Date Presented 04/20/2023
The purpose of this randomized controlled trial (RCT) was to examine the efficacy of the Nutrition and Exercise for Wellness and Recovery (NEW-R) Intervention in improving competency and behaviors related to weight management for individuals with psychiatric disabilities. The intervention group improved more than the control group on healthy lifestyle behaviors and perceived competence. Participants at only some of the sites had significant weight loss, suggesting a supportive setting is important when providing the intervention.
Primary Author and Speaker: Catana Brown
Contributing Authors: Judith A. Cook, Jessica A. Jonikas, Pamela J. Steigman, Jane K. Burke-Miller
PURPOSE: Adults with psychiatric disabilities have high rates of obesity due to multiple factors including poverty, lack of exercise, poor diets and side effects of psychotropic medicine (Compton et al, 2006; Martland et al, 2021, & Hirsch et al, 2017). The purpose of this study was to examine the efficacy of the NEW-R Intervention for improving competency and behaviors related to weight management.
DESIGN: Randomized Controlled trial. Participants with psychiatric disability were recruited from four community mental health agencies and a hospital-based psychiatric outpatient clinic and randomly assigned to receive the NEW-R intervention (N = 55) or a treatment as usual control condition (N = 58).
METHOD: NEW-R participants received the intervention once a week for eight weeks. The two groups were compared on the following outcome measures: Perceived Competence Scale, Health-Promoting Lifestyle Profile (HPLP), and weight management using random effects regression models. A follow-up analysis examined the interaction of group, time, and site.
RESULTS: The two groups did not differ significantly on any measured baseline characteristic. The intervention group had statistically significant improvements greater than the control group on Perceived Competence for Exercise and Healthy Living, Overall Score on HPLP, and the Nutrition and Spirituality Subscales of the HPLP. There was no difference between the groups in terms of weight management. However, when only responder sites (3 of the 5 sites in which participants lost weight) were included in the analysis there was a significant difference in weight loss in the intervention compared to the control condition.
CONCLUSIONS AND IMPACT STATEMENT: NEW-R offers promise as an intervention that can initiate changes in healthy lifestyle behaviors and perceived competence towards making these changes. NEW-R may also be effective for weight loss when administered in a supportive setting.
References
Compton, M.T., Daumit, G.L., & Druss, B.G. (2006). Cigarette smoking and overweight/obesity among individuals with serious mental illnesses. Harvard Review of Psychiatry, 14, 212-222. https://doi.org/10.1080/10673220600889256
Martland, R., Teasdale, S., Murray, R. M., Gardner-Sood, P., Smith, S., Ismail, K., Atakan, Z., Greenwood, K., Stubbs, B., & Gaughran, F. (2021). Dietary intake, physical activity and sedentary behaviour patterns in a sample with established psychosis and associations with mental health symptomatology. Psychological Medicine, 1–11. https://doi.org/10.1017/S0033291721003147
Hirsch, L., Yang, J., Bresee, L., Jette, N., Patten, S., & Pringsheim, T. (2017). Second-generation antipsychotics and metabolic side effects: A systematic review of population-based studies. Drug Safety, 40, 771–781. https://doi.org/10.1007/s40264-017-0543-0
