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

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 Effectiv...

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Bibliographic Details
Published in:	Obesity science & practice 2023-12, Vol.9 (6), p.618-630
Main Authors:	Gudzune, Kimberly A., Jerome, Gerald J., Dalcin, Arlene T., Gao, Ruiyi, Mace, Elizabeth, Fink, Tyler, Minahan, Eva, Yuan, Christina, Xie, Anping, Goldsholl, Stacy, Gennusa, Joseph V., Daumit, Gail L.
Format:	Article
Language:	eng
Subjects:	Adaptation Behavior modification Body weight loss Clinical trials community mental health centers Curricula Executive function Exercise Food security Health behavior implementation science Intervention Lifestyles Mental disorders Mortality Obesity Original Patient safety Physical fitness Rehabilitation Schizophrenia Systems engineering Weight control weight reduction programs
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Summary:	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. This study is an example of an application of the pre‐conditions phase of the Enhanced Replicating Effective Programs (REP) Framework, specifically within the community mental health setting. We used the Systems Engineering Initiative for Patient Safety (SEIPS) Model to leverage experience from the original trial team members to identify implementation barriers and solutions that were then integrated in a preliminary strategy for adapting the evidence‐based practice. We describe implementation challenges unique to the community mental health setting and identify solutions to these challenges by engaging participants with serious mental illness and m
ISSN:	2055-2238 2055-2238