Science Department, GGz Centraal, Amersfoort, the Netherlands.
Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
BMC Psychiatry. 2024 Nov 14;24(1):804. doi: 10.1186/s12888-024-06216-x.
People with severe mental illness (SMI) face not only impaired mental health, but also a greater risk of physical comorbidities and a shorter life expectancy compared to the general population. A poor lifestyle plays a substantial role in this disparity. Combined Lifestyle Interventions targeting multiple lifestyle behaviors can improve mental and physical health, and quality of life. However, there is currently no appropriate structural support for people with SMI in outpatient care in the Netherlands. The Combined Lifestyle Intervention for Outpatients with SMI (GOAL!) is developed to address this gap. This study examines the (cost-)effectiveness and implementation of GOAL!.
In a type 1 hybrid quasi-experimental study with a mixed-method matched design, GOAL! participants (N = 50) are compared to people receiving care as usual (N = 50). The GOAL! program includes group and individual sessions, given by allied health professionals, over a period of two years. The first year starts with a 3-month intensive course on physical activity and nutrition, followed by 9 months of aftercare covering various lifestyle topics tailored to the group's needs. There is close collaboration with local stakeholders to facilitate transfer to the community setting. The second year focuses on maintaining established activities in one's daily living environment. Our primary outcome will be the change in physical activity, comparing GOAL! participants to those receiving care as usual. Secondary outcomes are changes in other lifestyle behaviors, physical health, mental well-being, and healthcare and societal costs. Additionally, achieving lifestyle-related goals, adverse effects, and barriers and facilitators to implementation are examined. Measurements are obtained at start (T0), and after 3 (T1), 12 (T2) and 24 months (T3).
This study investigates the effects of GOAL! on lifestyle behaviors, health outcomes, implementation factors and cost-effectiveness after two years, aiming to offer valuable insights into the effectiveness and implementation outcomes of lifestyle interventions for outpatients with SMI.
ClinicalTrials.gov (Identifier: NCT05600205). Prospectively registered on October 26, 2022.
与普通人群相比，患有严重精神疾病（SMI）的人群不仅面临心理健康受损，还面临更高的身体合并症风险和更短的预期寿命。不良的生活方式在这种差异中起着重要作用。针对多种生活方式行为的综合生活方式干预可以改善心理健康和身体健康以及生活质量。然而，目前荷兰在门诊护理中没有为 SMI 患者提供适当的结构性支持。针对 SMI 门诊患者的综合生活方式干预（GOAL！）旨在解决这一差距。本研究旨在评估 GOAL！的（成本）效果和实施情况。
在一项 1 型混合准实验研究中，采用混合方法匹配设计，将 GOAL！参与者（N=50）与接受常规护理的人（N=50）进行比较。GOAL！计划包括由联合健康专业人员提供的小组和个体会议，为期两年。第一年从为期 3 个月的体育活动和营养强化课程开始，随后是 9 个月的后续护理，涵盖针对小组需求的各种生活方式主题。与当地利益相关者密切合作，以促进向社区环境转移。第二年侧重于维持日常生活环境中已建立的活动。我们的主要结果将是比较 GOAL！参与者和接受常规护理的人在体育活动方面的变化。次要结果是改变其他生活方式行为、身体健康、心理健康以及医疗保健和社会成本。此外，还将研究实现与生活方式相关的目标、不良反应以及实施的障碍和促进因素。测量在开始时（T0）、3 个月（T1）、12 个月（T2）和 24 个月（T3）时进行。
本研究调查了 GOAL！对生活方式行为、健康结果、实施因素和成本效益的影响，为期两年，旨在为 SMI 门诊患者的生活方式干预的有效性和实施结果提供有价值的见解。
ClinicalTrials.gov（标识符：NCT05600205）。于 2022 年 10 月 26 日前瞻性注册。
