• Stephen J Bartels, Sarah I Pratt, Kelly A Aschbrenner, Laura K Barre, John A Naslund, Rosemarie Wolfe, Haiyi Xie, Gregory J McHugo, Daniel E Jimenez, Ken Jue, James Feldman, and Bruce L Bird.
• From the Department of Psychiatry, the Department of Community and Family Medicine, and the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, N.H.; the Division of Nutritional Sciences, Cornell University, Ithaca, N.Y.; the Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami; Ken Jue Consulting, Keene, N.H.; Massachusetts Mental Health Center, Boston; and Vinfen Corporation, Cambridge, Mass.
• Am J Psychiatry. 2015 Apr 1;172(4):344-52.

ObjectiveFew studies targeting obesity in serious mental illness have reported clinically significant risk reduction, and none have been replicated in community settings or demonstrated sustained outcomes after intervention withdrawal. The authors sought to replicate positive health outcomes demonstrated in a previous randomized effectiveness study of the In SHAPE program across urban community mental health organizations serving an ethnically diverse population.MethodPersons with serious mental illness and a body mass index (BMI) >25 receiving services in three community mental health organizations were recruited and randomly assigned either to the 12-month In SHAPE program, which included membership in a public fitness club and weekly meetings with a health promotion coach, or to fitness club membership alone. The primary outcome measures were weight and cardiorespiratory fitness (as measured with the 6-minute walk test), assessed at baseline and at 3, 6, 9, 12, and 18 months.ResultsParticipants (N=210) were ethnically diverse (46% were nonwhite), with a mean baseline BMI of 36.8 (SD=8.2). At 12 months, the In SHAPE group (N=104) had greater reduction in weight and improved fitness compared with the fitness club membership only group (N=106). Primary outcomes were maintained at 18 months. Approximately half of the In SHAPE group (51% at 12 months and 46% at 18 months) achieved clinically significant cardiovascular risk reduction (a weight loss ≥5% or an increase of >50 meters on the 6-minute walk test).ConclusionsThis is the first replication study confirming the effectiveness of a health coaching intervention in achieving and sustaining clinically significant reductions in cardiovascular risk for overweight and obese persons with serious mental illness.

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