Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled Trial
BackgroundObesity is common in individuals with severe mental illness (SMI), contributing to a significantly shortened lifespan when compared to the general population. Available weight loss treatments have attenuated efficacy in this population, underscoring the importance o...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-06-01
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| Series: | JMIR Research Protocols |
| Online Access: | https://www.researchprotocols.org/2023/1/e42114 |
| _version_ | 1797734056517959680 |
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| author | Ginger E Nicol Madeline O Jansen Amanda R Ricchio Julia A Schweiger Katie E Keenoy J Philip Miller Elaine H Morrato Zhaohua Guo Bradley A Evanoff Joseph J Parks John W Newcomer |
| author_facet | Ginger E Nicol Madeline O Jansen Amanda R Ricchio Julia A Schweiger Katie E Keenoy J Philip Miller Elaine H Morrato Zhaohua Guo Bradley A Evanoff Joseph J Parks John W Newcomer |
| author_sort | Ginger E Nicol |
| collection | DOAJ |
| description |
BackgroundObesity is common in individuals with severe mental illness (SMI), contributing to a significantly shortened lifespan when compared to the general population. Available weight loss treatments have attenuated efficacy in this population, underscoring the importance of prevention and early intervention.
ObjectiveHere, we describe a type 1 hybrid study design for adapting and pilot-testing an existing mobile health intervention for obesity prevention in individuals with early SMI and Class I or early-stage obesity, defined as a BMI of 30-35.
MethodsAn existing, evidence-based interactive obesity treatment approach using low-cost, semiautomated SMS text messaging was selected for adaptation. Community mental health clinics and Clubhouse settings in Eastern Missouri and South Florida were identified to participate. This study has the following 3 aims. First, using the Enhanced Framework for Reporting Adaptations and Modifications to Evidence-based interventions, contextual aspects of the clinical and digital treatment environments are identified for adaptation, considering 5 main stakeholder groups (clinical administrators, prescribing clinicians, case managers, nurses, and patients). Following a 2-week trial of unadapted SMS text messaging, Innovation Corps methods are used to discover needed intervention adaptations by stakeholder group and clinical setting. Second, adaptations to digital functionality and intervention content will be made based on themes identified in aim 1, followed by rapid usability testing with key stakeholders. A process for iterative treatment adaptation will be developed for making unplanned modifications during the aim 3 implementation pilot study. Individuals working in partner community mental health clinics and Clubhouse settings will be trained in intervention delivery. Third, in a randomized pilot and feasibility trial, adults with 5 years or less of treatment for an SMI diagnosis will be randomized 2:1 to 6 months of an adapted interactive obesity treatment approach or to an attentional control condition, followed by a 3-month extension phase of SMS text messages only. Changes in weight, BMI, and behavioral outcomes, as well as implementation challenges, will be evaluated at 6 and 9 months.
ResultsInstitutional review board approval for aims 1 and 2 was granted on August 12, 2018, with 72 focus group participants enrolled; institutional review board approval for aim 3 was granted on May 6, 2020. To date, 52 participants have been enrolled in the study protocol.
ConclusionsIn this type 1 hybrid study design, we apply an evidence-based treatment adaptation framework to plan, adapt, and feasibility test a mobile health intervention in real-world treatment settings. Resting at the intersection of community mental health treatment and physical health promotion, this study aims to advance the use of simple technology for obesity prevention in individuals with early-stage mental illness.
Trial RegistrationClinicalTrials.gov NCT03980743; https://clinicaltrials.gov/ct2/show/NCT03980743
International Registered Report Identifier (IRRID)DERR1-10.2196/42114 |
| first_indexed | 2024-03-12T12:38:42Z |
| format | Article |
| id | doaj.art-c0444bd26d984c49927bd02565d13501 |
| institution | Directory Open Access Journal |
| issn | 1929-0748 |
| language | English |
| last_indexed | 2024-03-12T12:38:42Z |
| publishDate | 2023-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Research Protocols |
| spelling | doaj.art-c0444bd26d984c49927bd02565d135012023-08-29T00:02:15ZengJMIR PublicationsJMIR Research Protocols1929-07482023-06-0112e4211410.2196/42114Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled TrialGinger E Nicolhttps://orcid.org/0000-0001-5823-6129Madeline O Jansenhttps://orcid.org/0000-0001-9544-0321Amanda R Ricchiohttps://orcid.org/0000-0003-1754-2036Julia A Schweigerhttps://orcid.org/0000-0003-3824-6164Katie E Keenoyhttps://orcid.org/0000-0001-7207-5974J Philip Millerhttps://orcid.org/0000-0003-4568-6846Elaine H Morratohttps://orcid.org/0000-0001-6105-7826Zhaohua Guohttps://orcid.org/0000-0001-9586-5688Bradley A Evanoffhttps://orcid.org/0000-0003-0085-333XJoseph J Parkshttps://orcid.org/0000-0002-3444-3497John W Newcomerhttps://orcid.org/0000-0003-2153-9382 BackgroundObesity is common in individuals with severe mental illness (SMI), contributing to a significantly shortened lifespan when compared to the general population. Available weight loss treatments have attenuated efficacy in this population, underscoring the importance of prevention and early intervention. ObjectiveHere, we describe a type 1 hybrid study design for adapting and pilot-testing an existing mobile health intervention for obesity prevention in individuals with early SMI and Class I or early-stage obesity, defined as a BMI of 30-35. MethodsAn existing, evidence-based interactive obesity treatment approach using low-cost, semiautomated SMS text messaging was selected for adaptation. Community mental health clinics and Clubhouse settings in Eastern Missouri and South Florida were identified to participate. This study has the following 3 aims. First, using the Enhanced Framework for Reporting Adaptations and Modifications to Evidence-based interventions, contextual aspects of the clinical and digital treatment environments are identified for adaptation, considering 5 main stakeholder groups (clinical administrators, prescribing clinicians, case managers, nurses, and patients). Following a 2-week trial of unadapted SMS text messaging, Innovation Corps methods are used to discover needed intervention adaptations by stakeholder group and clinical setting. Second, adaptations to digital functionality and intervention content will be made based on themes identified in aim 1, followed by rapid usability testing with key stakeholders. A process for iterative treatment adaptation will be developed for making unplanned modifications during the aim 3 implementation pilot study. Individuals working in partner community mental health clinics and Clubhouse settings will be trained in intervention delivery. Third, in a randomized pilot and feasibility trial, adults with 5 years or less of treatment for an SMI diagnosis will be randomized 2:1 to 6 months of an adapted interactive obesity treatment approach or to an attentional control condition, followed by a 3-month extension phase of SMS text messages only. Changes in weight, BMI, and behavioral outcomes, as well as implementation challenges, will be evaluated at 6 and 9 months. ResultsInstitutional review board approval for aims 1 and 2 was granted on August 12, 2018, with 72 focus group participants enrolled; institutional review board approval for aim 3 was granted on May 6, 2020. To date, 52 participants have been enrolled in the study protocol. ConclusionsIn this type 1 hybrid study design, we apply an evidence-based treatment adaptation framework to plan, adapt, and feasibility test a mobile health intervention in real-world treatment settings. Resting at the intersection of community mental health treatment and physical health promotion, this study aims to advance the use of simple technology for obesity prevention in individuals with early-stage mental illness. Trial RegistrationClinicalTrials.gov NCT03980743; https://clinicaltrials.gov/ct2/show/NCT03980743 International Registered Report Identifier (IRRID)DERR1-10.2196/42114https://www.researchprotocols.org/2023/1/e42114 |
| spellingShingle | Ginger E Nicol Madeline O Jansen Amanda R Ricchio Julia A Schweiger Katie E Keenoy J Philip Miller Elaine H Morrato Zhaohua Guo Bradley A Evanoff Joseph J Parks John W Newcomer Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled Trial JMIR Research Protocols |
| title | Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled Trial |
| title_full | Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled Trial |
| title_fullStr | Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled Trial |
| title_full_unstemmed | Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled Trial |
| title_short | Adaptation of a Mobile Interactive Obesity Treatment Approach for Early Severe Mental Illness: Protocol for a Mixed Methods Implementation and Pilot Randomized Controlled Trial |
| title_sort | adaptation of a mobile interactive obesity treatment approach for early severe mental illness protocol for a mixed methods implementation and pilot randomized controlled trial |
| url | https://www.researchprotocols.org/2023/1/e42114 |
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