Society for Social Work and Research 18th Annual Conference: Research for Social Change: Addressing Local and Global Challenges

January 15 - 19, 2014

The reduced life expectancy of people with serious mental illness represents one of the greatest health disparities in the nation, a gap that has increased over the past three decades.  This vulnerable population experiences a mortality rate that is, on average, 25-30 years lower than the general population, with cardiovascular disease representing the leading cause of death.  Thus, much of their risk may be attributed to potentially modifiable lifestyle factors such as obesity, exercise, and smoking.  Lifestyle modification is one of the greatest opportunities to reduce disease morbidity and mortality in persons with serious mental illness, yet much remains to be learned about key targets at the individual, social, environmental, and health services level to promote sustainable health behavior change in this population. This symposium will present four studies, drawing upon a range of qualitative and quantitative methods, which aim to further our understanding of potential points of intervention for healthy lifestyle change in persons with serious mental illness.

The first presentation takes on the issue of nicotine dependence in adults with serious mental illness. Data collected from a trial of a computerized intervention to engage and educate smokers with serious mental illness to quit with an evidence-based treatment, was used to evaluate the relationships between participant perceptions of the positives and negatives of smoking, stage of change, and their use of a quit smoking treatment. Implications for clinician-delivered motivation enhancement therapy will be discussed.

The second presentation draws upon social ecological models of health promotion, which highlight the pivotal role that social networks have in in determining individual decisions about engaging in health promoting behaviors.  This qualitative study with fitness providers delivering a healthy lifestyle intervention to adults with serious mental illness explored their perspectives on enlisting support for participants’ health goals from family and friends.  Potential strategies for engaging family and significant others to increase the effectiveness of healthy lifestyle programs will be discussed.

The third presentation also uses an ecological lens to examine how the interactions of individual, social, and environmental factors shape the health behaviors of Hispanics with SMI at risk for cardiovascular disease.  This focus group study demonstrates how participants’ efforts to live a healthy lifestyle were negatively impacted by a layering of individual, social, and environmental factors.  The findings carry important implications for defining intervention targets at multiple levels to improve the physical health of people with serious mental illness and reduce health disparities.

The fourth study examines how clinicians in assertive community treatment address healthy lifestyle issues in everyday practice. This presentation will draw upon conversation analysis of audio-recorded sessions between consumers and their psychiatrists and case managers exploring “health talk” in the clinical encounter.  Implications for training providers in effective communication related to health promotion will be discussed. 

The results from these four studies represent a range of qualitative and quantitative methods that will provide insights into “who, what, and where” to target intervention strategies to promote lasting health behavior change in persons with serious mental illness.