Healthy choices, healthy changes: A randomized trial of incentives to promote healthy eating and exercise in people with schizophrenia and other serious mental illnesses.

Autor: Pratt SI; Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America. Electronic address: sarah.i.pratt@dartmouth.edu., Ferron JC; Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America., Wolfe R; Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America., Xie H; Department of Biomedical Data Sciences, The Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America., Brunette M; Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America., Santos M; Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America., Williams G; Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Hanover, NH, United States of America., Bartels S; Department of Medicine, Massachusetts General Hospital, Mongan Institute, Harvard University, Boston, MA, United States of America., Jue K; Ken Jue Consulting, Keene, NH, United States of America., Capuchino K; New Hampshire Department of Health and Human Services, Division of Behavioral Health, Concord, NH, United States of America.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2023 May; Vol. 255, pp. 1-8. Date of Electronic Publication: 2023 Mar 16.
DOI: 10.1016/j.schres.2023.03.007
Abstrakt: Introduction: People with schizophrenia and other serious mental illnesses (SMI) represent a concerning health disparity population, with 10-30 fewer years of life compared to the general population, mainly from high rates of cardiovascular disease (CVD). Preventing CVD is possible with exercise and diet interventions, but only 50 % of participants in clinical trials achieve reduction in CVD risk. This study assessed whether cash incentives improved weight loss, cardiovascular endurance, and/or mortality risk when added to one of four healthy lifestyle programs (gym membership, Weight Watchers membership, the InSHAPE program, InSHAPE + Weight Watchers).
Methods: From 2012 to 2015, 1348 overweight or obese adults with SMI enrolled in a study using equipoise stratified randomization. Participants were randomly assigned to intervention, then to cash incentives, or not, for participation (gym and/or Weight Watchers), with baseline and quarterly assessments for 12 months. We examined effects of the interventions, key covariates, and incentives, using generalized linear models.
Results: Main effects of randomization to receive cash incentives was not significant for any outcome; whereas total amount of incentives was significantly associated with all three primary outcomes (weight loss, cardiovascular endurance, mortality risk), mainly for participants in the InSHAPE+WW group who received additional cash incentives.
Conclusions: Incentives may be effective at preventing CVD and improving health outcomes for people with SMI, especially in the context of intensive support for healthy lifestyle behaviors. Policy changes are required to increase access to healthy lifestyle programming and more research is needed to establish the optimal amount of incentives for people with SMI.
Trial Registration: ClinicalTrials.gov identifier: NCT02515981.
Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest to report.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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