Catana Brown PhD, OTR, FAOTA Midwestern University, Glendale, AZ

 University of Illinois at Chicago National Research and Training Center on Psychiatric Disability and Co-Occurring Medical Conditions  Funding from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research; and the Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, under Cooperative Agreement No. H133B

 Cost  Transportation  Stigma  Medication/symptom issues  Accessible instruction

 Provide a weight loss program specifically designed for people in recovery that is…..  Easy to adopt in a variety of settings  Detailed participant and leader manuals  Can be provided by people in recovery and professionals  Informed by evidence, people in recovery and experts  RENEW program (12 month program)  Panel of experts providing input  Participant feedback

Recovering Energy using Nutrition and Exercise for Weight Loss (RENEW) – A Weight Loss Program for People in Recovery NIMH Funded: 1R34MH PI: Catana Brown/Edna Hamera

Intensive Phase Weekly 3 hr session 2 exercise sessions Meal Replacements Maintenance Phase Monthly 3 hr session 2 exercise sessions Phone Buddies Newsletter Intermittent Phase No face to face contact Phone buddies Newsletter  Evidence based weight loss strategies  Psychiatric rehabilitation principles 3 months 6 months Timeline of Program

GroupAt 3 MonthsAt 6 MonthsAt 12 Months Intervention range Control range ± ± Intent to Treat Analysis Intervention/control differences: 3 months p =.005, 6 months p =.106, 12 months p =.67

Weight Loss (lb)

Development of NEW-R Curriculum

 Used RENEW Program curriculum as the foundation  Adapted for lessons learned  Conducted interviews with peer educators & providers  Assessed themes from interviews and incorporated when possible  Thank you to those providing guidance:  Peggy Swarbrick  Beth Stoneking  Karen Cook  Richard Goldberg  Dori Hutchinson  Mary Ellen Copeland  Judy Young  Joe Parks

 Change thinking  Setting goals  Social support  Important topics  Changing environment of the setting  Develop more structure to daily life  Strategies to continue the good work

NEW-R Curriculum

Available at: wellbeing.asphttp:// wellbeing.asp Participant Manual Leader Manual

 Group format  8 sessions  1 x per week  1 ½ hour session with one brief break  Commitment from leaders and participants to attend all sessions

 Based on principles from research of weight loss interventions:  Changes in intake, make the biggest impact on weight loss  Being aware of what you eat can have a positive effect on intake  Physical activity can support changes in diet, help maintain weight loss and promote other health benefits  People that are overweight/obese tend to lead very sedentary lifestyles  Social support is important for weight loss  Belief in one’s ability to lose weight/self-efficacy contributes to behavioral change Placing an emphasis on making a plan and/or thinking about what you are going to do each day.

Each day ……  I will wake up at a reasonable time in the morning.  I will do something meaningful.  I will spend more time moving and less time sitting and/or watching TV.  I will make a plan about what I am going to eat each day.  I will eat healthy foods that I enjoy and avoid unhealthy foods.  I will talk to someone that supports my weight loss goals.  And if I have a bad day, it’s not a big deal. I will remind myself of the plan and try to do better the next day.

 Distilled most important topics into 8 sessions:  I can make a change!  ABCs of healthier eating  Reading food labels and portion control  Let’s get moving  Eating out  Meal planning and thrifty shopping  Let’s get cooking without the fat  Celebrating accomplishments and keeping up the good work

 Opening quote – creating a positive mind set  Instruction and active learning  Goal setting  Reminders of things to do this week  Success story  Physical Activity

 Dance  Yoga  Upper Body Strength  Lower Body Strength  Kickboxing  Core  Cardio  Mixed

 Average body weight loss – 3.6%  6 participants had > 5% body weight loss  Small increase in knowledge from 10.4 – 11.4 points (p =.05)