Need for Cardiovascular Risk Reduction in Persons With Serious Mental Illness: Design of a Comprehensive Intervention

Frontiers in Psychiatry

Rosa M. Crum¹  Emma E. McGinty²  Gerald J. Jerome³  Stacy Goldsholl⁴  Deborah R. Young⁴  Gail L. Daumit⁴  Jeanne B. Charleston⁴  Arlene T. Dalcin⁴  Lawrence J. Appel⁴  Ann Heller⁴  Edgar R. Miller⁴  Nae-Yuh Wang⁴  Joseph V. Gennusa⁴  Corinne Cather⁵  A. Eden Evins⁵  Faith B. Dickerson⁶ 

[1] Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States;Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States;Department of Kinesiology, Towson University, Baltimore, MD, United States;Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States;Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;Sheppard Pratt Health System, Baltimore, MD, United States;

关键词: serious mental disorder;    cardiovascular risk;    intervention;    care coordination;    behavioral coaching;   

DOI  :  10.3389/fpsyt.2018.00786

来源: DOAJ

【 摘 要 】

Persons with serious mental illness (SMI) comprise a high-risk group for cardiovascular disease (CVD)-related mortality with rates at least twice those of the overall US. Potentially modifiable CVD risk behaviors (tobacco smoking, obesity, physical inactivity, unhealthy diet) and risk factors (hypertension, diabetes, dyslipidemia) are all markedly elevated in persons with SMI. Evaluations of programs implementing integrated medical care into specialty mental health settings have not shown meaningful effects on CVD risk factor reduction. Rigorously tested, innovative interventions are needed to address the large burden of CVD risk in populations with SMI. In this article, we describe the design of a comprehensive 18-month intervention to decrease CVD risk that we are studying in a randomized clinical trial in a community mental health organization with psychiatric rehabilitation programs. The individual-level intervention incorporated health behavior coaching and care coordination/care management to address all seven CVD risk behaviors and risk factors, and is delivered by a health coach and nurse. If successful, the intervention could be adopted within current integrated care models and significantly improve the physical health of persons with SMI.

【 授权许可】

Unknown