title: Cardiometabolic health nursing to improve health and primary care access in community mental health consumers: protocol for a randomised controlled trial.
abstract: BACKGROUND
  People with a serious mental illness are at significantly greater risk of poor cardiometabolic health with recent studies showing a greater than two-fold increase in the risk of obesity, infectious diseases, diabetes and cardiovascular disease. Contributing factors to this disparity include poorer health behaviours such as suboptimal physical activity, poor diet, smoking, alcohol and illicit drug misuse. In particular, the limited access to primary health care experienced by people with a serious mental illness has been highlighted. Persons with a serious mental illness are around 30% less likely than those without serious mental illness to receive health assessments, hospital admissions or procedures for cardiovascular disease and diabetes, and are less likely to undergo cancer screening or receive vaccinations. Studies show that mental health consumers may be more likely to use mental health services rather than primary care for contact with the health care system. However mental health nurses report several barriers to their capacity to provide cardiometabolic health care crucial for the treatment of people with a serious mental illness.
  
  
  OBJECTIVE
  To assess the impact of a specialist Cardiometabolic Health Nurse on the physical health care of community based mental health consumers.
  
  
  METHODS
  Community mental health facility in a large regional centre in Central Queensland, Australia.
  
  
  METHODS
  Community based mental health consumers will be randomised to receive either usual care, or consultations with a Cardiometabolic Health Nurse. The Cardiometabolic Health Nurse will be responsible for assessing the client and coordinating cardiometabolic health care as required. Post intervention review of health records will be performed with the primary outcome measure being self-reported physical health. Secondary outcomes include the utilisation of primary care services and changes in health behaviours. We hypothesise that the Cardiometabolic Health Nurse will increase the utilisation of health care services for mental health consumers.
  
  
  RESULTS
  Data collection commenced in March 2013 and will conclude September 2013. Preliminary finding are expected in December 2013.
authors.affiliation: Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, Bruce Highway, Rockhampton, Queensland 4702, Australia.
authors.forename: Brenda
authors.initials: B
authors.lastname: Happell
authors.affiliation: Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, Bruce Highway, Rockhampton, Queensland 4702, Australia. Electronic address: r.stanton@cqu.edu.au.
authors.forename: Robert
authors.initials: R
authors.lastname: Stanton
authors.affiliation: Central Queensland Mental Health Alcohol and Other Drugs Service, Central Queensland Hospital and Health Service, Rockhampton, Queensland 4700, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Hoey
authors.affiliation: Central Queensland University, Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, Bruce Highway, Rockhampton, Queensland 4702, Australia; NorthWest Academic Centre, University of Melbourne, Melbourne, Victoria 3001, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Scott
mesh_terms: D002320:Cardiovascular Physiological Phenomena; D002985:Clinical Protocols; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D015438:Health Behavior; D006297:Health Services Accessibility; D006801:Humans; D008511:Medicine; D008660:Metabolism; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011793:Queensland
keywords: Health care utilisation; Mental illness; Physical health; Primary health care; Randomised controlled trial