A System for Preference Assessment in Mental Health
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss, Obesity Weight Loss, Schizophrenia, Psychiatric, Psychiatric |
| Therapuetic Areas: | Endocrinology, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/8/2017 |
| Start Date: | June 16, 2014 |
| End Date: | October 31, 2017 |
Implementing Patient-Centered Decision Support for Mental Health
It is important that individuals with serious mental illness make informed choices among
alternative healthcare treatments based on their preferences. However, at present,
individuals' preferences are often not being elicited, nor used to guide which treatments are
made available. In this pilot project, the investigators implement and evaluate a
computerized method for assessing treatment preferences of individuals with schizophrenia.
The investigators use weight management treatments for this initial test of the system. If
this assessment method is found to predict treatment use and satisfaction, it can be used to
guide implementation of treatments that improve outcomes while meeting individuals'
preferences.
alternative healthcare treatments based on their preferences. However, at present,
individuals' preferences are often not being elicited, nor used to guide which treatments are
made available. In this pilot project, the investigators implement and evaluate a
computerized method for assessing treatment preferences of individuals with schizophrenia.
The investigators use weight management treatments for this initial test of the system. If
this assessment method is found to predict treatment use and satisfaction, it can be used to
guide implementation of treatments that improve outcomes while meeting individuals'
preferences.
Background/Rationale: It is important that individuals with serious mental illness have
access to treatments that meet their preferences, and that they make informed choices among
alternative treatments. Too often, preferences are not being routinely elicited, nor used to
guide which treatments are made available. Schizophrenia is a serious mental illness that is
common and produces substantial disability when poorly treated. National treatment guidelines
specify that individuals with schizophrenia should receive evidence-based treatments that
improve outcomes. For example, obesity is a pressing problem in this population, a
side-effect of commonly used medications, and a cause of cardiovascular disease and premature
mortality. There are multiple, different psychosocial interventions for weight management
that can lead to reduced weight. None are widely used. If individuals' preferences were
routinely assessed, then clinicians and managers would know when to make alternative
treatments available.
Objectives: This project implements and evaluates a method for routinely assessing the
treatment preferences of individuals with schizophrenia. The objectives are to: 1) develop a
computerized, kiosk-based system that delivers education regarding treatment options for
weight, uses conjoint analysis to elicit preferences, and meets the cognitive needs of
individuals with schizophrenia; 2) study the feasibility and acceptability of implementing
this method at a mental health clinic; and, 3) evaluate the extent to which this method
predicts use of evidence-based weight services, and satisfaction with services at three
months.
Methods: This is a prospective evaluation of preferences, treatment use, and satisfaction in
individuals with schizophrenia. 94 individuals are enrolled who are overweight and receiving
treatment at a busy, urban mental health clinic. These participants use a kiosk system that
provides them with education about treatment options, and assesses their preferences
regarding alternative treatments for weight. They are then offered a weekly, intensive,
evidence-based psychosocial treatment for weight. Research assessments occur at baseline and
3 months. Treatment preferences are analyzed to determine how they relate to use of weight
treatment, and satisfaction with treatment.
Significance: People with serious mental illness could benefit from access to effective
treatments. Implementing these treatments would be facilitated by routinely collecting
information regarding individuals' preferences. If the assessment method in this study is
found to be feasible, acceptable, and accurate, it could be used to support implementation of
improved care at clinics, medical centers, and community-based programs.
access to treatments that meet their preferences, and that they make informed choices among
alternative treatments. Too often, preferences are not being routinely elicited, nor used to
guide which treatments are made available. Schizophrenia is a serious mental illness that is
common and produces substantial disability when poorly treated. National treatment guidelines
specify that individuals with schizophrenia should receive evidence-based treatments that
improve outcomes. For example, obesity is a pressing problem in this population, a
side-effect of commonly used medications, and a cause of cardiovascular disease and premature
mortality. There are multiple, different psychosocial interventions for weight management
that can lead to reduced weight. None are widely used. If individuals' preferences were
routinely assessed, then clinicians and managers would know when to make alternative
treatments available.
Objectives: This project implements and evaluates a method for routinely assessing the
treatment preferences of individuals with schizophrenia. The objectives are to: 1) develop a
computerized, kiosk-based system that delivers education regarding treatment options for
weight, uses conjoint analysis to elicit preferences, and meets the cognitive needs of
individuals with schizophrenia; 2) study the feasibility and acceptability of implementing
this method at a mental health clinic; and, 3) evaluate the extent to which this method
predicts use of evidence-based weight services, and satisfaction with services at three
months.
Methods: This is a prospective evaluation of preferences, treatment use, and satisfaction in
individuals with schizophrenia. 94 individuals are enrolled who are overweight and receiving
treatment at a busy, urban mental health clinic. These participants use a kiosk system that
provides them with education about treatment options, and assesses their preferences
regarding alternative treatments for weight. They are then offered a weekly, intensive,
evidence-based psychosocial treatment for weight. Research assessments occur at baseline and
3 months. Treatment preferences are analyzed to determine how they relate to use of weight
treatment, and satisfaction with treatment.
Significance: People with serious mental illness could benefit from access to effective
treatments. Implementing these treatments would be facilitated by routinely collecting
information regarding individuals' preferences. If the assessment method in this study is
found to be feasible, acceptable, and accurate, it could be used to support implementation of
improved care at clinics, medical centers, and community-based programs.
Inclusion Criteria:
1. diagnosis of schizophrenia
2. age 18 or older
3. Body Mass Index (BMI) of either 28.0-29.9 and gained 10 pounds in the last 3 months;
OR, BMI of 30 or above
4. able to provide informed consent
Exclusion Criteria:
1. a medical condition for which a weight program is contraindicated
2. pregnant and nursing mothers
3. attendance at a psychosocial intervention for weight management in the past month
4. individuals with legal conservators who manage informed consent
5. can not speak English
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