Cited by 363Mental Health and Patient InvolvementDiabetes Management and EducationChronic Disease Management Strategies

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The Health and Recovery Peer (HARP) Program: A peer-led intervention to improve medical self-management for persons with serious mental illness

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Druss, Benjamin G., Zhao, Liping, von Esenwein, Silke A., Bona, Joseph R., Fricks, Larry, Jenkins-Tucker, Sherry, Sterling, Evelina, DiClemente, Ralph, Lorig, Kate·2010·Schizophrenia Research

DOI 10.1016/j.schres.2010.01.026PMC PMC2856811

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Abstract

Objectives Persons with serious mental illnesses (SMI) have elevated rates of comorbid medical conditions, but may also face challenges in effectively managing those conditions.Methods The study team developed and pilot-tested the Health and Recovery Program (HARP), an adaptation of the Chronic Disease Self-Management Program (CDSMP) for mental health consumers. A manualized, six-session intervention, delivered by mental health peer leaders, helps participants become more effective managers of their chronic illnesses. A pilot trial randomized 80 consumers with one or more chronic medical illness to either the HARP program or usual care.Results At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care (7.7% relative improvement vs. 5.7% decline, p=0.03 for group *time interaction), and in rates of having one or more primary care visit (68.4% vs. 51.9% with one or more visit, p=0.046 for group *time interaction). Intervention advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence, and, and though not statistically significant, had similar effect sizes as those seen for the CDSMP in general medical populations. Improvements in HRQOL were largest among medically and socially vulnerable subpopulations.Conclusions This peer-led, medical self-management program was feasible and showed promise for improving a range of health outcomes among mental health consumers with chronic medical comorbidities. The HARP intervention may provide a vehicle for the mental health peer workforce to actively engage in efforts to reduce morbidity and mortality among mental health consumers.

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Background
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Self-citation
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“Other variables of interest included stress,(29) social support,(20,23) self-efficacy,(22,23) depression,(20,23) exercise/physical activity,(25,26) and quality of life.(26,30) Attrition and Attendance at Intervention Sessions Overall attrition (ie, dropout) rates were low and attendance at intervention sessions was hi…”
Influential
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Background
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“In 15 studies, SMI was diagnosed solely on the basis of the diagnosed psychiatric disorder (Table 3), whereas Lehman et al. (1997), Druss et al. (2010), and Druss et al. (2011) used different criteria to diagnose SMI depending on the psychiatric diagnosis (Table 3).”
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Authors: Druss, B. G., Zhao, L., von Esenwein, S. A., Bona, J. R., Fricks, L., Jenkins-Tucker, S., Sterling, E., DiClemente, R., & Lorig, K.
Affiliations: Emory University (US)
Stanford University (US)
ORCID: Druss, Benjamin G.
Zhao, Liping
Sterling, Evelina
DiClemente, Ralph
Lorig, Kate
Venue: Schizophrenia Research
Publisher: Elsevier BV
Published: 2010-05
Volume: 118
Issue: 1-3
Pages: 264-270
ISSN: 0920-9964 (ISSN-L)
DOI: 10.1016/j.schres.2010.01.026
PMC: PMC2856811
OpenAlex: W2020969377
Cited by: 363
References: 49
Citations by year: 2026: 6 · 2025: 13 · 2024: 14 · 2023: 21 · 2022: 22 · 2021: 25 · 2020: 25 · 2019: 27 · 2018: 22 · 2017: 23 · 2016: 31 · 2015: 35 · 2014: 39 · 2013: 35 · 2012: 11
FWCI: 34.17
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Schizophrenia Research (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (K24MH075867, R34MH078583)
Topics: Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords: peer-led intervention
MeSH terms: Adolescent, Adult, Mental Disorders, Chronic Disease, Female, Follow-Up Studies, Home Care Services, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Self Care, Self-Help Groups, Severity of Illness Index, Disease Management, Young Adult

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The Health and Recovery Peer (HARP) Program: A peer-led intervention to improve medical self-management for persons with serious mental illness

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