Chronic Disease, Mental Illness
Conditions
Keywords
integrated health, mental health, illness management, cardiovascular disease, physical health
Brief summary
The study will enroll 600 people with serious mental illness who receive services at Centerstone in KY or TN and will compare two different evidence-based self-management interventions: Integrated Illness Management and Recovery (I-IMR), a program developed by the study team at Dartmouth that trains people with serious mental illness on physical and mental health self-management, and the Stanford Chronic Disease Self-Management Program (CDSMP), a program largely focused on physical health self-management that has been used widely in the general population.
Detailed description
The proposed study will be the first to compare two commonly used but substantially different, evidence-based self-management interventions. Integrated Illness Management and Recovery (I-IMR), is an individually-tailored, 16-session, integrated program combining both physical and mental health self-management specifically developed for people with SMI. In contrast, the Stanford Chronic Disease Self-Management Program (CDSMP) is a group-based, 6-session, chronic disease self-management program largely focused on physical health self-management alone. I-IMR is delivered by community mental health providers or by community outreach workers, while CDSMP is co-delivered by two peers or by a health professional and a peer. Both programs have been widely recommended, disseminated, and used. The proposed parent study will randomize people with serious mental illness to I-IMR (n=300) and CDSMP (n=300).
Interventions
Education and skills training groups on illness management of chronic medical and psychiatric illness.
BEHAVIORALChronic Disease Self-Management Program
Education and skills training groups on illness management of chronic conditions
Sponsors
Dartmouth-Hitchcock Medical Center
Patient-Centered Outcomes Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Serious Mental Illness (diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or chronic depression with moderate impairment in functioning) receiving services at Centerstone(KY and TN) * Diagnosis of a chronic medical condition increasing risk of early mortality from cardiovascular or respiratory disease (e.g., diabetes, hyperlipidemia, hypertension, COPD, heart failure, tobacco dependence, obesity), and at least 1 ER visit or hospitalization within the past year or judgment by the treatment team of substantial need for illness self-management training.
Exclusion criteria
* Consumers who do not speak English * Consumers with either no, or a well-controlled medical condition will not be included * Individuals residing in a nursing home or other institution * Evidence of significant cognitive impairment as indicated by a Mini Mental Status Examination score \<24, will be excluded Eligibility for the COVID -related substudy is dependent on enrollment and participation in the parent project.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Knowledge and skills in illness self-management using the Illness Management and Recovery Scale | Change from Baseline to 12 months | Change in knowledge and skills for illness self-management. Range of scores from 15-75 with higher scores meaning better illness self-management. |
| Change in Patient Activation on the Patient Activation Measure (PAM) | Change from Baseline to 12 months | Change in Patient Activation (engagement in health care). Maximum score of 100, higher scores meaning greater activation. |
| Change in Acute Hospital Events from Electronic Medical Record Review. | Change from Baseline to 12 months | Change in the number of acute hospital events. At each assessment a combination of participant report and verified information from mental health clinics will be used to validate the number acute hospital events. |
| Knowledge and Behaviors for Preventing Catching and Spreading COVID-19 Scale | Change from Baseline to 12 weeks | Change in score on this measure, which was developed as part of the study plan because no suitable scale existed to assess knowledge and safety behaviors for COVID-19. Scores range from 0-100%, with higher scores indicating greater knowledge and enactment of safety behaviors. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORSarah Pratt
Dartmouth-Hitchcock Medical Center
Outcome results
None listed