Title

Top-down transformation: Re-envisioning weight management in the lives of adults with mental illness

Start Time

4-10-2012 8:00 PM

End Time

4-10-2012 9:30 PM

Session Type

Event

Abstract

Addressing the health and wellness needs of adults living with serious mental illness (SMI) is a crucial public health concern in need of urgent attention, given that this group is estimated to have a 25-year decrease in life expectancy over the general population. For example, research indicates that those with SMI evidence overweight and obesity rates up to twice that of the general populace, resulting in cardiovascular disease and metabolic disorders that lead to premature death.1 A literature review revealed that weight management interventions for people with SMI are typically based on interventions designed for those without mental illness and that theoretical models for change relative to those with SMI are sorely lacking.2 As a result, weight management interventions use circumscribed approaches oriented toward personal changes to improve nutrition and decrease sedentary lifestyle, rather than data-driven methods based on an understanding of the particular needs of those with SMI. Occupational science, with its attention to the intricacies of participation in daily life, is particularly well suited to positively influence health and wellness intervention research for those with psychiatric disabilities.

This poster communicates research designed to gain a complex understanding of weight management for adults with SMI. Specifically, it examines the intersection of personal factors, life circumstances, and occupation for community dwelling adults with SMI. Fourteen participants were purposefully selected from a community-based mental health program in an urban area of Southern California. Participants engaged in one of four focus group interviews lasting 1½ to 2 hours each. Additionally, four of the participants volunteered to participate in a 2-3 hour individual semi-structured interview followed by a participant observation session lasting 2 to 4 hours. The data generation-analysis process included initial coding to construct tentative analytic categories and focused coding to synthesize ideas and further develop emerging themes.

Findings of this study support a re-conceptualization of weight management intervention tailored to the needs of this population. Applying a transactional perspective3 to these findings offers an opportunity to consider how complexities of disability experiences4 and notions of transformative social change5 relate to intervention development research. Particularly, a focus on sociopolitical and socioeconomic forces is proposed as a starting point in a new era of community-based weight management interventions for those with psychiatric disabilities.

Objectives for poster presentation:

  1. Discuss how occupational science can contribute to remediating health disparities through intervention development translational research
  2. Explore the connection between theoretical perspectives in occupational science and occupational therapy practice
  3. Disseminate findings and collaborate with occupational scientists around future directions for health and wellness research

References

1 National Association of State Mental Health Program Directors Medical Directors Council (October, 2006). Morbidity and mortality in people with serious mental illness (Technical Report No. 13). Alexandria, VA: Author. Retrieved June 25, 2008 from http://www.nasmhpd.org/

2 Galletly, C. L., & Murray, L. E. (2009). Managing weight in persons living with severe mental illness in community settings: A review of strategies used in community interventions. Issues in Mental Health Nursing, 30(11), 660-668. http://dx.doi.org/10.3109/01612840903131784

3 Dickie, V., Cutchin, M. P., & Humphry, R. (2006). Occupation as transactional experience: A critique of individualism in occupational science. Journal of Occupational Science, 13(1), 83-93. http://dx.doi.org/10.1080/14427591.2006.9686573

4 Sakiyama, M., Josephsson, S., & Asaba, E. (2010). What is participation? A story of mental illness, metaphor, & everyday occupation. Journal of Occupational Science, 17(4), 224-230. http://dx.doi.org/10.1080/14427591.2010.9686699

5Townsend, E. (2012). Boundaries and bridges to adult mental health: Critical occupational and capabilities perspectives of justice. Journal of Occupational Science, iFirst, 1-17. http://dx.doi.org/10/1080/14427591.2011.639723

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Oct 4th, 8:00 PM Oct 4th, 9:30 PM

Top-down transformation: Re-envisioning weight management in the lives of adults with mental illness

Addressing the health and wellness needs of adults living with serious mental illness (SMI) is a crucial public health concern in need of urgent attention, given that this group is estimated to have a 25-year decrease in life expectancy over the general population. For example, research indicates that those with SMI evidence overweight and obesity rates up to twice that of the general populace, resulting in cardiovascular disease and metabolic disorders that lead to premature death.1 A literature review revealed that weight management interventions for people with SMI are typically based on interventions designed for those without mental illness and that theoretical models for change relative to those with SMI are sorely lacking.2 As a result, weight management interventions use circumscribed approaches oriented toward personal changes to improve nutrition and decrease sedentary lifestyle, rather than data-driven methods based on an understanding of the particular needs of those with SMI. Occupational science, with its attention to the intricacies of participation in daily life, is particularly well suited to positively influence health and wellness intervention research for those with psychiatric disabilities.

This poster communicates research designed to gain a complex understanding of weight management for adults with SMI. Specifically, it examines the intersection of personal factors, life circumstances, and occupation for community dwelling adults with SMI. Fourteen participants were purposefully selected from a community-based mental health program in an urban area of Southern California. Participants engaged in one of four focus group interviews lasting 1½ to 2 hours each. Additionally, four of the participants volunteered to participate in a 2-3 hour individual semi-structured interview followed by a participant observation session lasting 2 to 4 hours. The data generation-analysis process included initial coding to construct tentative analytic categories and focused coding to synthesize ideas and further develop emerging themes.

Findings of this study support a re-conceptualization of weight management intervention tailored to the needs of this population. Applying a transactional perspective3 to these findings offers an opportunity to consider how complexities of disability experiences4 and notions of transformative social change5 relate to intervention development research. Particularly, a focus on sociopolitical and socioeconomic forces is proposed as a starting point in a new era of community-based weight management interventions for those with psychiatric disabilities.

Objectives for poster presentation:

  1. Discuss how occupational science can contribute to remediating health disparities through intervention development translational research
  2. Explore the connection between theoretical perspectives in occupational science and occupational therapy practice
  3. Disseminate findings and collaborate with occupational scientists around future directions for health and wellness research