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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1112 — Mental Health Consumer and Provider Perspectives on a Weight Management Program: Improving Implementation of Needed Services

Cohen AN, and Hamilton AB, Greater Los Angeles VA and UCLA; Armstrong NP, Greater Los Angeles VA; Young AS, Greater Los Angeles VA and UCLA;

Veterans with serious mental illness have a high rate of obesity and die, on average, 25 years prematurely due to the health consequences of weight gain. Effective psychosocial weight interventions have been developed for this population, but are rarely utilized. Typical of weight programs generally, enrollment and attrition are considerable problems. “Enhancing QUality of care In Psychosis” (EQUIP) was a multi-site project to improve care in specialty mental health; one target was weight services. The objective of this paper is to discuss consumers’ and providers’ perspectives on weight services for this population.

EQUIP implemented an evidence-based weight intervention in four large mental health clinics across 4 VISNs. Data indicated that sites had varying levels of attendance at the groups. Following study completion, attenders (overweight Veterans who attended at least 8 weekly weight groups) and non-attenders (overweight Veterans who were referred to the program, but did not attend any sessions) were asked to complete an interview. Twenty-two attenders and 29 non-attenders (22% of the eligible population) were interviewed before reaching thematic saturation regarding barriers, facilitators, and recommended improvements to the program. Providers (n = 47) were also interviewed. All interviews were professionally transcribed and analyzed by two experts, using Atlas.ti.

Non-attenders identified barriers including a feeling that weight problems were a low priority or of no concern, no provider referral, and transportation and scheduling issues. Attenders identified convenience of the session times and locations, shared group experience, friendly group facilitators, and helpful nutritional information as facilitative of their sustained attendance. Recommendations by both groups included a more personalized program, access to a gym, and more information about the purpose of the groups. Providers noted similar barriers and facilitators, and also noted sociocultural influences on dietary behaviors as an area to be addressed.

In order to affect the largest group possible, stakeholder preferences regarding weight services need to be addressed. Weight program enrollment and attendance would be increased with attention to education around the deleterious effects of weight gain and attention to the strong influence providers could have on Veteran attendance.

This is one of the first studies to report mental health consumer and provider attitudes toward weight programs in VA.

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