Technology-enabled collaborative care for youth with early psychosis: Results of a feasibility study to improve physical health behaviours.

Osnat Melamed, Aristotle Voineskos, Lenka Vojtila, Iqra Ashfaq, Scott Veldhuizen, Rosa Dragonetti, Rebecca Carriere, Laura LaChance, Sara Ahola Kohut, Trisha Tulloch, Sri Mahavir Argarwal, Margaret Hahn, Benoit H Mulsant, Peter Selby

Journal: Early intervention in psychiatry 2022;16(10):1143-1151

PMID: 35103380

Abstract

AIM

Psychotic disorders are associated with excess morbidity and premature mortality. Contributing factors include tobacco smoking, low physical activity, and poor nutrition. This study tested a Technology-Enabled Collaborative Care model to improve health behaviours among youth with early psychosis.

METHODS

A feasibility study among youth (ages 16-29) with early psychosis in Ontario, Canada. Participants were randomized to either a health coach supervised by a virtual care team (high intensity, n = 29), or self-directed learning (low intensity, n = 23) for 12 weeks. The primary outcome was participant engagement, defined as self-perceived benefit of changing health behaviours. Secondary outcomes were measures of health behaviours and programme-use metrics.

RESULTS

Engagement was higher for high intensity participants for physical activity (adjusted group difference in change at 24 weeks = 3.4, CI95% = 1.9-4.9, p < .001) and nutrition (adjusted difference = 2.9, CI95% = 1.2-4.6, p = .001). No change was observed in health behaviours. Sixty two percent of participants completed 6 or more of the 12 weekly remote individualized health coaching sessions. Nine (39%) low intensity and 12 (41%) high intensity participants completed the final follow-up.

CONCLUSIONS

Personalized health coaching for youth with psychosis is feasible and may have sustained benefits. However, retention with this population for 12 weeks is challenging.

© 2022 John Wiley & Sons Australia, Ltd.

Address: Nicotine Dependence Clinic, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.; Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental health, Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.; Ambulatory Mental Health, Trillium Health Partners, Mississauga, Ontario, Canada.; McGill University, Department of Psychiatry, Montreal, Quebec, Canada.; SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.; Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Addictions Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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