Hypertension Clinical Trial
Official title:
A Peer-Led, Medical Disease Self-Management Program for Mental Health Consumers
Individuals with serious mental illnesses (SMI) face high rates of medical comorbidity as well as challenges in managing these conditions. A growing workforce of certified peer specialists is available to help these individuals more effectively manage their health and health care. However, there is little existing research examining the effectiveness of peer-led medical self-management programs for this population. in this trial, participants were randomized to either the Health and Recovery Peer program (HARP), a medical disease self-management program led by certified peer specialists, or to care as usual. Assessments were conducted at baseline, 3 months, and 6 months.
Persons with serious mental illnesses (SMI) face elevated rates of medical comorbidity, and
also challenges in effectively managing these health problems. There is an urgent need to
develop self-management strategies that allow persons with SMI to more effectively manage
their chronic medical illnesses.
In general populations, peer-led disease self-management interventions have been demonstrated
to be feasible, effective, scalable, and to lead to sustainable improvements in
self-management and health outcomes. With funding from an R34 intervention development grant
from NIMH, the study team has developed and piloted a modified version of the most widely
tested and used peer-led self management program, the Chronic Disease Self-Management Program
(CDSMP), for persons with serious mental illness. Two pilot tests of this intervention, the
Health and Recovery Peer (HARP) program, demonstrated that the program can be implemented
with high engagement, retention, and program fidelity, and can result in effect sizes across
a range of outcomes comparable to or greater than those seen in general medical populations.
This application proposes to conduct a fully-powered, multisite trial of the HARP program. A
total of 400 individuals with serious mental illnesses and one or more chronic medical
condition will be recruited from three diverse community mental health clinics in the Atlanta
metro region and randomized to the HARP program or usual care. For individuals in the HARP
program, two peer educators with SMI and one or more chronic medical condition will lead a
six-session, six-week manualized intervention, which helps participants become more effective
managers of their chronic illnesses. Follow-up interviews and chart reviews at 3 months, 6
months and one year will assess changes in clinical outcomes, improvement in generic and
disease-specific measures of illness self-management, and quality of care. During the final
phase of the study, a dissemination strategy building on the CDSMP training infrastructure
will allow program participants to lead HARP groups.
This study will establish the first fully peer-led, evidence-based intervention for improving
physical self-management in this vulnerable population.
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