can be addressed with a web-based weight intervention that is
tailored for individuals with SMI. Specialized web-based approaches have been studied and
found to be effective in this population, and can deliver content that is intensive and
engaging with minimal requirements for clinician time.
Objectives: The investigators on this proposal previously developed a prototype web-based
system that provides limited diet education to individuals with SMI. The current project
extends and evaluates this system. The project's objectives are to: 1) build on the
prototype to develop "eWellness," a comprehensive web-based system that delivers an
evidence-based weight management program focused on diet and activity, and that meets the
needs of individuals with SMI; 2) evaluate the effectiveness, in individuals with SMI, of an
eWellness program compared with a control group; and, 3) characterize, from the perspective
of individuals with SMI, the strengths, weaknesses, and barriers to the use of eWellness.
Methods: This is a randomized, controlled trial of 90 individuals with SMI at a community
mental health center who are overweight and prescribed medications that have weight gain as
a common side-effect. Participants are assigned to the eWellness program or a comparison
group. Research assessments occur at baseline, 3, and 6 months. Changes in outcomes are
compared over time between the two groups.
Significance: By losing weight, individuals with mental illness can decrease their risk for
medical problems, and improve their quality of life and life expectancy. A web-based system
that helps individuals lose weight could be feasible to disseminate broadly at medical
centers, clinics, and community based programs in both rural and urban areas.
Inclusion Criteria:
- diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or recurrent
major depressive disorder with psychosis
- age 18 and over
- prescribed antipsychotic medication for at least 3 months
- BMI of 30 or higher or recent weight gain
- medical clearance to participate
Exclusion Criteria:
- any medical condition for which a weight program is contraindicated
- history of bariatric surgery
- psychiatric hospitalization during the prior month
- pregnant and nursing mothers
- diagnosis of dementia or Mini-Mental Status Examination score of 23 or less
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