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Stettaford T, Fehily C, Campbell E, Barker D, Oldmeadow C, McKeon E, Love S, Lawn S, Castle D, Bowman J. Risk prevalence, readiness and confidence to change lifestyle risk factors among clients of community mental health services. Aust N Z J Psychiatry 2024; 58:702-712. [PMID: 38845145 PMCID: PMC11308284 DOI: 10.1177/00048674241257751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
OBJECTIVE People with mental health conditions have high rates of chronic physical diseases, partially attributable to lifestyle risks factors. This study examined risk prevalence among community mental health service clients, their readiness and confidence to change, and associations with participant characteristics. METHODS Cross-sectional survey of adult clients from 12 community mental health services across 3 local health districts in New South Wales, Australia, collected from 2021 to 2022. Participants (n = 486) completed a telephone interview determining five risk factors, and readiness and confidence to change these. Multiple binary logistic regression models determined associations between readiness and confidence (for each risk), and participant characteristics (demographics and diagnosis). RESULTS Participants most commonly reported a diagnosis of schizophrenia (36.7%) or depression (21.1%). Risk factors were prevalent: ranging from 26% (harmful alcohol use) to 97% (poor nutrition). High readiness was greatest for smoking (68%), weight (66%) and physical inactivity (63%), while confidence was highest for changing alcohol use (67%). Two significant associations were identified; females were more likely than males to have high readiness to change nutrition (odds ratio = 1.14, confidence interval = [1.13, 2.34], p = 0.0092), with males more likely to have high confidence to change physical activity (odds ratio = 0.91, confidence interval = [0.45, 0.99], p = 0.0109). CONCLUSIONS Many participants were ready and confident to change risk factors. Gender influenced readiness to change nutrition and physical activity confidence. Training to upskill mental health clinicians in provision of preventive care that builds confidence and readiness levels may aid in supporting positive behaviour change.
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Affiliation(s)
- Tegan Stettaford
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Caitlin Fehily
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- Hunter New England Population Health, Wallsend, NSW, Australia
| | - Elizabeth Campbell
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter New England Population Health, Wallsend, NSW, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
| | - Emma McKeon
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
| | - Sophie Love
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Sharon Lawn
- Lived Experience Australia, Brighton, SA, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - David Castle
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
- Tasmanian Centre for Mental Health Service Innovation, Hobart, TAS, Australia
| | - Jennifer Bowman
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
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Sawyer C, Hassan L, Sainsbury J, Carney R, Bucci S, Burgess H, Lovell K, Torous J, Firth J. Using digital technology to promote physical health in mental healthcare: A sequential mixed-methods study of clinicians' views. Early Interv Psychiatry 2024; 18:140-152. [PMID: 37318221 DOI: 10.1111/eip.13441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/02/2023] [Accepted: 05/05/2023] [Indexed: 06/16/2023]
Abstract
AIM Recent years have seen innovation in 'mHealth' tools and health apps for the management/promotion of physical health and fitness across the general population. However, there is limited research on how this could be applied to mental healthcare. Therefore, we examined mental healthcare professionals' current uses and perceived roles of digital lifestyle interventions for promoting healthy lifestyles, physical health and fitness in youth mental healthcare. METHODS A sequential, mixed-methods design was used, consisting of a quantitative online survey, followed by qualitative in-depth interviews. RESULTS A total of 127 mental healthcare professionals participated in the online survey. Participants had limited mHealth experience, and the majority agreed that further training would be beneficial. Thirteen mental healthcare professionals were interviewed. Five themes were generated (i) digital technology's ability to enhance the physical healthcare; (ii) Conditions for the acceptability of apps; (iii) Limitations on staff capability and time; (iv) Motivation as the principal barrier; and (v) Practicalities around receiving lifestyle data. Systematic integration of data produced novel insights around: (i) staff involvement and needs; (ii) ideal focus and content of digital lifestyle interventions; and (iii) barriers towards implementation (including mental healthcare professionals own limited experience using digital lifestyle interventions, which aligned with the appeal of formal training). CONCLUSIONS Overall, digital lifestyle interventions were positively received by mental healthcare professionals, particularly for health behaviour-tracking and mHealth support for exercise and nutrition. Practical suggestions for facilitating their uptake/implementation to improve availability of physical health interventions in mental healthcare are presented.
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Affiliation(s)
- Chelsea Sawyer
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Lamiece Hassan
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - John Sainsbury
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Rebekah Carney
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Harriet Burgess
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - John Torous
- Beth Israel Deaconness Medical Centre, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph Firth
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Regan C, Bartlem K, Fehily C, Campbell E, Lecathelinais C, Doherty E, Wolfenden L, Clancy R, Fogarty M, Conrad A, Bowman J. Evaluation of an implementation support package to increase community mental health clinicians' routine delivery of preventive care for multiple health behaviours: a non-randomised controlled trial. Implement Sci Commun 2023; 4:137. [PMID: 37957727 PMCID: PMC10644601 DOI: 10.1186/s43058-023-00509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 10/04/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND People with a mental health condition are more likely to engage in risk behaviours compared to people without. Delivery of preventive care to improve such behaviours is recommended for community mental health services, but inadequately implemented. This study assessed the effectiveness of an implementation support package on clinicians' delivery of preventive care (assessment, advice, referral) for four risk behaviours (tobacco smoking, harmful alcohol consumption, physical inactivity, inadequate fruit and vegetable intake) compared to no implementation support. The participatory approach to developing the support package, and fidelity of the implementation strategies, are also described. METHODS A non-randomised controlled trial was undertaken in 2019-2020 with two community mental health services (control and target) in one health district in New South Wales, Australia. A 4-month support package consisting of multiple implementation strategies was delivered to one site following a two-phase participatory design process. Five implementation strategies were proposed to service managers by researchers. After consultation with managers and clinicians, the final implementation support package included four strategies: training and education materials, enabling resources and prompts, client activation material, and audit and feedback. Client-reported receipt of the three elements of preventive care for the four risk behaviours was collected from a cross-sectional sample of clients who had recently attended the service at baseline (6 months) and follow-up (5 months). Logistic regression models examined change in receipt of preventive care to assess effectiveness. RESULTS A total of 860 client surveys were completed (control baseline n = 168; target baseline n = 261; control follow-up n = 164; and target follow-up n = 267). Analyses revealed no significant differential changes in preventive care receipt between the target and control sites from baseline to follow-up, including across the four primary outcomes: assessed for all behaviours (OR = 1.19; 95% CI 0.55, 2.57; p = 0.65); advised for all relevant risk behaviours (OR = 1.18; 95% CI 0.39, 3.61; p = 0.77); referred for any relevant risk behaviour (OR = 0.80; 95% CI 0.40, 1.63; p = 0.55); and complete care (OR = 3.11; 95% CI 0.62, 15.63; p = 0.17). Fidelity of the implementation strategies was limited as one of the four strategies (audit and feedback) was not delivered, components of two strategies (enabling resources and prompts, and client activation material) were not delivered as intended, and one strategy (education and training) was delivered as intended although some components were offered late in the implementation period. CONCLUSIONS The implementation support package was ineffective at increasing preventive care delivery. Further investigation is required to determine optimal participatory design methods to develop effective implementation strategies, including those that support delivery of care in community mental health settings within the ongoing context of uncertain environmental challenges. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12619001379101.
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Affiliation(s)
- Casey Regan
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia.
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
| | - Kate Bartlem
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Caitlin Fehily
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Elizabeth Campbell
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | | | - Emma Doherty
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Richard Clancy
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Mental Health Services, Po Box 833, Newcastle, NSW, 2300, Australia
| | - Marcia Fogarty
- Hunter New England Mental Health Services, Po Box 833, Newcastle, NSW, 2300, Australia
- Central Adelaide Local Health Network, PO Box 17, Fullarton, SA, 5063, Australia
| | - Agatha Conrad
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Mental Health Services, Po Box 833, Newcastle, NSW, 2300, Australia
| | - Jenny Bowman
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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Sawyer C, McKeon G, Hassan L, Onyweaka H, Martinez Agulleiro L, Guinart D, Torous J, Firth J. Digital health behaviour change interventions in severe mental illness: a systematic review. Psychol Med 2023; 53:6965-7005. [PMID: 37759417 PMCID: PMC10719689 DOI: 10.1017/s0033291723002064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 09/29/2023]
Abstract
The use of digital technologies as a method of delivering health behaviour change (HBC) interventions is rapidly increasing across the general population. However, the role in severe mental illness (SMI) remains overlooked. In this study, we aimed to systematically identify and evaluate all of the existing evidence around digital HBC interventions in people with an SMI. A systematic search of online electronic databases was conducted. Data on adherence, feasibility, and outcomes of studies on digital HBC interventions in SMI were extracted. Our combined search identified 2196 titles and abstracts, of which 1934 remained after removing duplicates. Full-text screening was performed for 107 articles, leaving 36 studies to be included. From these, 14 focused on physical activity and/or cardio-metabolic health, 19 focused on smoking cessation, and three concerned other health behaviours. The outcomes measured varied considerably across studies. Although over 90% of studies measuring behavioural changes reported positive changes in behaviour/attitudes, there were too few studies collecting data on mental health to determine effects on psychiatric outcomes. Digital HBC interventions are acceptable to people with an SMI, and could present a promising option for addressing behavioural health in these populations. Feedback indicated that additional human support may be useful for promoting adherence/engagement, and the content of such interventions may benefit from more tailoring to specific needs. While the literature does not yet allow for conclusions regarding efficacy for mental health, the available evidence to date does support their potential to change behaviour across various domains.
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Affiliation(s)
- Chelsea Sawyer
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - Grace McKeon
- School of Population Health, University of New South Wales, Randwick, NSW 2052, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW 2052, Australia
| | - Lamiece Hassan
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - Henry Onyweaka
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General/Mclean Hospital, Boston, MA, USA
| | - Luis Martinez Agulleiro
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Daniel Guinart
- Hospital del Mar Research Institute, Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain
- Department of Psychiatry, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA
| | - John Torous
- Department of Psychiatry, Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Zucker School of Medicine at Northwell/Hofstra, New York, NY, USA
- Department of Psychiatry, Beth Israel Deaconess Hospital, Boston, MA, USA
| | - Joseph Firth
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
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Plever S, Kisely S, Bonevski B, McCarthy I, Emmerson B, Ballard E, Anzolin M, Siskind D, Allan J, Gartner C. Can improvement in delivery of smoking cessation care be sustained in psychiatry inpatient settings through a system change intervention? An analysis of statewide administrative health data. Aust N Z J Psychiatry 2023; 57:1375-1383. [PMID: 37038343 DOI: 10.1177/00048674231164566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE This study evaluated maintenance of improved delivery of smoking cessation assistance in adult acute psychiatry inpatient units 3 years post statewide implementation of a system change intervention through analysis of a statewide administrative health dataset. METHOD Rates of documenting smoking status and providing a brief smoking cessation intervention (the Smoking Cessation Clinical Pathway) in all eligible Queensland public adult acute psychiatry inpatient units (N = 57) during the implementation phase (October 2015-September 2017) of a system change intervention were compared to the maintenance phase (October 2017-October 2020) using interrupted time series analysis. RESULTS Across implementation and maintenance phases, the percentage of discharges from psychiatry inpatient units that had a smoking status recorded remained high with the statewide average exceeding 90% (implementation phase 93.2%, 95% confidence interval = [92.4, 93.9]; and maintenance phase 94.6%, 95% confidence interval = [94.0, 95.2]). The percentage of discharges statewide with a completed Pathway stabilised during the maintenance phase (change in slope -3.7%, 95% confidence interval = [-5.2, -2.3]; change in level 0.4%, 95% confidence interval = [-7.0, 7.9]). CONCLUSION An evidence-based smoking cessation intervention implemented with a system change intervention resulted in sustained improvement in addressing smoking in adult inpatient psychiatry units up to 3 years post implementation.
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Affiliation(s)
- Sally Plever
- The QLD Mental Health Clinical Collaborative, Metro North Mental Health, Brisbane, QLD, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (Tobacco Endgame CRE), The University of Queensland, Brisbane, QLD, Australia
| | - Steve Kisely
- Department of Psychiatry, School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - Billie Bonevski
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (Tobacco Endgame CRE), The University of Queensland, Brisbane, QLD, Australia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Irene McCarthy
- The QLD Mental Health Clinical Collaborative, Metro North Mental Health, Brisbane, QLD, Australia
| | - Brett Emmerson
- The QLD Mental Health Clinical Collaborative, Metro North Mental Health, Brisbane, QLD, Australia
| | - Emma Ballard
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Melissa Anzolin
- The QLD Mental Health Clinical Collaborative, Metro North Mental Health, Brisbane, QLD, Australia
| | - Dan Siskind
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (Tobacco Endgame CRE), The University of Queensland, Brisbane, QLD, Australia
- Department of Psychiatry, School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - John Allan
- Mental Health Alcohol and Other Drugs Branch, Clinical Excellence Queensland, Queensland Health, Brisbane, QLD, Australia
| | - Coral Gartner
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame (Tobacco Endgame CRE), The University of Queensland, Brisbane, QLD, Australia
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Martinez Agulleiro L, Patil B, Firth J, Sawyer C, Amann BL, Fonseca F, Torrens M, Perez V, Castellanos FX, Kane JM, Guinart D. A systematic review of digital interventions for smoking cessation in patients with serious mental illness. Psychol Med 2023; 53:4856-4868. [PMID: 37161690 PMCID: PMC10476065 DOI: 10.1017/s003329172300123x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
Tobacco smoking is highly prevalent among patients with serious mental illness (SMI), with known deleterious consequences. Smoking cessation is therefore a prioritary public health challenge in SMI. In recent years, several smoking cessation digital interventions have been developed for non-clinical populations. However, their impact in patients with SMI remains uncertain. We conducted a systematic review to describe and evaluate effectiveness, acceptability, adherence, usability and safety of digital interventions for smoking cessation in patients with SMI. PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, PsychINFO and the Cochrane Tobacco Addiction Group Specialized Register were searched. Studies matching inclusion criteria were included and their information systematically extracted by independent investigators. Thirteen articles were included, which reported data on nine different digital interventions. Intervention theoretical approaches ranged from mobile contingency management to mindfulness. Outcome measures varied widely between studies. The highest abstinence rates were found for mSMART MIND (7-day point-prevalent abstinence: 16-40%). Let's Talk About Quitting Smoking reported greater acceptability ratings, although this was not evaluated with standardized measures. Regarding usability, Learn to Quit showed the highest System Usability Scale scores [mean (s.d.) 85.2 (15.5)]. Adverse events were rare and not systematically reported. Overall, the quality of the studies was fair to good. Digitally delivered health interventions for smoking cessation show promise for improving outcomes for patients with SMI, but lack of availability remains a concern. Larger trials with harmonized assessment measures are needed to generate more definitive evidence and specific recommendations.
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Affiliation(s)
- Luis Martinez Agulleiro
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Bhagyashree Patil
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, NY, USA
| | - Joseph Firth
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK, M13 9 PL
| | - Chelsea Sawyer
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK, M13 9 PL
| | - Benedikt L. Amann
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Francina Fonseca
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Marta Torrens
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
- Universitat de Vic i Central de Catalunya, Vic, Spain
| | - Victor Perez
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Francisco Xavier Castellanos
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - John M. Kane
- Department of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Daniel Guinart
- Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
- Department of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
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7
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Watkins A, Stein-Parbury J, Curtis J, Poole J, Teasdale S, Fibbins H, Rossimel E, Lederman O, Ward PB, Rosenbaum S, Denney-Wilson E. Tackling change in mental health service delivery: A qualitative evaluation of a lifestyle program targeting mental health staff - Keeping our Staff in Mind (KoSiM). Health Promot J Austr 2023; 34:237-245. [PMID: 35718992 PMCID: PMC10083901 DOI: 10.1002/hpja.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 01/30/2023] Open
Abstract
ISSUES ADDRESSED People with severe mental illness have adverse health outcomes compared to the general population. Lifestyle interventions are effective in improving health outcomes in this population. Current cultural processes in mental health services do not generally incorporate physical health care practices. Innovative education is required to improve knowledge and confidence of staff in the delivery of preventative health measures. METHODS The Keeping our Staff in Mind (KoSiM) program delivered a brief lifestyle intervention to mental health staff. A qualitative analysis following the Standards for Reporting Qualitative Research was undertaken. Semi-structured interviews designed to elicit information about the acceptability of the program and the impact of the intervention on participants' personal and professional lives. The interviews were analysed using thematic analysis, with coding independently developed and reviewed by three authors. RESULTS Of the 103 eligible participants, 75 were interviewed. Responses revealed four main themes: (i) positive changes in clinician's approach to physical health care, (ii) improvements in attitudes to self-care and family wellbeing, (iii) positive changes in workplace culture associated with physical health care delivery and (iv) high levels of acceptability of the program. CONCLUSION The KoSiM model may be useful in other settings as a means of changing the culture of mental health services to better integrate physical health care as a core part of mental health service provision. SO WHAT?: A novel approach using staff focussed lifestyle interventions model may cut through the resistance that is encountered when implementing proven methods of clinical intervention where cultural barriers exist.
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Affiliation(s)
- Andrew Watkins
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jane Stein-Parbury
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jackie Curtis
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Josephine Poole
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Scott Teasdale
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Hamish Fibbins
- Mindgardens Neuroscience Network, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Elisa Rossimel
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Oscar Lederman
- Keeping the Body in Mind, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
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8
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AbdulRaheem Y. Unveiling the Significance and Challenges of Integrating Prevention Levels in Healthcare Practice. J Prim Care Community Health 2023; 14:21501319231186500. [PMID: 37449436 PMCID: PMC10350749 DOI: 10.1177/21501319231186500] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
In recent years, there has been a global increase in human life expectancy, but preventable morbidity and mortality remain significant concerns. To address these issues, preventive healthcare practice has gained importance in various healthcare disciplines. Its goal is to maintain and promote health, reduce risk factors, diagnose illnesses early, and prevent complications. This approach encompasses different stages of disease progression, including primordial prevention, primary prevention, secondary prevention, tertiary prevention, and quaternary prevention. Primordial prevention focuses on addressing root causes and social determinants of diseases to prevent the emergence and development of risk factors. Primary prevention aims to prevent diseases before they occur by implementing interventions such as vaccinations and health education. Secondary prevention focuses on early detection and prompt intervention to prevent the progression of diseases. Tertiary prevention manages the consequences of diseases by restoring health and providing rehabilitation. Lastly, quaternary prevention aims to protect patients from unnecessary medical interventions and harm caused by excessive medicalization. Despite the recognition of the cost-effectiveness of preventive measures, a significant portion of healthcare resources and attention is still allocated to disease management, and only a small percentage of individuals receive all recommended preventive services. Healthcare providers need to prioritize the implementation of preventive care services, even when clinical interventions are necessary, and overcome barriers to preventive care. By investing in preventive care and implementing these strategies, healthcare practitioners can play a crucial role in disease prevention and contribute to the well-being of individuals, families, communities, and countries.
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9
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Gibbons SM, Gurry T, Lampe JW, Chakrabarti A, Dam V, Everard A, Goas A, Gross G, Kleerebezem M, Lane J, Maukonen J, Penna ALB, Pot B, Valdes AM, Walton G, Weiss A, Zanzer YC, Venlet NV, Miani M. Perspective: Leveraging the Gut Microbiota to Predict Personalized Responses to Dietary, Prebiotic, and Probiotic Interventions. Adv Nutr 2022; 13:1450-1461. [PMID: 35776947 PMCID: PMC9526856 DOI: 10.1093/advances/nmac075] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 01/28/2023] Open
Abstract
Humans often show variable responses to dietary, prebiotic, and probiotic interventions. Emerging evidence indicates that the gut microbiota is a key determinant for this population heterogeneity. Here, we provide an overview of some of the major computational and experimental tools being applied to critical questions of microbiota-mediated personalized nutrition and health. First, we discuss the latest advances in in silico modeling of the microbiota-nutrition-health axis, including the application of statistical, mechanistic, and hybrid artificial intelligence models. Second, we address high-throughput in vitro techniques for assessing interindividual heterogeneity, from ex vivo batch culturing of stool and continuous culturing in anaerobic bioreactors, to more sophisticated organ-on-a-chip models that integrate both host and microbial compartments. Third, we explore in vivo approaches for better understanding of personalized, microbiota-mediated responses to diet, prebiotics, and probiotics, from nonhuman animal models and human observational studies, to human feeding trials and crossover interventions. We highlight examples of existing, consumer-facing precision nutrition platforms that are currently leveraging the gut microbiota. Furthermore, we discuss how the integration of a broader set of the tools and techniques described in this piece can generate the data necessary to support a greater diversity of precision nutrition strategies. Finally, we present a vision of a precision nutrition and healthcare future, which leverages the gut microbiota to design effective, individual-specific interventions.
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Affiliation(s)
| | - Thomas Gurry
- Pharmaceutical Biochemistry group, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland (PSI-WS), University of Geneva/University of Lausanne, Geneva, Switzerland
| | - Johanna W Lampe
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Veerle Dam
- Sensus BV (Royal Cosun), Roosendaal, The Netherlands
| | - Amandine Everard
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), UCLouvain, Université Catholique de Louvain, Brussels, Belgium
| | - Almudena Goas
- Department of Food, Nutrition, and Exercise Sciences, University of Surrey, Guildford, United Kingdom
| | - Gabriele Gross
- Medical and Scientific Affairs, Reckitt| Mead Johnson Nutrition Institute, Nijmegen, The Netherlands
| | - Michiel Kleerebezem
- Host Microbe Interactomics Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Jonathan Lane
- Health and Happiness Group, H&H Research, Cork, Ireland
| | | | - Ana Lucia Barretto Penna
- Department of Food Engineering and Technology, São Paulo State University, São José do Rio Preto, Brazil
| | - Bruno Pot
- Yakult Europe BV, Almere, The Netherlands
| | - Ana M Valdes
- Nottingham NIHR Biomedical Research Centre at the School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Gemma Walton
- Food and Nutritional Sciences, University of Reading, Reading, United Kingdom
| | - Adrienne Weiss
- Yili Innovation Center Europe, Wageningen, The Netherlands
| | | | - Naomi V Venlet
- International Life Sciences Institute, European Branch, Brussels, Belgium
| | - Michela Miani
- International Life Sciences Institute, European Branch, Brussels, Belgium
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10
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Mawer T, Kent K, Williams AD, McGowan CJ, Murray S, Bird ML, Hardcastle S, Bridgman H. The knowledge, barriers and opportunities to improve nutrition and physical activity amongst young people attending an Australian youth mental health service: a mixed-methods study. BMC Health Serv Res 2022; 22:789. [PMID: 35715836 PMCID: PMC9205652 DOI: 10.1186/s12913-022-08182-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mental illnesses are the leading cause of disability in young people, and lifestyle interventions in young people at risk of mental illness remain a priority. Opportunities to improve nutrition and physical activity among young people through youth mental health services remain unclear. This study aimed to determine the knowledge and behaviors towards nutrition and physical activity, the barriers and enablers to improving behaviors, and the preferred providers and sources of information for nutrition and physical activity among a sample of young people attending a youth mental health service. Methods A mixed-method study was conducted in regional Tasmania, Australia in a sample of young people (15–25 years) attending a youth mental health service (headspace). A quantitative survey (n = 48) determined young people’s nutrition and physical activity knowledge, behaviors, barriers and enablers to achieving recommendations, and their preferred providers and sources of information. Structured interviews and a focus group further explored these concepts (n = 8), including the role of the mental health service as a provider of this support. Results The majority of participants did not meet national recommendations for nutrition and physical activity, despite possessing a high level of knowledge regarding their importance for mental health. Improving mental health was a common enabling factor for participants choosing to alter diet and physical activity habits, but also the leading barrier for participating in physical activity. Young people wanted to receive information from reputable health providers, ideally through social media sources. headspace was seen as an important potential provider of this information. Conclusions Our results indicate that there is a clear need to improve diet and physical activity habits to enhance mental and physical health outcomes in this at-risk group, and youth mental health services could provide further interventions to support their clients. Specialized staff (e.g. dietitians and exercise physiologists) may provide additional benefits alongside existing mental health care support. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08182-0.
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Affiliation(s)
- Tamieka Mawer
- Centre for Rural Health, University of Tasmania, Locked Bag 1322, Launceston, Tasmania, 7250, Australia
| | - Katherine Kent
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia.,School of Health Sciences, Western Sydney University, Kingswood, New South Wales, Australia
| | - Andrew D Williams
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Courtney J McGowan
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia.,Sport Performance Optimization Research Team, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Sandra Murray
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Marie-Louise Bird
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Sibella Hardcastle
- School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, University of Tasmania, Locked Bag 1322, Launceston, Tasmania, 7250, Australia.
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11
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Barriers to the Provision of Preventive Care to People Living with Mental Health Conditions: Self-Report by Staff Working in an Australian Community Managed Organisation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084458. [PMID: 35457326 PMCID: PMC9027436 DOI: 10.3390/ijerph19084458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/02/2022] [Accepted: 04/02/2022] [Indexed: 11/30/2022]
Abstract
People living with mental health conditions experience a reduced life expectancy largely due to a higher prevalence of chronic diseases. Addressing health risk behaviours, including tobacco smoking, inadequate nutrition, harmful alcohol consumption, and physical inactivity (SNAP), through the provision of preventive care, is recommended to reduce this burden. Community Managed Organisations (CMOs) may play an important role in providing preventive care to consumers with mental health conditions, however, few studies have examined preventive care provision in CMO settings; and no studies have comprehensively assessed barriers to the provision of this care using a tool such as the Theoretical Domains Framework (TDF). To fill this research gap, we conducted an online survey among staff (N = 190) from one CMO in Australia to (1) identify barriers to preventive care provision (ask, advise, assist, connect) to address SNAP behaviours among consumers; and (2) explore associations between barriers and preventive care provision. Results demonstrate that while staff reported knowing how to provide preventive care and believed it would positively impact consumers; barriers including confidence in providing this care and consumer uptake of referrals, were identified. Further research among multiple CMOs is needed to identify care provision and associated barriers in the sector more widely.
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12
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The Effectiveness and Cost of an Intervention to Increase the Provision of Preventive Care in Community Mental Health Services: Protocol for a Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053119. [PMID: 35270810 PMCID: PMC8910711 DOI: 10.3390/ijerph19053119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 02/04/2023]
Abstract
Preventive care to address chronic disease risk behaviours is infrequently provided by community mental health services. In this cluster-randomised controlled trial, 12 community mental health services in 3 Local Health Districts in New South Wales, Australia, will be randomised to either an intervention group (implementing a new model of providing preventive care) or a control group (usual care). The model of care comprises three components: (1) a dedicated ‘healthy choices’ consultation offered by a ‘healthy choices’ clinician; (2) embedding information regarding risk factors into clients’ care plans; and (3) the continuation of preventive care by mental health clinicians in ongoing consultations. Evidence-based implementation strategies will support the model implementation, which will be tailored by being co-developed with service managers and clinicians. The primary outcomes are client-reported receipt of: (1) an assessment of chronic disease risks (tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol use and physical inactivity); (2) brief advice regarding relevant risk behaviours; and (3) referral to at least one behaviour change support. Resources to develop and implement the intervention will be captured to enable an assessment of cost effectiveness and affordability. The findings will inform the development of future service delivery initiatives to achieve guideline- and policy-concordant preventive care delivery.
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13
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Shekhar R, Prasad N, Singh T. Lifestyle factors influencing medical and nursing student's health status at the rural health-care institute. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:21. [PMID: 35281381 PMCID: PMC8893071 DOI: 10.4103/jehp.jehp_206_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/27/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Noncommunicable diseases (NCDs) may be influenced by lifestyle behavior, acquired during transition in student life at university. Health is a major concern globally. The developing counties are facing a double burden of disease, both communicable and NCD. This study is aimed to assess the lifestyle and its associated factors that can affect the health status of medical and nursing students. MATERIALS AND METHODS A community-based cross-sectional study was conducted among medical and nursing students of Sasaram, Bihar, by universal sampling. The study population consisted of 303 medical and 233 nursing students. The 536 students in the study, included 195 from rural areas and 341 from urban areas. Simple Lifestyle Indicator Questionnaire was used and Chi-square statistics was computed to determine the association of demographic variables with lifestyle behavior using Epi InfoTM 7 analysis software. RESULTS Mean age and body mass index were 21 ± 2.59 years and 22.12 ± 3.77, respectively. After statistical analysis utilizing the Chi-square test, it was shown that the difference was found to be nonsignificant (P > 0.05) in all the following variables, such as gender, age, marital status except in designation, and alcohol and tobacco intake which showed the difference to be highly significant. CONCLUSIONS The maximum number of students in the study population showed intermediate healthy lifestyle (57.1%), despite being the upcoming health-care providers of future. Fruits were rarely present in diet in 82%, no physical activity in 21.2%, and tobacco and alcohol were consumed by 11.7% and 13%, respectively. Targeted intervention for healthy diet, physical activity, stress, tobacco, and alcohol reduction can lead to healthy lifestyle. Independence and autonomy gained in the transition phase in student life needs guided supervision to raise responsible adults. It may help to assist or to plan accordingly in future to improve lifestyle of the students.
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Affiliation(s)
- Ravi Shekhar
- Department of Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
- Address for correspondence: Dr. Ravi Shekhar, Department of Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India. E-mail:
| | - Nidhi Prasad
- Department of Community Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Tulika Singh
- Department of Community Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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14
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Gibson L, Clinton-McHarg T, Wilczynska M, Latter J, Bartlem K, Henderson C, Wiggers J, Wilson A, Searles A, Bowman J. Preventive care practices to address health behaviours among people living with mental health conditions: A survey of Community Managed Organisations. Prev Med Rep 2021; 23:101495. [PMID: 34336560 PMCID: PMC8313583 DOI: 10.1016/j.pmedr.2021.101495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 12/26/2022] Open
Abstract
People living with mental health conditions have a reduced life expectancy of approximately 10 years compared to the general population, largely due to physical chronic diseases and higher rates of tobacco smoking, poor nutrition, harmful alcohol consumption, physical inactivity and poor sleep behaviours. Community managed organisations (CMOs) may play a valuable role in providing preventive care to people with mental health conditions (consumers) to address these health behaviours. This paper reports the findings of a cross-sectional survey undertaken between November 2018 and February 2019 with leaders of CMOs (n = 76) that support people with mental health conditions in the state of New South Wales, Australia to: 1) measure the provision of preventive care (screening, support, and connections to specialist services) for five health behaviours; 2) identify the presence of key organisational features (e.g., data collection, staff training); and 3) explore if these organisational features were associated with the provision of preventive care. Preventive care provision to a majority of consumers (50% or more) was least frequently reported for tobacco smoking and most frequently reported for physical activity. Staff training and guidelines regarding the provision of preventive care were associated with the provision of such care. The results demonstrate that CMOs are already engaged in providing preventive care to some extent, with certain behaviours and preventive care elements addressed more frequently than others. Further research with additional CMO stakeholders, including staff and consumers, is needed to gain a deeper understanding of factors that may underlie CMOs capacity to routinely provide preventive care.
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Affiliation(s)
- Lauren Gibson
- School of Psychological Sciences, College of Engineering, Science & Environment, University of Newcastle, Callaghan, NSW, Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tara Clinton-McHarg
- School of Psychological Sciences, College of Engineering, Science & Environment, University of Newcastle, Callaghan, NSW, Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Magdalena Wilczynska
- School of Psychological Sciences, College of Engineering, Science & Environment, University of Newcastle, Callaghan, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Joanna Latter
- School of Psychological Sciences, College of Engineering, Science & Environment, University of Newcastle, Callaghan, NSW, Australia
| | - Kate Bartlem
- School of Psychological Sciences, College of Engineering, Science & Environment, University of Newcastle, Callaghan, NSW, Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | | | - John Wiggers
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Andrew Wilson
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Menzies Centre for Health Policy, School of Public Health, University of Sydney, Australia
| | - Andrew Searles
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jenny Bowman
- School of Psychological Sciences, College of Engineering, Science & Environment, University of Newcastle, Callaghan, NSW, Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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15
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Fehily C, Latter J, Bartlem K, Wiggers J, Bradley T, Rissel C, Reakes K, Reid K, Browning E, Bowman J. Awareness and use of telephone-based behaviour change support services among clients of a community mental health service. Aust N Z J Public Health 2020; 44:482-488. [PMID: 33104282 DOI: 10.1111/1753-6405.13039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/01/2020] [Accepted: 08/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine the prevalence of, and factors associated with, awareness and use of telephone-based behaviour change support services among clients of a community mental health service. METHODS Adult clients (n=375) of one Australian community mental health service completed a telephone interview and self-reported not meeting Australian National Guidelines for smoking, nutrition, alcohol consumption and/or physical activity. Descriptive statistics summarised awareness and use of the New South Wales Quitline® and Get Healthy Service® for participants with lifestyle risk factors addressed by each service. Chi-squares and logistic regressions explored associations between client characteristics, and service awareness and use. RESULTS Awareness (16.1%) and use (1.9%) of the Get Healthy Service was lower than that of Quitline (89.1%; 18.1%). Television was the most common source of awareness (39.7% Get Healthy Service; 74.0% Quitline). In the regression models, persons in a relationship were more likely to have heard of the Get Healthy Service (OR:2.19, CI:1.15-4.18), and persons aged 36-50 were more likely to have used the Quitline (OR:5.22, CI:1.17-23.37). CONCLUSIONS Opportunities exist for increasing awareness and use of both services, particularly the Get Healthy Service, among clients of community mental health services. Implications for public health: Strategies to optimise reach for this population group are recommended.
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Affiliation(s)
- Caitlin Fehily
- School of Psychology, Faculty of Science, The University of Newcastle, New South Wales.,The Australian Prevention Partnership Centre (TAPPC), Sax Institute, New South Wales
| | - Joanna Latter
- School of Psychology, Faculty of Science, The University of Newcastle, New South Wales
| | - Kate Bartlem
- School of Psychology, Faculty of Science, The University of Newcastle, New South Wales.,The Australian Prevention Partnership Centre (TAPPC), Sax Institute, New South Wales
| | - John Wiggers
- Population Health, Hunter New England Local Health District, New South Wales.,School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, New South Wales
| | - Tegan Bradley
- School of Psychology, Faculty of Science, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, Clinical Research Centre, New South Wales
| | - Chris Rissel
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, New South Wales.,NSW Office of Preventive Health, New South Wales
| | | | - Kate Reid
- NSW Office of Preventive Health, New South Wales
| | - Ellen Browning
- School of Psychology, Faculty of Science, The University of Newcastle, New South Wales
| | - Jenny Bowman
- School of Psychology, Faculty of Science, The University of Newcastle, New South Wales.,The Australian Prevention Partnership Centre (TAPPC), Sax Institute, New South Wales
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16
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Fehily C, Hodder R, Bartlem K, Wiggers J, Wolfenden L, Dray J, Bailey J, Wilczynska M, Stockings E, Clinton-McHarg T, Regan T, Bowman J. The effectiveness of interventions to increase preventive care provision for chronic disease risk behaviours in mental health settings: A systematic review and meta-analysis. Prev Med Rep 2020; 19:101108. [PMID: 32477852 PMCID: PMC7248238 DOI: 10.1016/j.pmedr.2020.101108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/01/2020] [Accepted: 04/26/2020] [Indexed: 11/25/2022] Open
Abstract
Clinical practice guidelines direct mental health services to provide preventive care to address client chronic disease risk behaviours, however, this care is not routinely provided. The aim of this systematic review was to synthesise evidence regarding the effectiveness of interventions to increase provision of preventive care by mental health services; by care element (ask, assess, advice, assist, arrange) and risk behaviour (tobacco smoking, poor nutrition, harmful alcohol consumption, physical inactivity). Electronic bibliographic databases, Google Scholar, relevant journals, and included study reference lists were searched. Eligible studies were of any design with a comparison group that reported the effectiveness of an intervention to increase the provision of at least one element of preventive care for at least one risk behaviour in a mental health setting. Twenty studies were included, most commonly examining smoking (n = 20) and 'ask' (n = 12). Meta-analysis found interventions involving task shifting were effective in increasing smoking 'advice' (n = 2 RCTs; p = 0.009) and physical activity 'advice' (n = 2 RCTs; p = 0.002). Overall, meta-analysis and narrative synthesis indicated that effective intervention strategies (categorised according to the Effective Practice and Organisation of Care taxonomy) were: task shifting, educational meetings, health information systems, local consensus processes, authority and accountability, and reminders. The most consistent findings across studies were with regard to preventive care for smoking, while conflicting or limited evidence was found regarding other risk behaviours. While further rigorous research examining key risk behaviours is recommended, the findings may inform the selection of strategies for future interventions and service delivery initiatives.
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Affiliation(s)
- Caitlin Fehily
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Rebecca Hodder
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Kate Bartlem
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - John Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Luke Wolfenden
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia
| | - Julia Dray
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- Population Health, Hunter New England Local Health District, NSW, Australia
| | - Jacqueline Bailey
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
| | - Magda Wilczynska
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, Randwick, NSW, Australia
| | - Tara Clinton-McHarg
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Timothy Regan
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
| | - Jenny Bowman
- School of Psychology, Faculty of Science, The University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
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17
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Romain AJ, Trottier A, Karelis AD, Abdel-Baki A. Do Mental Health Professionals Promote a Healthy Lifestyle among Individuals Experiencing Serious Mental Illness? Issues Ment Health Nurs 2020; 41:531-539. [PMID: 32286095 DOI: 10.1080/01612840.2019.1688436] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: While a healthy lifestyle would be an asset to people experiencing psychotic disorders, not all mental health professionals provide counselling regarding healthy behaviours, such as physical activity, healthy nutrition, and tobacco cessation. Therefore, the objective of the present study was to investigate the factors associated with health promotion practice (HPP) among mental health professionals.Methods: Cross-sectional survey including mental health professionals across the Province of Quebec (Canada). The promotion of health behaviour and the "Exercise in Mental Illness Questionnaire - Health Practitioner Version" and its adaptation for nutrition improvement and tobacco cessation were used to evaluate knowledge, beliefs, promotion behaviours, and barriers to HPP.Results: One hundred mental health professionals, most being nurses (29%) and medical doctors/psychiatrists (20%) were recruited throughout the province of Quebec (Canada). The rate of formal training among professionals was 11% for physical activity, 26% for nutrition, and 21% for tobacco cessation. Approximately 60% were promoting physical activity, 49% good nutrition, and 41% tobacco cessation. Professionals promoting healthy behaviours had a higher level of self-efficacy in HPP, were more likely to value physical health, and less likely to endorse barriers to HPP.Conclusion: Rates of formal training in lifestyle habits and health promotion (aiming at improving a healthy lifestyle in patients experiencing psychotic disorders) among mental health professionals are currently low in the Province of Quebec and need to be improved. In addition, the level of confidence and barriers that endorse healthy behaviours appear to be key factors in HPP among mental health professionals.
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Affiliation(s)
- Ahmed Jerome Romain
- Department of Psychiatry, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Alexia Trottier
- Department of Psychiatry, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Antony D Karelis
- Department of Physical Activity Sciences, University of Quebec at Montreal, Montreal, Quebec, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.,Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada.,Department of Psychiatry, University Hospital of Montreal (CHUM) - Notre-Dame Hospital, Montreal, Quebec, Canada
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Fehily CMC, Bartlem KM, Wiggers JH, Wye PM, Clancy RV, Castle DJ, Wilson A, Rissel CE, Wutzke S, Hodder RK, Colyvas K, Murphy F, Bowman JA. Effectiveness of embedding a specialist preventive care clinician in a community mental health service in increasing preventive care provision: A randomised controlled trial. Aust N Z J Psychiatry 2020; 54:620-632. [PMID: 32403938 PMCID: PMC7285986 DOI: 10.1177/0004867420914741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Clinical practice guidelines recommend that community mental health services provide preventive care for clients' chronic disease risk behaviours; however, such care is often not routinely provided. This study aimed to assess the effectiveness of offering clients an additional consultation with a specialist clinician embedded within a community mental health service, in increasing client-reported receipt of, and satisfaction with, preventive care. METHOD A randomised controlled trial was undertaken in one Australian community mental health service. Participants (N = 811) were randomised to receive usual care (preventive care in routine consultations; n = 405) or usual care plus the offer of an additional consultation with a specialist preventive care clinician (n = 406). Blinded interviewers assessed at baseline and 1-month follow-up the client-reported receipt of preventive care (assessment, advice and referral) for four key risk behaviours individually (smoking, poor nutrition, alcohol overconsumption and physical inactivity) and all applicable risks combined, acceptance of referrals and satisfaction with preventive care received. RESULTS Analyses indicated significantly greater increases in 12 of the 18 preventive care delivery outcomes in the intervention compared to the usual care condition from baseline to follow-up, including assessment for all risks combined (risk ratio = 4.00; 95% confidence interval = [1.57, 10.22]), advice for all applicable risks combined (risk ratio = 2.40; 95% confidence interval = [1.89, 6.47]) and offer of referral to applicable telephone services combined (risk ratio = 20.13; 95% confidence interval = [2.56, 158.04]). For each component of care, there was a significant intervention effect for at least one of the individual risk behaviours. Participants reported high levels of satisfaction with preventive care received, ranging from 77% (assessment) to 87% (referral), with no significant differences between conditions. CONCLUSION The intervention had a significant effect on the provision of the majority of recommended elements of preventive care. Further research is needed to maximise its impact, including identifying strategies to increase client uptake.
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Affiliation(s)
- Caitlin MC Fehily
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Kate M Bartlem
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - John H Wiggers
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Paula M Wye
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Richard V Clancy
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Mental Health, Hunter New England Local Health District, NSW Health, New Lambton, NSW, Australia
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
- St Vincent’s Health, Fitzroy, VIC, Australia
| | - Andrew Wilson
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Menzies Centre for Health Policy, The University of Sydney, Sydney, NSW, Australia
| | - Chris E Rissel
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- NSW Office of Preventive Health, Liverpool, NSW, Australia
| | - Sonia Wutzke
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Rebecca K Hodder
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Kim Colyvas
- School of Mathematical and Physical Sciences, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
| | - Fionna Murphy
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jenny A Bowman
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
- The Australian Prevention Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Fehily C, Ling R, Searles A, Bartlem K, Wiggers J, Hodder R, Wilson A, Colyvas K, Bowman J. An economic evaluation of a specialist preventive care clinician in a community mental health service: a randomised controlled trial. BMC Health Serv Res 2020; 20:405. [PMID: 32393307 PMCID: PMC7212584 DOI: 10.1186/s12913-020-05204-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Clinical practice guidelines and policies direct community mental health services to provide preventive care to address chronic disease risks, however, such care is infrequently provided in routine consultations. An alternative model of care is to appoint a clinician to the dedicated role of offering and providing preventive care in an additional consultation: the 'specialist clinician' model. Economic evaluations of models of care are needed to determine the cost of adhering to guidelines and policies, and to inform pragmatic service delivery decisions. This study is an economic evaluation of the specialist clinician model; designed to achieve policy concordant preventive care delivery. METHODS A retrospective analysis of the incremental costs, cost-effectiveness, and budget impact of a 'specialist preventive care clinician' (an occupational therapist) was conducted in a randomised controlled trial, where participants were randomised to receive usual care; or usual care plus the offer of an additional preventive care consultation with the specialist clinician. The study outcome was client acceptance of referrals to two free telephone-based chronic disease prevention services. This is a key care delivery outcome mandated by the local health district policy of the service. The base case analysis assumed the mental health service cost perspective. A budget impact analysis determined the annual budget required to implement the model of care for all clients of the community mental health service over 5 years. RESULTS There was a significantly greater increase from baseline to follow-up in the proportion of intervention participants accepting referrals to both telephone services, compared to usual care. The incremental cost-effectiveness ratio was $347 per additional acceptance of a referral (CI: $263-$494). The annual budget required to implement the model of care for all prospective clients was projected to be $711,446 over 5-years; resulting in 2616 accepted referrals. CONCLUSIONS The evaluation provides key information regarding the costs for the mental health service to adhere to policy targets, indicating the model of care involved a low per client cost whilst increasing key preventive care delivery outcomes. Additional modelling is required to further explore its economic benefits. TRIAL REGISTRATION ACTRN12616001519448. Registered 3 November 2016, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371709.
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Affiliation(s)
- Caitlin Fehily
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia.
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia.
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia.
| | - Rod Ling
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Andrew Searles
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Kate Bartlem
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- Population Health, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - John Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
- Population Health, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Rebecca Hodder
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
- Population Health, Hunter New England Local Health District, New Lambton, NSW, Australia
| | - Andrew Wilson
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
| | - Kim Colyvas
- School of Mathematical and Physical Sciences, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, Australia
| | - Jenny Bowman
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- The Australian Preventive Partnership Centre (TAPPC), Sax Institute, Ultimo, NSW, Australia
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Bailey JM, Clinton-McHarg TL, Wye PM, Wiggers JH, Bartlem KM, Bowman JA. Preventive care for physical activity and fruit and vegetable consumption: a survey of family carer expectations of health service delivery for people with a mental health condition. BMC Health Serv Res 2020; 20:201. [PMID: 32164730 PMCID: PMC7068924 DOI: 10.1186/s12913-020-5059-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/28/2020] [Indexed: 11/07/2022] Open
Abstract
Background Chronic disease is a leading cause of death globally, where inadequate fruit and vegetable consumption and inadequate physical activity are consistently implicated as key contributing risk factors for such diseases. People with a mental health condition are reported to experience a higher prevalence of such risks and experience an increased morbidity and mortality from resultant chronic disease. Despite guidelines identifying a need for services accessed by people with a mental health condition to provide care to address such health risk behaviours, sub-optimal care is frequently reported suggesting a need for innovative strategies to increase the provision of physical health care. An exploratory study was conducted to examine: 1) family carers’ expectations of care provision regarding fruit and vegetable consumption and physical activity by health and community services for people with a mental health condition; 2) carer’s own health risk behaviour status and perceptions of the influence of the health risk behaviours on mental health; and 3) possible associations of socio-demographic, clinical and attitudinal factors with carer expectations of care provision for fruit and vegetable consumption and physical activity. Methods Family carers (n = 144) of a person with a mental health condition completed a cross-sectional survey. Participants were members of a mental health carer support organisation operating in New South Wales, Australia. Results A high proportion of participants considered care for fruit and vegetable consumption and physical activity respectively should be provided by: mental health hospitals (78.5, 82.7%); community mental health services (76.7, 85.9%); general practice (81.1, 79.2%); and non-government organisations (56.2, 65.4%). Most participants perceived adequate fruit and vegetable consumption (55.9%), and physical activity (71.3%) would have a very positive impact on mental health. Carers who perceived adequate fruit and vegetable consumption and physical activity would have a positive impact on mental health were more likely to expect care for such behaviours from some services. Conclusions The majority of participants expected care for fruit and vegetable consumption and physical activity be provided by all services catering for people with a mental health condition, reinforcing the appropriateness for such services to provide physical health care for clients in a systematic manner.
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Affiliation(s)
- Jacqueline M Bailey
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
| | - Tara L Clinton-McHarg
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Paula M Wye
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - John H Wiggers
- Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Population Health, Hunter New England Local Health District, Booth Building, Wallsend Health Services, Longworth Avenue, Wallsend, Wallsend, NSW, 2287, Australia.,School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Kate M Bartlem
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Jennifer A Bowman
- School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, Clinical Research Centre, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
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