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Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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4083 — Impact of In-Person and Online Delivered Weight Management Interventions on Physical Activity Levels for Veterans with Serious Mental Illness

Lead/Presenter: Anjana Muralidharan
All Authors: Muralidharan A (VA Capitol Healthcare Network, MIRECC) Brown C (Department of Epidemiology and Public Health, University of Maryland School of Medicine) Kreyenbuhl J (VA Capitol Healthcare Network, MIRECC) Goldberg RW (VA Capitol Healthcare Network, MIRECC) Oberman R (VA Greater Los Angeles Healthcare System) Cohen AN (VA Greater Los Angeles Healthcare System) Niv N (VA Long Beach Healthcare System) Young AS (VA Greater Los Angeles Healthcare System)

Individuals with serious mental illness (SMI) exhibit very low levels of physical activity and fitness, elevated rates of obesity and cardiovascular disease, and dramatically reduced life expectancy. Few studies have examined the impact of weight management interventions for adults with SMI on levels of general physical activity. The present study examined whether in-person delivery of a weight management intervention or computerized provision of the same intervention with peer coaching, increased levels of physical activity compared with usual care.

Overweight individuals with SMI receiving care at a Veterans Administration Medical Center were randomized to one of the following six month interventions: (1) computerized weight management with peer coaching (WebMOVE), (2) in-person clinician-led weight services (MOVE SMI), or (3) usual care. Participants who attended at least one intervention session (n = 237) were included in the present analyses. Participants completed the International Physical Activity Questionnaire at baseline, three months, and six months. Mixed effects models examined group differences in change from baseline at three month and six month time points.

At three months (TP2) and six months (TP3), there was a significant condition by time point effect (F = 4.06, p = 0.019 at TP2 and F = 3.88, p = .022 at TP3). At both TP2 and TP3, participants randomized to the MOVE SMI condition exhibited significant increases in total physical activity from baseline compared to usual care (t = 2.84, p = .005 at TP2 and t = 2.77, p = 0.006 at TP3). There was a trend towards individuals randomized to the WebMOVE condition exhibiting an increase in total physical activity from baseline to TP3 compared to usual care (t = 1.94, p = .053).

In-person weight management counseling can significantly increase general levels of physical activity in adults with SMI. A computerized weight management intervention with peer support may also impact physical activity levels, although the intervention may take longer to have an effect and may need to be continued for longer than six months.

The present study directly informs strategies to help Veterans with SMI, a population with high medical illness burden and complex care needs, to increase physical activity, which can have downstream effects on health and functioning.