In SHAPE is a wellness program to improve the physical health and quality of life, reduce the risk of preventable diseases and enhance the life expectancy of people with severe mental illness. Monadnock Family Services, a community mental health agency located in Keene, N.H., in the rural, southwestern part of the state, launched the program in 2003. The Robert Wood Johnson Foundation (RWJF) funded In SHAPE from 2004 to 2008, as part of its Local Initiative Funding Partners program.
Dartmouth Medical School (Department of Community and Family Medicine, Dartmouth Psychiatric Research Center, Center for Aging and the Dartmouth Institute for Health Policy and Clinical Practice) researchers conducted an evaluation of In SHAPE from August 2004 to August 2006. The Endowment for Health and the National Institutes of Mental Health (NIMH) supported the evaluation.
In SHAPE served 435 individuals with mental illness in rural, southwestern New Hampshire and provided services to 41 of their family members. The average length of stay in the program is 9.69 months. As of August 2008, of the 157 active program participants:
- Fifty-four were in the program for less than one year.
- Twenty-nine were in the program for one to two years.
- Twenty-four were involved for two to three years.
- Fifty were in the program for three to four years.
Staff disseminated the In SHAPE model to more than 80 mental health centers around the country that might be good candidates to implement the model. The Dartmouth researchers reported their findings in the article “A Pilot Evaluation of the In SHAPE Individualized Health Promotion Intervention for Adults with Mental Illness” in the December 2010 issue of the Community Mental Health Journal. (Abstract available online.) Some 76 In SHAPE clients participated in the evaluation and reported:
- Increased number of hours exercising per week
- Increased overall activity and participation in vigorous activities
- Feeling more satisfied with their physical fitness Increased readiness to limit caloric intake
- Having greater confidence in social situations
- Reduction in waist circumference, blood pressure and depressive symptoms
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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