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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
Open accessAbstract
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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“One U.S. study had explored the impact of care coordination in patients with severe mental illness, using a composite cardiovascular risk score, finding a significant effect 41 .”
From The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity (2016) · cites this paper as [41]
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Metadata
- 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)
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 118
- Issue
- 1-3
- Pages
- 264-270
- ISSN
- 0920-9964 (ISSN-L)
- 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
- 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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