Title: Do Incentives Increase Health Behavior Change for Obesity When Integrated Into Community Mental Health Services? A Statewide CMS-funded Demonstration
People with serious mental illness receiving community mental health services in the United States have a 25-30 year shorter life expectancy than the general population, primarily due to elevated rates of cardiovascular disease from nearly twice as much tobacco smoking and nearly double the rate of overweight and obesity. Although fitness programs for people with mental illness demonstrate promise for some participants in clinical trials, approximately half do not lose significant amounts of weight nor demonstrate improvements in fitness. Other strategies are needed to address this substantial health disparity. New Hampshire’s Healthy Choices, Healthy Changes (HCHC) program was created in 2011 in response to Section 4108 of the Affordable Care Act, the Medicaid Incentives for the Prevention of Chronic Diseases program, which funded 10 programs in the US designed to test the effectiveness of providing incentives to Medicaid beneficiaries to encourage adoption of healthy behaviors. We will describe the equipoise stratified randomized design employed in our evaluation of the HCHC program (offered at all 10 public sector community mental health centers in the state of NH) as well as the use of incentives to encourage engagement in fitness activities. Baseline characteristics of the large, well-characterized sample (n=1348) of people who joined the HCHC program will be presented, as well as 12-month outcomes of HCHC. Finally, we will discuss our plans for future use of behavioral economics in the design of interventions to enhance fitness among people with serious mental illness who are at risk of early mortality due to cardiovascular disease risk factors.
Location: 46 Centerra Parkway, 3rd Floor, Aquarium Conference Room
This location is across the highway from Dartmouth-Hitchcock Medical Center and has easy parking.