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Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale

People with serious mental illnesses (SMIs) die 10–20 years earlier than the general population, mainly due to cardiovascular disease. Obesity is a key driver of cardiovascular risk in this group. Because behavioral weight loss interventions tailored to the needs of people with SMI have been shown t...

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Autores principales: McGinty, Emma E., Gudzune, Kimberly A., Dalcin, Arlene, Jerome, Gerald J, Dickerson, Faith, Gennusa, Joseph, Goldsholl, Stacy, Young, Deborah, Daumit, Gail L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256009/
https://www.ncbi.nlm.nih.gov/pubmed/30515109
http://dx.doi.org/10.3389/fpsyt.2018.00604
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author McGinty, Emma E.
Gudzune, Kimberly A.
Dalcin, Arlene
Jerome, Gerald J
Dickerson, Faith
Gennusa, Joseph
Goldsholl, Stacy
Young, Deborah
Daumit, Gail L.
author_facet McGinty, Emma E.
Gudzune, Kimberly A.
Dalcin, Arlene
Jerome, Gerald J
Dickerson, Faith
Gennusa, Joseph
Goldsholl, Stacy
Young, Deborah
Daumit, Gail L.
author_sort McGinty, Emma E.
collection PubMed
description People with serious mental illnesses (SMIs) die 10–20 years earlier than the general population, mainly due to cardiovascular disease. Obesity is a key driver of cardiovascular risk in this group. Because behavioral weight loss interventions tailored to the needs of people with SMI have been shown to lead to clinically significant weight loss, achieving widespread implementation of these interventions is a public health priority. In this Perspective, we consider strategies for scaling the ACHIEVE behavioral weight loss intervention for people with SMI, shown to be effective in a randomized clinical trial (RCT), to mental health programs in the U.S. and internationally. Given the barriers to high-fidelity implementation of the complex, multi-component ACHIEVE intervention in often under-resourced mental health programs, we posit that substantial additional work is needed to realize the full public health potential of this intervention for people with SMI. We discuss considerations for successful “scale-up,” or efforts to expand ACHIEVE to similar settings and populations as those included in the RCT, and “scale-out,” or efforts to expand the intervention to different mental health program settings/sub-populations with SMI. For both, we focus on considerations related (1) intervention adaptation and (2) implementation strategy development, highlighting four key domains of implementation strategies that we believe need to be developed and tested: staff capacity building, leadership engagement, organizational change, and policy strategies. We conclude with discussion of the types of future research needed to support ACHIEVE scale-up/out, including hybrid trial designs testing the effectiveness of intervention adaptations and/or implementations strategies.
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spelling pubmed-62560092018-12-04 Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale McGinty, Emma E. Gudzune, Kimberly A. Dalcin, Arlene Jerome, Gerald J Dickerson, Faith Gennusa, Joseph Goldsholl, Stacy Young, Deborah Daumit, Gail L. Front Psychiatry Psychiatry People with serious mental illnesses (SMIs) die 10–20 years earlier than the general population, mainly due to cardiovascular disease. Obesity is a key driver of cardiovascular risk in this group. Because behavioral weight loss interventions tailored to the needs of people with SMI have been shown to lead to clinically significant weight loss, achieving widespread implementation of these interventions is a public health priority. In this Perspective, we consider strategies for scaling the ACHIEVE behavioral weight loss intervention for people with SMI, shown to be effective in a randomized clinical trial (RCT), to mental health programs in the U.S. and internationally. Given the barriers to high-fidelity implementation of the complex, multi-component ACHIEVE intervention in often under-resourced mental health programs, we posit that substantial additional work is needed to realize the full public health potential of this intervention for people with SMI. We discuss considerations for successful “scale-up,” or efforts to expand ACHIEVE to similar settings and populations as those included in the RCT, and “scale-out,” or efforts to expand the intervention to different mental health program settings/sub-populations with SMI. For both, we focus on considerations related (1) intervention adaptation and (2) implementation strategy development, highlighting four key domains of implementation strategies that we believe need to be developed and tested: staff capacity building, leadership engagement, organizational change, and policy strategies. We conclude with discussion of the types of future research needed to support ACHIEVE scale-up/out, including hybrid trial designs testing the effectiveness of intervention adaptations and/or implementations strategies. Frontiers Media S.A. 2018-11-20 /pmc/articles/PMC6256009/ /pubmed/30515109 http://dx.doi.org/10.3389/fpsyt.2018.00604 Text en Copyright © 2018 McGinty, Gudzune, Dalcin, Jerome, Dickerson, Gennusa, Goldsholl, Young and Daumit. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
McGinty, Emma E.
Gudzune, Kimberly A.
Dalcin, Arlene
Jerome, Gerald J
Dickerson, Faith
Gennusa, Joseph
Goldsholl, Stacy
Young, Deborah
Daumit, Gail L.
Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale
title Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale
title_full Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale
title_fullStr Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale
title_full_unstemmed Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale
title_short Bringing an Effective Behavioral Weight Loss Intervention for People With Serious Mental Illness to Scale
title_sort bringing an effective behavioral weight loss intervention for people with serious mental illness to scale
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256009/
https://www.ncbi.nlm.nih.gov/pubmed/30515109
http://dx.doi.org/10.3389/fpsyt.2018.00604
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