Department of Psychiatry (Aschbrenner, Wolfe) and Department of Biomedical Data Science (Xie), Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Global Health and Social Medicine, Harvard Medical School, Boston (Naslund); Department of Psychology, University of Connecticut, Storrs (Gorin); Departments of Occupational Therapy and Psychological and Brain Sciences, Center for Psychiatric Rehabilitation, Boston University, Boston (Mueser); Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina (Browne); Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston (Bartels).
Psychiatr Serv. 2022 Feb 1;73(2):141-148. doi: 10.1176/appi.ps.202100047. Epub 2021 Jun 30.
Evidence-based lifestyle interventions tailored to young adults with serious mental illness are needed to reduce their cardiometabolic risk. This study evaluated the effectiveness of a group lifestyle intervention ("PeerFIT") enhanced with mobile health (mHealth) compared with one-on-one mHealth coaching (basic education supported by activity tracking [BEAT]) for young adults with serious mental illness who were overweight or obese.
Participants were young adults ages 18-35 years with serious mental illness and a body mass index ≥25 kg/m, who were randomly assigned to PeerFIT or BEAT. Research staff collected data at baseline and at 6 and 12 months. Main outcomes were clinically significant changes from baseline in weight (≥5% weight loss), cardiorespiratory fitness (CRF; increase of >50 m on the 6-minute walk test), and cardiovascular disease (CVD) risk reduction (clinically significant weight loss or CRF improvement).
Participants were 150 young adults with a mean ± SD body mass index of 37.1±7.4. Intent-to-treat analyses revealed no significant between-group difference for weight-loss, CRF, or CVD outcomes at 6 and 12 months. Participants in both conditions achieved clinically significant CVD risk reduction, weight loss, and CRF from baseline to 6 and 12 months, and all these improvements were statistically significant (p<0.01).
The PeerFIT group lifestyle intervention was not superior to one-on-one mHealth coaching in achieving clinically significant changes in weight, CRF, and CVD risk reduction. Although both interventions improved outcomes, low-intensity mHealth coaching may be a more scalable approach for addressing modifiable cardiometabolic risk factors among young adults with serious mental illness.
需要针对患有严重精神疾病的年轻人制定基于证据的生活方式干预措施，以降低其心血管代谢风险。本研究评估了群体生活方式干预（“PeerFIT”）与一对一移动健康（mHealth）辅导（通过活动追踪支持的基础教育[BEAT]）对超重或肥胖的患有严重精神疾病的年轻人的有效性。
参与者为年龄在 18-35 岁之间、患有严重精神疾病且体重指数（BMI）≥25kg/m 的成年人，他们被随机分配到 PeerFIT 或 BEAT 组。研究人员在基线和 6 个月及 12 个月时收集数据。主要结局是从基线开始体重（≥5%的体重减轻）、心肺功能（CRF；6 分钟步行试验增加>50m）和心血管疾病（CVD）风险降低（体重显著减轻或 CRF 改善）的临床显著变化。
共有 150 名参与者，平均（±SD）BMI 为 37.1±7.4。意向性治疗分析显示，在 6 个月和 12 个月时，体重减轻、CRF 或 CVD 结局在两组之间没有显著差异。两组参与者均从基线到 6 个月和 12 个月实现了临床显著的 CVD 风险降低、体重减轻和 CRF 改善，所有这些改善均具有统计学意义（p<0.01）。
PeerFIT 群体生活方式干预在实现体重、CRF 和 CVD 风险降低的临床显著变化方面并不优于一对一 mHealth 辅导。尽管两种干预措施都改善了结果，但低强度的 mHealth 辅导可能是针对患有严重精神疾病的年轻人可改变的心血管代谢危险因素的更具可扩展性的方法。
