Core Research Project

Statewide Integrated Health Promotion to Decrease Obesity and Smoking in Community Mental Health Settings

Co-Principal Investigators: Sarah I. Pratt, PhD and Kelly A. Aschbrenner, PhD

Project Description: The life expectancy of people with serious mental illness (SMI), approximately five to six percent of Americans, is an alarming 25–30 years less than that of the general population. The main cause of this early death is heart disease associated with risk factors that can be changed, such as obesity and smoking. Up to 80 percent of Americans with SMI smoke cigarettes and many develop related chronic health conditions. The obesity rate in adults with SMI is nearly 2-3 times that of the general population. Obesity and metabolic disorders among people with SMI are associated with high rates of sedentary behavior, poor nutrition, and antipsychotic medications that are associated with high weight gain, high cholesterol, and diabetes. People with SMI represent an important public health challenge because they are the highest-cost Medicare and Medicaid recipient group. They also account for high use of acute and long-term-care medical services and experience the greatest health disparity of any U.S. major population subgroup.

Aim 1: To identify clinical, psychological, and program predictors of long-term health outcomes for 500 people with obesity and mental illness and 400 smokers with mental illness in a statewide, incentive-based health promotion program.

Aim 2: To explore individual, social, and environmental factors associated with long-term health outcomes in a statewide health promotion program comparing high (n=30) vs. low (n=30) improved health outcomes.

Aim 3: To evaluate long-term sustainability and costs of integrated health promotion programs for the vulnerable health disparity population of adults with mental illness.

CDC ASTHO Ask the Experts Webinar Series: Integrating Mental and Public Health

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ASTHO and CDC co-hosted this webinar on how public health professionals can integrate mental health services in their work. Expert panelists, including Dr. Stephen Bartels, discussed public health programs implemented for people with mental health disorders, how to systematically coordinate behavioral and public health systems, and strategies for reducing the stigma surrounding mental and behavioral health. The event features panelists who will lead a dialogue on mental health program implementation and adaptation and key partnerships for successfully integrating mental and public health efforts.

HPRCD Core Research Project Featured in Psychiatric Services Podcast


Psychiatric Services Editor Lisa Dixon, M.D., M.P.H., and Podcast Editor and co-host Josh Berezin, M.D., M.S., discuss In SHAPE, a lifestyle intervention for individuals with serious mental illness; outcomes of a peer mentor intervention for persons with recurrent psychiatric hospitalizations; and the inaugural Viewpoint column in Psychiatric Services. Viewpoint is a new feature that touches on controversial, important current topics. Our first Viewpoint touches on work requirements in Medicaid.

HPRCD Featured in New CDC Podcast

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Health Promotion Research Center at Dartmouth Co-Investigator, Dr. Stephen Bartels, was featured in a recent CDC Podcast about our Core Research Project. The podcast is titled: Prevention Research Matters: Fitness for People with Mental Illness Who are Overweight.

"People with serious mental illness who are overweight or obese can benefit from taking part in a fitness program called InSHAPE where they receive help with fitness, weight loss, and even grocery shopping on a budget."

HPRCD Core Research Project: CDC Feature Story

The Health Promotion Research Center at Dartmouth Core Research Project is showcased as a Centers for Disease Control and Prevention Feature story. 

"Research by the HPRCD has shown that a program known as InSHAPE is effective in helping people with serious mental illness who are overweight or have obesity to lose weight and to be more physically fit."

PRC 30th Anniversary: Community Highlight Story featuring the Health Promotion Research Center at Dartmouth

We’re still in the process of evaluating all of our data, so the overall results aren’t available yet. But it looks very promising—we’re seeing a lot of great success stories, where people like Tara and Mike have literally turned their lives around.”
— Sarah I. Pratt, PhD