Abstract
Preventive care to address chronic disease risk behaviours is infrequently provided by community mental health services. In this cluster-randomised controlled trial, 12 community mental health services in 3 Local Health Districts in New South Wales, Australia, will be randomised to either an intervention group (implementing a new model of providing preventive care) or a control group (usual care). The model of care comprises three components: (1) a dedicated ‘healthy choices’ consultation offered by a ‘healthy choices’ clinician; (2) embedding information regarding risk factors into clients’ care plans; and (3) the continuation of preventive care by mental health clinicians in ongoing consultations. Evidence-based implementation strategies will support the model implementation, which will be tailored by being co-developed with service managers and clinicians. The primary outcomes are client-reported receipt of: (1) an assessment of chronic disease risks (tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol use and physical inactivity); (2) brief advice regarding relevant risk behaviours; and (3) referral to at least one behaviour change support. Resources to develop and implement the intervention will be captured to enable an assessment of cost effectiveness and affordability. The findings will inform the development of future service delivery initiatives to achieve guideline- and policy-concordant preventive care delivery.
Highlights
Mental health conditions are a clinically diagnosable disorder that impacts a person’s thinking, feeling, behaviour or mood [1]
To address this evidence gap, the present study will assess the effectiveness of a model of care in increasing the provision of preventive care for key chronic disease risk factors in community mental health services
The primary outcomes are the proportion of clients who reported receiving elements of the AAR framework of preventive care: (1) assessment for all chronic disease risk behaviours, (2) brief advice for all relevant risk behaviours (Table 1), and
Summary
Mental health conditions are a clinically diagnosable disorder that impacts a person’s thinking, feeling, behaviour or mood [1]. One study has explored the effectiveness of implementation strategies in increasing preventive care provision by clinicians in mental health settings for the key chronic disease risk behaviours of tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol use and physical inactivity [35]. The results indicated a significant increase for only one of 16 preventive care outcomes, and it was suggested that the use of generic implementation strategies that were not tailored to the specific context of mental health settings may have contributed to the limited effect [35] To address this evidence gap, the present study will assess the effectiveness of a model of care in increasing the provision of preventive care for key chronic disease risk factors (tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, physical inactivity, and overweight/obesity) in community mental health services. Cost and cost-effectiveness of the intervention will be quantified
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