Translational Behavioral Medicine

, Volume 1, Issue 3, pp 453–460 | Cite as

Translation of the diabetes prevention program into a community mental health organization for individuals with severe mental illness: a case study

  • Kristin L Schneider
  • J Cherry Sullivan
  • Sherry L Pagoto


Individuals with severe mental illness (SMI) have significant health disparities. Wellness services embedded in community mental health organizations could lessen these disparities. This case study illustrates the integration of the Diabetes Prevention Program (DPP) lifestyle intervention into a community mental health organization. The Diffusion of Innovations Theory was used as a model for integration, which included a collaboration between researchers and the organization and qualitative work, culminating in a small pilot of the DPP led by peer specialists to test the feasibility of the DPP in this setting. Fourteen individuals with SMI participated in the 19-week intervention. Three dropped out, but the remaining 11 demonstrated 92% attendance. Weight loss was minimal, but the participants reported benefit and showed continued interest in the intervention. The use of a peer-led DPP in a community mental health organization is feasible and warrants further investigation to demonstrate efficacy.


Severe mental illness Obesity Lifestyle intervention Community mental health 


  1. 1.
    Hennekens, C. H. (2007). Increasing global burden of cardiovascular disease in general populations and patients with schizophrenia. The Journal of Clinical Psychiatry, 68(Suppl 4), 4–7.PubMedGoogle Scholar
  2. 2.
    DE Hert, M., Schreurs, V., Vancampfort, D., & VAN Winkel, R. (2009). Metabolic syndrome in people with schizophrenia: a review. World Psychiatry, 8(1), 15–22.Google Scholar
  3. 3.
    Douglas, I. J., & Smeeth, L. (2008). Exposure to antipsychotics and risk of stroke: self controlled case series study. BMJ, 337, a1227.PubMedCrossRefGoogle Scholar
  4. 4.
    Newcomer, J. W. (2005). Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs, 19(Suppl 1), 1–93.PubMedGoogle Scholar
  5. 5.
    Pagoto S, Schneider K, Appelhans B, Curtin C, Hadjuk A. Psychological comorbidities of obesity. In: Pagoto S, editor. Psychological comorbidities of physical illness: a behavioral medicine perspective. New York: Springer; (in press).Google Scholar
  6. 6.
    American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, North American Association for the Study of Obesity. (2004). Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care, 27(2), 596–601.CrossRefGoogle Scholar
  7. 7.
    Brown, S., Birtwistle, J., Roe, L., & Thompson, C. (1999). The unhealthy lifestyle of people with schizophrenia. Psychological Medicine, 29(3), 697–701.PubMedCrossRefGoogle Scholar
  8. 8.
    Hennekens, C. H., Hennekens, A. R., Hollar, D., & Casey, D. E. (2005). Schizophrenia and increased risks of cardiovascular disease. American Heart Journal, 150(6), 1115–1121.PubMedCrossRefGoogle Scholar
  9. 9.
    Dixon, L. B., Dickerson, F., Bellack, A. S., et al. (2010). The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophrenia Bulletin, 36(1), 48–70.PubMedCrossRefGoogle Scholar
  10. 10.
    Alvarez-Jimenez, M., Hetrick, S. E., Gonzalez-Blanch, C., Gleeson, J. F., & McGorry, P. D. (2008). Non-pharmacological management of antipsychotic-induced weight gain: systematic review and meta-analysis of randomised controlled trials. The British Journal of Psychiatry, 193(2), 101–107.PubMedCrossRefGoogle Scholar
  11. 11.
    Gabriele, J. M., Dubbert, P. M., & Reeves, R. R. (2009). Efficacy of behavioural interventions in managing atypical antipsychotic weight gain. Obesity Reviews, 10(4), 442–455.PubMedCrossRefGoogle Scholar
  12. 12.
    Radke, A. Q., Parks, J., & Ruter, T. J. (2010). A call for improved prevention and reduction of obesity among persons with serious mental illness. Psychiatric Services, 61(6), 617–619.PubMedCrossRefGoogle Scholar
  13. 13.
    USDHHS. (2010). The 10 by 10 campaign: a national wellness action plan to improve life expectancy by 10 years in 10 years for people with mental illness. A report of the 2007 National Wellness Summit for people with mental illness. Washington, D.C.: International Med Publishing.Google Scholar
  14. 14.
    Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Free Press.Google Scholar
  15. 15.
    Ryan, T., Webb, L., & Meier, P. S. (2006). A systems approach to care pathways into in-patient alcohol detoxification: outcomes from a retrospective study. Drug and Alcohol Dependence, 85(1), 28–34.PubMedCrossRefGoogle Scholar
  16. 16.
    DPP Research Group. (2004). Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obesity Research, 12(9), 1426–1434.CrossRefGoogle Scholar
  17. 17.
    Weber, M., & Wyne, K. (2006). A cognitive/behavioral group intervention for weight loss in patients treated with atypical antipsychotics. Schizophrenia Research, 83(1), 95–101.PubMedCrossRefGoogle Scholar
  18. 18.
    Mau, M. K., Keawe'aimoku Kaholokula, J., West, M. R., et al. (2010). Translating diabetes prevention into native Hawaiian and Pacific Islander communities the PILI 'Ohana Pilot project. Progress in community health partnerships research, education, and action, 4(1), 7–16.PubMedCrossRefGoogle Scholar
  19. 19.
    Parikh, P., Simon, E. P., Fei, K., Looker, H., Goytia, C., & Horowitz, C. R. (2010). Results of a Pilot Diabetes Prevention Intervention in East Harlem, New York City: Project HEED. American Journal of Public Health, 100(Suppl 1), S232–S239.PubMedCrossRefGoogle Scholar
  20. 20.
    Pagoto, S. L., Kantor, L., Bodenlos, J. S., Gitkind, M., & Ma, Y. (2008). Translating the Diabetes Prevention Program into a hospital-based weight loss program. Health Psychology, 27(1), S91–S98.PubMedCrossRefGoogle Scholar
  21. 21.
    Schneider, K. L., Bodenlos, J. S., Ma, Y., et al. (2008). Design and methods for a randomized clinical trial for co-morbid obesity and major depressive disorder. BMC Psychiatry, 8(1), 77.PubMedCrossRefGoogle Scholar
  22. 22.
    Pagoto, S. L., Bodenlos, J. S., Schneider, K. L., Olendzki, B., Spates, R. C., & Ma, Y. (2008). Initial investigation of behavioral activation therapy for co-morbid major depressive disorder and obesity. Psychotherapy Theory, Research, Practice, Training., 45(3), 410–415.CrossRefGoogle Scholar
  23. 23.
    Backer, T. E. (2000). Finding the balance: program fidelity and adaptation in substance abuse prevention. Washington, D.C.: Center for Substance Abuse Prevention.Google Scholar
  24. 24.
    Van Citters, A. D., Pratt, S. I., Jue, K., et al. (2010). A pilot evaluation of the In SHAPE individualized health promotion intervention for adults with mental illness. Community Mental Health Journal, 46, 540–552.PubMedCrossRefGoogle Scholar
  25. 25.
    Pagoto, S. L., Bodenlos, J. S., Kantor, L., Gitkind, M., Curtin, C., & Ma, Y. (2007). Association of major depression and binge eating disorder with weight loss in a clinical setting. Obesity, 15(11), 2557–2559.PubMedCrossRefGoogle Scholar
  26. 26.
    Pagoto, S. L., Curtin, C., Bandini, L. G., et al. (2010). Weight loss following a clinic-based weight loss program among adults with attention deficit/hyperactivity. Disorder symptoms Eat Weight Disord, 15, e166–172.Google Scholar

Copyright information

© Society of Behavioral Medicine 2011

Authors and Affiliations

  • Kristin L Schneider
    • 1
  • J Cherry Sullivan
    • 2
  • Sherry L Pagoto
    • 1
  1. 1.Department of Medicine, Division of Preventive and Behavioral MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.ServiceNetNorthamptonUSA

Personalised recommendations