TY - JOUR
T1 - The Health and Recovery Peer (HARP) Program
T2 - A peer-led intervention to improve medical self-management for persons with serious mental illness
AU - Druss, Benjamin G.
AU - Zhao, Liping
AU - von Esenwein, Silke A.
AU - Bona, Joseph R.
AU - Fricks, Larry
AU - Jenkins-Tucker, Sherry
AU - Sterling, Evelina
AU - DiClemente, Ralph
AU - Lorig, Kate
N1 - Funding Information:
The study was funded by NIMH R34MH078583. The study sponsor had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.
PY - 2010/5
Y1 - 2010/5
N2 - Objectives: Persons with serious mental illnesses (SMI) have elevated rates of comorbid medical conditions, but may also face challenges in effectively managing those conditions. Methods: The study team developed and pilot-tested the Health and Recovery Program (HARP), an adaptation of the Chronic Disease Self-Management Program (CDSMP) for mental health consumers. A manualized, six-session intervention, delivered by mental health peer leaders, helps participants become more effective managers of their chronic illnesses. A pilot trial randomized 80 consumers with one or more chronic medical illness to either the HARP program or usual care. Results: At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care (7.7% relative improvement vs. 5.7% decline, p=0.03 for group time interaction), and in rates of having one or more primary care visit (68.4% vs. 51.9% with one or more visit, p=0.046 for group time interaction). Intervention advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence, and, and though not statistically significant, had similar effect sizes as those seen for the CDSMP in general medical populations. Improvements in HRQOL were largest among medically and socially vulnerable subpopulations. Conclusions: This peer-led, medical self-management program was feasible and showed promise for improving a range of health outcomes among mental health consumers with chronic medical comorbidities. The HARP intervention may provide a vehicle for the mental health peer workforce to actively engage in efforts to reduce morbidity and mortality among mental health consumers.
AB - Objectives: Persons with serious mental illnesses (SMI) have elevated rates of comorbid medical conditions, but may also face challenges in effectively managing those conditions. Methods: The study team developed and pilot-tested the Health and Recovery Program (HARP), an adaptation of the Chronic Disease Self-Management Program (CDSMP) for mental health consumers. A manualized, six-session intervention, delivered by mental health peer leaders, helps participants become more effective managers of their chronic illnesses. A pilot trial randomized 80 consumers with one or more chronic medical illness to either the HARP program or usual care. Results: At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care (7.7% relative improvement vs. 5.7% decline, p=0.03 for group time interaction), and in rates of having one or more primary care visit (68.4% vs. 51.9% with one or more visit, p=0.046 for group time interaction). Intervention advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence, and, and though not statistically significant, had similar effect sizes as those seen for the CDSMP in general medical populations. Improvements in HRQOL were largest among medically and socially vulnerable subpopulations. Conclusions: This peer-led, medical self-management program was feasible and showed promise for improving a range of health outcomes among mental health consumers with chronic medical comorbidities. The HARP intervention may provide a vehicle for the mental health peer workforce to actively engage in efforts to reduce morbidity and mortality among mental health consumers.
KW - Chronic disease
KW - Recovery
KW - Self management
KW - Serious mental illness
KW - Wellness
UR - http://www.scopus.com/inward/record.url?scp=77952107604&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77952107604&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2010.01.026
DO - 10.1016/j.schres.2010.01.026
M3 - Article
C2 - 20185272
AN - SCOPUS:77952107604
SN - 0920-9964
VL - 118
SP - 264
EP - 270
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1-3
ER -