Get Moving and Get Well - Pilot Study

Anticipated Impacts on Veteran's Healthcare: Individuals with serious mental illness (SMI)
have greater physical illness morbidity and mortality than the general population, but
typically do not enroll in nor complete health promotion interventions. This pilot study will
provide preliminary evaluation of a low-demand physical activity intervention that may be
acceptable to Veterans with SMI and lead to improved health in this medically vulnerable
population.

Project Background: The relatively high rates of morbidity and mortality found among
individuals with SMI have led to prioritization by Mental Health QUERI, and other groups, of
prevention and health promotion in addition to improved coordination of physical health care
for this population. Although promising health promotion interventions have been developed,
they are intensive and none seem to successfully address the challenge of improving reach and
enrollment while minimizing attrition. We propose to conduct a pilot evaluation of a novel
low-demand intervention that may be an acceptable introduction to health promotion, the Get
Moving and Get Well! (GMGW) program. Participants in the current version of GMGW have
described benefits beyond those expected. We believe a 12-week GMGW program may be an
effective and relatively low-demand intervention to promote self-efficacy and physical health
in Veterans with SMI through increasing Veteran behavioral activation.

Project Objectives: The objectives of the proposed study are to: (a) determine the effects of
participation in the 12-week GMGW program on a measure of behavioral activation; (b)
determine the effects of GMGW on measures of self-efficacy, physical activity, general
physical and mental health, and mood; and (c) determine the effects of participation in the
class on measures of intent to engage and actual engagement in more intensive physical health
programs.

Project Methods: In order to inform a future full scale study, we will complete the
development of a 12-week manualized GMGW class, assess its acceptability, feasibility and
time burden, and evaluate effects of the intervention on key outcome measures. To achieve the
aims of the study, we will randomly assign 30 participants to either GMGW or an attention
control condition. Participants will complete baseline measures investigating behavioral
activation, self-efficacy, physical activity, physical and emotional health, mood, and intent
to engage in health promotion activities before beginning the class. These measures will be
repeated at the end of the 12-week class, along with questions investigating the
acceptability of the interventions. A chart review will investigate actual engagement in
health promotion interventions. We will be looking for the emergence of trends for
differences in expected directions and response patterns within and between groups that will
inform us about effect sizes for the measures and permit a power analysis for the full scale
trial. We plan to use repeated measures analysis of variance, controlling for any variables
that differ significantly between the intervention and control groups, to test the hypothesis
that GMGW participants will have greater improvements on the measures at the end of the
12-week intervention than the control participants. Finally, we will also compare the number
of participants who have evidence of participation in new health promotion activities in
their medical record using a chi-square test of equal proportions.

Inclusion Criteria:

- To be considered for participation, potential participants must be Veterans at the
Central Arkansas Veterans Healthcare System.

- They must express an interest in improving their physical health but not be referred
to MOVE! at the time of enrollment in the study;

- not have attended more than six class sessions of GMGW in the past; agree to be
randomized to one of two treatment groups (GMGW or control health promotion
class);

- be between the ages of 18 and 65; speak and understand English;

- and be able to increase walking and light to moderate physical activity as
indicated by a progress note by their primary care provider.

- Participants must meet PRRC admission criteria for serious mental illness (primary
diagnosis of psychotic disorders,

- bipolar disorder, major depression and/or severe PTSD) and

- dysfunction (Global Assessment of Functioning (GAF) score of 50 or less); this
will be assessed though a review of the Veteran's CPRS electronic record.

Exclusion Criteria:

- We will exclude Veterans who have been found to be legally incompetent or have a legal
guardian of person.