Randomized Controlled Trial of a Healthy Lifestyle Intervention Among Smokers With Psychotic Disorders.
BACKGROUND
People with severe mental disorders typically experience a range of health problems; consequently, interventions addressing multiple health behaviors may provide an efficient way to tackle this major public health issue. This two-arm randomized controlled trial among people with psychotic disorders examined the efficacy of nicotine replacement therapy (NRT) plus either a face-to-face or predominantly telephone delivered intervention for smoking cessation and cardiovascular disease (CVD) risk reduction.


METHODS
Following baseline assessment and completion of a common, individually delivered 90-minute face-to-face intervention, participants (n = 235) were randomized to receive NRT plus: (1) a "Healthy Lifestyles" intervention for smoking cessation and CVD risk behaviors or (2) a predominantly telephone-based intervention (designed to control for NRT provision, session frequency, and other monitoring activities). Research assistants blind to treatment allocation performed assessments at 15 weeks (mid-intervention) and 12 months after baseline.


RESULTS
There were no significant differences between intervention conditions in CVD risk or smoking outcomes at 15 weeks or 12 months, with improvements in both conditions (eg, 12 months: 6.4% confirmed point prevalence abstinence rate; 17% experiencing a 50% or greater smoking reduction; mean reduction of 8.6 cigarettes per day; mean improvement in functioning of 9.8 points).


CONCLUSIONS
The health disparity experienced by people with psychotic disorders is high. Face-to-face Healthy Lifestyle interventions appear to be feasible and somewhat effective. However, given the accessibility of telephone delivered interventions, potentially combined with lower cost, further studies are needed to evaluate telephone delivered smoking cessation and lifestyle interventions for people with psychotic disorders.
Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia; amanda.baker@newcastle.edu.au.
Amanda L
AL
Baker
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia;
Robyn
R
Richmond
Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia;
Frances J
FJ
Kay-Lambkin
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Alfred Hospital, Melbourne, Australia;
Sacha L
SL
Filia
University of Melbourne and Department of Psychiatry, St Vincent's Hospital, Fitzroy, Australia;
David
D
Castle
Division of Addiction Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ;
Jill M
JM
Williams
Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia; Mental Health - Research, Evaluation, Analysis and Dissemination Unit, Hunter New England Mental Health, Newcastle, Australia;
Terry J
TJ
Lewin
Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia;
Vanessa
V
Clark
Priority Research Centre for Nutrition and Physical Activity, University of Newcastle, Callaghan, Australia;
Robin
R
Callister
Clinical Research Design, IT and Statistical Support Unit, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
Natasha
N
Weaver
D000328:Adult; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016037:Single-Blind Method; D012907:Smoking / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy