Changing the obesogenic environment of severe mentally ill residential patients: ELIPS, a cluster randomised study design

BMC Psychiatry

Eva Corpeleijn²  Ronald P Stolk²  Richard Bruggeman¹  Robert A Schoevers¹  Frederike Jörg³  Anne Looijmans² 

[1] Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;Department of Epidemiology, University of Groningen, University Medical Center Groningen, FA 40, PO box 30.001, Groningen, 9700 RB, The Netherlands;Research Department, Friesland Mental Health Services, Leeuwarden, The Netherlands

关键词: Pragmatic trial;    Physical activity;    Diet;    Obesogenic environment;    Cardiometabolic health;    Residential patients;    Severe mental illness;   

Others  :  1092128
DOI  :  10.1186/s12888-014-0293-9

 received in 2014-09-17, accepted in 2014-10-13,  发布年份 2014

【 摘 要 】

Background

Severe mentally ill (SMI) patients have a reduced life expectancy of 13–30 years compared to the general population, largely due to an increased risk of cardiovascular mortality. Unhealthy lifestyle behaviours in SMI patients contribute to this increased risk. The obesogenic living environment of patients in residential facilities may even pose an extra risk. Although several studies have shown positive effects of lifestyle interventions on SMI patients’ weight status, studies including residential patients and their obesogenic environment are scarce. This paper describes the Effectiveness of Lifestyle Interventions in PSychiatry trial (ELIPS). The goal of this trial is to improve cardiometabolic health in severe mentally ill residential patients by addressing the obesogenic environment.

Methods/design

The ELIPS study is a multi-site cluster randomised controlled trial (RCT) based on the principles of a pragmatic RCT. All residential and long-term clinical care teams of two large mental health care organisations in the North of the Netherlands serving SMI patients are invited to participate. The intervention is aimed at team level. Lifestyle coaches first develop a team specific lifestyle plan that tailors the ELIPS goals and protocol and then train teams on how to create a healthy environment and stimulate healthy behaviours in patients. After three months, teams take over the intervention after they have set out goals to achieve in the following nine months. In this phase, adherence to the lifestyle plan and pre-set goals is monitored. Patients in the control arm receive care as usual. Primary outcome measure is waist circumference at three and 12 months after baseline.

Discussion

ELIPS is different from previously published lifestyle intervention studies in three ways. First, it follows the principles of a pragmatic design, which enables the examination of effects in everyday practice. Second, by implementing the intervention at team level, we expect lifestyle activities to be maintained when interventionists leave. Last, by targeting the obesogenic environment we create a prerequisite for any sustainable health improvement, as patients can only make healthy choices in a healthy living environment.

Trial registration

Nederlands Trialregister NTR2720 webcite (Dutch Trial Register, www.trialregister.nl webcite). Registered 27 January 2011.

【 授权许可】

   
2014 Looijmans et al.; licensee BioMed Central Ltd.

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