Implementing an evidence-based behavioral weight-loss program in community mental health centers: A randomized pilot...

Area of Science:

• Implementation science
• Public health
• Clinical psychology

Background:

• Obesity is a major preventable cause of death in individuals with serious mental illness (SMI).
• A prior trial showed a lifestyle intervention's effectiveness for this population.
• Real-world adaptation and testing of such interventions are necessary.

Purpose of the Study:

• To assess implementation interventions for community mental health staff delivering a lifestyle intervention to clients with obesity and SMI.
• To evaluate the impact of performance coaching as an enhancement strategy.

Main Methods:

• A cluster-randomized pilot trial comparing standard implementation (training, meetings) with enhanced (standard plus coaching).
• Staff-coaches delivered a 6-month group-based lifestyle intervention.
• Linear mixed-effects modeling analyzed changes in staff knowledge, self-efficacy, and fidelity.

Main Results:

• Staff knowledge significantly increased; self-efficacy remained unchanged. Neither differed between standard and enhanced arms.
• Fidelity ratings were stable and consistent across arms.
• Clients with SMI achieved an average 6-month weight loss of 3.8 kg.

Conclusions:

• Multicomponent implementation strategies are feasible for delivering lifestyle interventions via mental health staff.
• Preliminary findings indicate feasibility and client weight reduction.
• The addition of performance coaching did not yield significant outcome differences; further research is warranted.