Mental Illness, Obesity, Tobacco Dependence
Conditions
Keywords
tobacco dependence, smoking cessation, mental health, cardiovascular disease, obesity
Brief summary
The New Hampshire Medicaid Wellness Incentive Program (WIP) will address both the health disparity and increased costs by providing incentivized health promotion programs to overweight or obese and/or tobacco-smoking Medicaid beneficiaries receiving services at New Hampshire's 10 regional Community Mental Health Centers (CMHCs).
Detailed description
In the New Hampshire Medicaid Wellness Incentive Program, multiple program options will fall into two categories: (1) Supported Fitness and Weight Management and (2) Supported Smoking Cessation. Eligible participants are able to participate in 1 or both of the programs. The program options for Supported Fitness and Weight Management are: 1. Fitness Club Membership for 12 months, 2. Fitness Club Membership plus weekly meetings with a Health Mentor for 12 months (In SHAPE), 3. Weight Watchers Membership for 12 months, 4. In SHAPE plus Weight Watchers for 12 months. The options for Supported Smoking Cessation are: 1. Prescriber meeting to discuss smoking cessation treatment options, 2. Prescriber meeting plus NH State Tobacco Helpline, 3. Prescriber meeting plus Telephone-based Cognitive Behavioral Therapy for Smoking Cessation. Vouchers for memberships to community fitness centers and formal weight loss programs will be provided, as well as incentives for participation and positive outcomes. An equipoise stratified randomization design will be used to preserve the research benefits of randomization while maintaining the highly valued opportunity for consumer choice. Research assessments will be conducted at baseline, 3 months, 6 months, 9 months, and 12 months.
Interventions
BEHAVIORALNH Medicaid Incentives Program
Sponsors
State of New Hampshire Bureau of Behavioral Health
Dartmouth-Hitchcock Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
for smoking intervention and weight management intervention: * Participants must be Medicaid recipients receiving mental health treatment at one of the participating study sites in New Hampshire. * 18 years or older Additional Inclusion Criteria for smoking intervention only: \*Smoking 5 or more cigarettes a day or a carbon monoxide level of 5 or higher at screening. Additional Inclusion Criteria for weight management only: \*Body Mass Index of 30 or higher or 25 or higher and sedentary lifestyle.
Exclusion criteria
for both interventions: * Diagnosis of dementia or terminal illness (expected to result in death in 1 year or less) * Nursing home * Inability to speak or understand English Additional
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Weight | Baseline, 3 months, 6 months, 9 months, 12 months and 1 year post program follow up | Weight obtained using a scale at each assessment. |
| Change in the 6 minute walk test | Baseline, 3 months, 6 monhts, 9 months, 12 months, and 1 year post program completion follow up | Each participant walks as many ft as possible at a brisk pace. The amount of feet covered in 6 minutes is documented. |
| Change in Days of Abstinence-Timeline follow back interview for tobacco smokers | Baseline, 3 months, 6 months, 9 months, 12 months, and 1 year post program completion follow up | A timeline follow back interview is completed for the smoking cessation intervention to identify days of abstinence within the assessment period as well as amount of cigarettes smoked. |
| Change in Carbon Monoxide Level | Baseline, 3 months, 6 months, 9 months, 12 months, and 1 year post program completion follow up | At each assessment and during the incentive quit cycles, carbon monoxide level is measured to confirm smoking abstinence or not. |
Countries
United States
Outcome results
None listed