Serious Mental Illness In Supportive Housing Research Articles

S87. IDEAL CARDIOVASCULAR HEALTH IN RACIALLY AND ETHNICALLY DIVERSE PEOPLE WITH SERIOUS MENTAL ILLNESS

BackgroundCardiovascular disease (CVD) is a primary contributor to premature death among people with serious mental illness (SMI). This study examined the prevalence and correlates of the American Heart Association (AHA) metric of ideal cardiovascular health (ICVH) in racially and ethnically diverse people with serious mental illness living in supportive housing.MethodsOur study used baseline data from an NIMH-funded trial testing the effectiveness of a peer-led healthy lifestyle intervention, for overweight/obese participants with SMI in three supportive housing agencies. A total of 314 participants were enrolled in the trial and included in these analyses. Five ICVH metrics (BMI, smoking, diet, physical activity, and blood pressure [BP]) were measured and summed to create a composite ICVH score. Correlates were informed by findings from systematic literature reviews examining ICVH in the general population and studies examining correlates of CVD in people with SMI. Hierarchal regression analysis was used to examine the associations of sample correlates with the composite ICVH score.ResultsThe mean age of participants was 48.7 and 57.3% were male. The most common lifetime mental health diagnoses were depression (75.2%), schizophrenia/schizoaffective disorder (56.7%), and bipolar disorder (46.5%). Approximately 38.5% of participants reported lifetime substance abuse/dependence. The majority (62.7%) were taking an antipsychotic medication. Lifetime physical health diagnoses were high cholesterol (36.3%), diabetes (32.5%), cardiovascular disease (17.2%), and cancer (4.5%). Participants walked on average 318.4 meters during the six-minute walking test (6MWT), a measure of cardiorespiratory fitness (CRF). The prevalence of smoking (64.7%) and obesity (64%) were high, while the prevalence of ideal physical activity (37.6%), healthy diet status (2.2%), and ideal BP (23.6%) were low. The mean ICVH composite score was 3.15 (range 0 – 8). After controlling for all covariates, women, racial/ethnic minorities, use of antipsychotic medications, lifetime cancer diagnosis, and poor CRF were significantly (p < .05) related to low ICVH scores.DiscussionIn our racially/ethnically diverse sample of people with SMI in supportive housing, the prevalence of ICVH was low. Our findings suggest that there are specific subgroups that may benefit from targeted screening and interventions to improve cardiovascular health. The association between CRF and ICVH scores highlights the importance of increasing physical activity and reducing sedentary behavior. The AHA ICVH metric can be a useful tool for tracking and improving the cardiovascular health of people with SMI.

Developing a peer-based healthy lifestyle program for people with serious mental illness in supportive housing

Overweight and obesity disproportionally impact people with serious mental illness (SMI). Healthy lifestyle interventions can improve the health of people with SMI but may need to be adapted for this population. The aims of this study were: to (1) examine the feasibility and acceptability of delivering the Peer-based Group Lifestyle Balance (PGLB) intervention and (2) describe intervention adaptations for people with SMI in supportive housing. Peer specialists and social workers co-facilitated 12 weekly PGLB sessions for 14 supportive housing clients. We conducted structured interviews and collected qualitative data through field notes and two focus groups. Frequencies and measures of central tendencies were used to describe participant characteristics and PGLB feasibility and acceptability measures. Qualitative data was analyzed using directed content analysis. Participants on average attended 8 of 12 sessions, and reported that services were satisfactory and helpful. Intervention adaptations, ongoing throughout the study, focused on adding peer-specialists as co-facilitators, increasing individualized support and developing strategies to address socioeconomic barriers impacting participants' ability to engage in healthy lifestyle changes. Study findings suggest that participants with SMI in supportive housing perceived PGLB as feasible and acceptable. Expanding the relevance and reach of peer-based healthy lifestyle interventions in community settings serving people with SMI requires careful adaptations to the socioeconomic realities of this population and the complexities of living with co-morbid health and mental health conditions.