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NCT03382782

Peer Navigators to Address Obesity-Related Concerns for African Americans With Serious Mental Illness

Completed NA Results posted Last updated 8 December 2023
What this trial tests

NA trial testing BWLI in Obesity in 234 participants. Completed in 11 March 2021.

Timeline
12 December 2017
Primary endpoint
12 March 2020
11 March 2021

Quick facts

Lead sponsorIllinois Institute of Technology
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment234
Start date12 December 2017
Primary completion12 March 2020
Estimated completion11 March 2021
Sites3 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Illinois Institute of Technology — full company profile →

Who can join

18 and older, any sex, with Obesity or Mental Disorder. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Weight Primary · 0, 4, 8 and 12 months

Change in Weight (pounds/lbs)

Baseline
GroupValue95% CI
Behavioral Weight Loss Intervention226.54± 41.22
BWLI & Peer Navigator225.46± 52.94
Integrated Care (Treatment as Usual)218.19± 40.41
4-Month
GroupValue95% CI
Behavioral Weight Loss Intervention225.63± 42.58
BWLI & Peer Navigator223.21± 51.27
Integrated Care (Treatment as Usual)214.85± 40.99
8-Month
GroupValue95% CI
Behavioral Weight Loss Intervention227.66± 42.12
BWLI & Peer Navigator223.25± 50.63
Integrated Care (Treatment as Usual)216.03± 39.62
12-Month
GroupValue95% CI
Behavioral Weight Loss Intervention228.86± 41.29
BWLI & Peer Navigator222.41± 50.13
Integrated Care (Treatment as Usual)216.65± 39.54
Quality of Life Scale (QLS) Secondary · 0, 8 months

Quality of Life Scale. Assesses life domains including general life, daily activities, and social contact. 6-items assessing how participants feel about different aspects of their lives including as a whole, accomplishments, how they handle problems, family, and activities (1=Terrible, 7=Delighted). Range from 0 to 126. Higher scores indicate better outcome (better quality of life).

Baseline
GroupValue95% CI
Behavioral Weight Loss Intervention27.61± 8.12
BWLI & Peer Navigator27.00± 6.78
Integrated Care (Treatment as Usual)27.58± 6.91
8-Month
GroupValue95% CI
Behavioral Weight Loss Intervention28.63± 7.69
BWLI & Peer Navigator28.53± 6.83
Integrated Care (Treatment as Usual)29.49± 6.84
Recovery Assessment Scale-Revised (RAS-R) Secondary · 0, 8 months

Based on Original Recovery Assessment Scale. RAS-Revised is shorter 24 item scale with individual items representing aspects of recovery to which participants respond on a 5-point agreement scale (1=strongly disagree, 5=strongly agree).There are five factors (1) personal confidence and hope; (2) willingness to ask for help; (3) goal and success orientation; (4) reliance on others; (5) not dominated by symptoms. Range from 24-120. Higher scores indicate better outcome (better recovery).

Baseline
GroupValue95% CI
Behavioral Weight Loss Intervention95.73± 13.81
BWLI & Peer Navigator95.32± 12.44
Integrated Care (Treatment as Usual)98.21± 11.96
8-Month
GroupValue95% CI
Behavioral Weight Loss Intervention98.72± 14.33
BWLI & Peer Navigator98.85± 13.01
Integrated Care (Treatment as Usual)97.65± 13.92
Weight Efficacy Lifetime (WEL) Questionnaire Secondary · 0, 8 months

Weight Efficacy Lifestyle Questionnaire. 20 items. Assesses participant confidence in resisting eating in some typical eating situations. Items rated on scale from 0=Not confident at all to 9=Very confident. Scores range from 0 to 180. Higher scores indicate better outcome (greater eating self-efficacy).

Baseline
GroupValue95% CI
Behavioral Weight Loss Intervention102.83± 38.32
BWLI & Peer Navigator99.22± 31.48
Integrated Care (Treatment as Usual)99.26± 32.35
8-Month
GroupValue95% CI
Behavioral Weight Loss Intervention124.72± 33.81
BWLI & Peer Navigator116.13± 32.40
Integrated Care (Treatment as Usual)109.93± 39.06
Self-Efficacy for Exercise Scale Secondary · 0, 8 months

Assesses participant beliefs in their ability to continue exercising on a three-time per week basis at moderate intensities. Range from 0 to 90. Higher score = better.

0 Month
GroupValue95% CI
Behavioral Weight Loss Intervention74.05± 24.50
BWLI & Peer Navigator69.02± 23.88
Integrated Care (Treatment as Usual)76.56± 22.70
8 Month
GroupValue95% CI
Behavioral Weight Loss Intervention66.34± 24.28
BWLI & Peer Navigator62.10± 25.62
Integrated Care (Treatment as Usual)67.15± 23.82
Waist Circumference Secondary · 0, 4, 8, 12 months

Change in waist circumference

0 Months (Baseline)
GroupValue95% CI
Behavioral Weight Loss Intervention46.00± 4.54
BWLI & Peer Navigator43.85± 6.18
Integrated Care (Treatment as Usual)44.99± 5.61
4 Months
GroupValue95% CI
Behavioral Weight Loss Intervention45.56± 4.90
BWLI & Peer Navigator44.78± 6.90
Integrated Care (Treatment as Usual)44.60± 6.34
8 Months
GroupValue95% CI
Behavioral Weight Loss Intervention46.23± 4.69
BWLI & Peer Navigator44.36± 6.44
Integrated Care (Treatment as Usual)43.82± 6.16
12 Months
GroupValue95% CI
Behavioral Weight Loss Intervention45.98± 5.04
BWLI & Peer Navigator44.13± 6.58
Integrated Care (Treatment as Usual)43.99± 5.59
Blood Pressure Secondary · 0, 4, 8, 12 months

Mean diastolic and systolic blood pressure (BP), in millimeters of mercury (mmHg) across 4 time frames.

0 Month (Baseline) Mean systolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention127.39± 15.52
BWLI & Peer Navigator124.98± 25.97
Integrated Care (Treatment as Usual)126.85± 25.79
0 Month (Baseline) Mean diastolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention89.11± 13.12
BWLI & Peer Navigator92.10± 12.55
Integrated Care (Treatment as Usual)90.27± 14.23
4 Month Mean systolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention129.35± 18.34
BWLI & Peer Navigator129.12± 25.78
Integrated Care (Treatment as Usual)125.93± 15.99
4 Month Mean diastolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention87.22± 14.13
BWLI & Peer Navigator86.62± 14.54
Integrated Care (Treatment as Usual)84.50± 10.06
8 Month Mean systolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention132.83± 21.30
BWLI & Peer Navigator124.80± 21.18
Integrated Care (Treatment as Usual)125.43± 18.22
8 Month Mean diastolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention86.87± 13.79
BWLI & Peer Navigator83.20± 12.31
Integrated Care (Treatment as Usual)85.63± 13.16
12 Month Mean systolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention130.06± 19.89
BWLI & Peer Navigator133.68± 24.34
Integrated Care (Treatment as Usual)130.95± 14.02
12 Month Mean diastolic BP
GroupValue95% CI
Behavioral Weight Loss Intervention86.70± 13.25
BWLI & Peer Navigator87.46± 12.06
Integrated Care (Treatment as Usual)86.52± 9.26
Height Secondary · 0 Month (Baseline)

Measure participants' height (inches)

GroupValue95% CI
Behavioral Weight Loss Intervention65.38± 3.65
BWLI & Peer Navigator66.68± 3.85
Integrated Care (Treatment as Usual)66.29± 4.70
36-Item Short Form Health Survey (SF-36) Secondary · 0, 8 months

36-Item Short Form Health Survey. Assess change in participants' health status and health related quality of life. Includes 4 subscales: (1) General health, (2) bodily pain, (3) physical functioning, (4) emotional well-being; range from 0-100 for each subscale. Higher score indicates better outcome.

0 Month-General Health Subscale (Baseline)
GroupValue95% CI
Behavioral Weight Loss Intervention60.20± 23.05
BWLI & Peer Navigator58.00± 22.11
Integrated Care (Treatment as Usual)59.13± 22.66
0 Month-Bodily Pain Subscale (Baseline)
GroupValue95% CI
Behavioral Weight Loss Intervention59.87± 26.25
BWLI & Peer Navigator61.94± 28.91
Integrated Care (Treatment as Usual)59.96± 27.31
0 Month-Physical Functioning Subscale (Baseline)
GroupValue95% CI
Behavioral Weight Loss Intervention63.86± 25.07
BWLI & Peer Navigator67.00± 26.51
Integrated Care (Treatment as Usual)69.23± 22.20
0 Month-Emotional Well-Being Subscale (Baseline)
GroupValue95% CI
Behavioral Weight Loss Intervention63.58± 20.57
BWLI & Peer Navigator60.43± 21.17
Integrated Care (Treatment as Usual)63.43± 23.53
8 Month-General Health Subscale
GroupValue95% CI
Behavioral Weight Loss Intervention62.11± 20.53
BWLI & Peer Navigator64.23± 21.96
Integrated Care (Treatment as Usual)58.17± 24.92
8 Month-Bodily Pain Subscale
GroupValue95% CI
Behavioral Weight Loss Intervention58.11± 27.13
BWLI & Peer Navigator63.25± 29.94
Integrated Care (Treatment as Usual)59.52± 26.29
8 Month-Physical Functioning Subscale
GroupValue95% CI
Behavioral Weight Loss Intervention59.74± 27.72
BWLI & Peer Navigator68.54± 27.23
Integrated Care (Treatment as Usual)60.48± 28.12
8 Month-Emotional Well-Being Subscale
GroupValue95% CI
Behavioral Weight Loss Intervention64.49± 20.70
BWLI & Peer Navigator67.20± 18.27
Integrated Care (Treatment as Usual)68.32± 18.86
Center for Epidemiologic Studies Depression Scale-Depression(CES-D) Secondary · 0, 8 months

Assess change in participants' experienced symptoms associated with depression. 10 items. Range from 0-60. Higher score indicates worse outcome (greater depressive symptoms).

Baseline
GroupValue95% CI
Behavioral Weight Loss Intervention23.79± 11.87
BWLI & Peer Navigator23.67± 10.97
Integrated Care (Treatment as Usual)21.93± 11.25
8-Month
GroupValue95% CI
Behavioral Weight Loss Intervention21.04± 12.93
BWLI & Peer Navigator20.53± 12.09
Integrated Care (Treatment as Usual)20.07± 11.22
Evidence-Based Practices Use (EBPU) Secondary · 0 months

Assess change in participants' enrollment in clinical and service interventions. Range from 0-10, higher scores = better outcome.

GroupValue95% CI
Behavioral Weight Loss Intervention4.07± 2.46
BWLI & Peer Navigator4.21± 2.65
Integrated Care (Treatment as Usual)4.09± 2.48
Emotional Eating Scale (EES) Secondary · 0, 8 months

Assess change in participants' experienced negative emotions and their relationships with desire to eat. 25 items. (0=No desire to eat, 5=Overwhelming urge to eat). Comprised of 3 subscales, added together for a total score. Range from 0 to 125. Higher scores indicate worse outcome (stronger desire to eat).

Baseline
GroupValue95% CI
Behavioral Weight Loss Intervention42.14± 23.25
BWLI & Peer Navigator43.14± 21.15
Integrated Care (Treatment as Usual)40.90± 21.15
8-Month
GroupValue95% CI
Behavioral Weight Loss Intervention35.60± 20.58
BWLI & Peer Navigator33.63± 21.26
Integrated Care (Treatment as Usual)36.61± 21.38

Adverse events — posted to ClinicalTrials.gov

Time frame: 2 years, 11 months. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Behavioral Weight Loss Intervention
Serious: 1/69 (1%)
Deaths: 0/69
BWLI & Peer Navigator
Serious: 1/74 (1%)
Deaths: 0/74
Integrated Care (Treatment as Usual)
Serious: 0/70 (0%)
Deaths: 0/70

Serious adverse events (2 terms)

ReactionSystemBehavioral Weight Loss Int…BWLI & Peer NavigatorIntegrated Care (Treatment…
High blood pressure observed at interviewGeneral disorders
Difficulty walking to interview, back painGeneral disorders

Most-reported serious reactions: High blood pressure observed at interview, Difficulty walking to interview, back pain.

Data from ClinicalTrials.gov NCT03382782 adverse events section.

Sponsor's own description

People with serious mental illness such as schizophrenia and bipolar disorder experience high rates of physical illness and die earlier than people without serious mental illness (WHO, 2005). Health differences seem to be worse among African Americans (Weber, Cowan, Millikan \& Niebuhr, 2009). High rates of obesity among this group contribute to health and wellness concerns (de Hert et al., 2011), with African American women at higher risk of obesity than men. Behavioral weight loss interventions (BWLIs) may promote diet and physical activity that lead to weight loss, but healthy food and safe physical activity options are less available in low-income neighborhoods. Peer navigators have been found to be effective in addressing health differences, and may help people living in low-income communities find healthy food and activity resources (Fischer, Sauaia, \& Kutner, 2007). In addition, traumatic experiences are common among persons with serious mental illness as well as African Americans, and may impact weight. Through this project, investigators will test two interventions designed to address overweight and obesity among African Americans with serious mental illness. The first is a BWLI designed for persons with serious mental illness and adapted to meet the needs of African Americans. This program has 8-month intervention phase and 4-month maintenance phase. The intervention includes group weight management classes, group physical activity, individual visits to address barriers to meeting weight goals, and weigh-ins. The second intervention is a peer navigator program that assists people with serious mental illness in meeting their health needs in the community. Two-hundred and seventy (270) research participants will be recruited and randomly assigned to one of three conditions: BWLI program, BWLI program plus peer navigator, and treatment as usual (integrated physical and mental health care). Investigators will evaluate these interventions over a 12-month period, and will track weight change, health behaviors, physical and mental health, recovery, and quality of life. Investigators also seek to understand the impact of gender and trauma on outcomes. Investigators hypothesize that peer navigators will improve outcomes over the BWLI program alone. Findings will advance knowledge and services to reduce racial disparities in obesity and comorbid health conditions for African Americans with serious mental illnesses.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Interventions for the management of obesity in people with bipolar disorder.
    Tully A, Smyth S, Conway Y, Geddes J, et al · · 2020 · cited 18× · PMID 32687629 · DOI 10.1002/14651858.cd013006.pub2

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