Coach to Fit Weight Loss Intervention for Individuals With Serious Mental Illness

NCT04560335 | Completed

• 1 other identifier: IIR 19-153
• Study Type: interventional
• Target: 257
• Locations: 1 country
• Sites: 1

Brief Summary

This project addresses obesity in the population with SMI by evaluating a weight management program that is not only evidence-based, it is sustainable, transportable, appealing to patients, easy to use, and minimally burdensome to the healthcare system. This effort addresses two HSR\&D priority areas: 1) Mental Health: Testing new models of care to improve access, cost, and/or outcomes, and 2) Health Care Informatics: Building the evidence base for ehealth/mhealth tools. Innovation: CoachToFit's use of mobile technology is an important innovation in VA service delivery and its user-centered design involving individuals with SMI was the first of its kind. CoachToFit is enhanced by data visualization in real-time via a web-based dashboard used by VA peer specialists and their supervisor. The Investigators are aware of no other evidence-based mobile platforms to help people with SMI reduce their weight

Conditions

Serious Mental Illness

Keywords

weight loss; mental illness; exercise

Outcome Measures

Primary Outcomes (5)

• EATING HABITS CONFIDENCE SURVEY

  Measures a participants confidence in their eating habits and potential for change. 32 items. Scale is 1 to 5. Total score ranges from 32 to 160, with higher scores meaning more confidence in changing to healthy eating habits.

  Change from Baseline to 6 months and baseline to 12 months

• Measure Usability and Acceptability

  Measures attitudes towards the Coach to fit intervention. 10 items. Scale is 1 = strongly disagree to 5 = strongly agree. After some calculations, total score ranges from 1- 100, with higher scores meaning more acceptability.

  6 month interview

• MOVE!11 Questionnaire

  Measures attitudes toward eating habits and weight loss. 1 item on number of minutes spent in moderate physical activity per day. higher minutes means more activity.

  Change from Baseline to 6 months and baseline to 12 months

• Weight control: Stages of change

  Measures willingness and readiness to change eating and exercise patterns. 4 Yes/No items. The pattern of responses places an individual into one of four categories: precontemplation (lowest), contemplation, action, maintenance (highest)

  Change from Baseline to 6 months and baseline to 12 months

• Body weight.

  Measurement of weight(in pounds) will be obtained for all participants using a hospital quality scale. Less pounds is better.

  Change from Baseline to 6 months and baseline to 12 months

Study Arms (2)

Coach to fit

EXPERIMENTAL

CoachToFit: Those randomized to CoachToFit will have the CoachToFit app downloaded to their phone by the peer coach and will work with the coach to initialize the app. Individuals will receive an activity tracker compatible with Android OS and iOS (Amazfit Bit) and a Bluetooth scale (Smart Body scale). Participants will be instructed by the peer to complete at least two CoachToFit modules per week. Modules take about 15 minutes to complete and have embedded knowledge quizzes and end with a choice of three goals to practice over the next week. They will also set up a time for the first 20-minute coaching call, which will then continue weekly.

Behavioral: Coach to FIt

Treatment as usual

OTHER

Veterans randomized to the treatment as usual arm will continue to access all services of the VA Pittsburgh, and will participate in three research interviews. After the first meeting, all participants will meet with a peer coach (peer specialists) who will discuss with them the importance of losing weight (using a structured conversation that follows a handout which is provided to the participant). The handout was developed with input from a VA dietitian as well as Veterans and is graphically appealing, with a simple layout, and provides information on diet and activity as well as the local MOVE! schedule

Behavioral: Treatment as Usual

Interventions

Coach to FIt BEHAVIORAL

CoachToFit: Those randomized to CoachToFit will have the CoachToFit app downloaded to their phone by the peer coach and will work with the coach to initialize the app. Individuals will receive an activity tracker compatible with Android OS and iOS (Amazfit Bit) and a Bluetooth scale (Smart Body scale). Participants will be instructed by the peer to complete at least two CoachToFit modules per week. Modules take about 15 minutes to complete and have embedded knowledge quizzes and end with a choice of three goals to practice over the next week. They will also set up a time for the first 20-minute coaching call, which will then continue weekly.

Coach to fit

Treatment as Usual BEHAVIORAL

Veterans randomized to the treatment as usual arm will continue to access all services of the VA Pittsburgh, and will participate in three research interviews. After the first meeting, all participants will meet with a peer coach (peer specialists) who will discuss with them the importance of losing weight (using a structured conversation that follows a handout which is provided to the participant). The handout was developed with input from a VA dietitian as well as Veterans and is graphically appealing, with a simple layout, and provides information on diet and activity as well as the local MOVE! schedule

Treatment as usual

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• chart diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or recurrent major depressive disorder with psychosis;
• age 18 and over;
• BMI \>= 30.0 (obese); and
• ownership of a phone running Android OS or iOS (iPhone).

You may not qualify if:

• chart diagnosis of dementia;
• history of bariatric surgery;
• pregnant and nursing mothers;
• patient has a conservator/legally authorized representative who makes their medical decisions;
• psychiatric hospitalization during the month prior to enrollment.
• Additionally, we will follow the American College of Sports Medicine recommendations for health screening and risk stratification in preparation for starting a moderate intensity exercise program to ensure that participants enrolled are capable of safely engaging in the app's recommendations regarding physical activity. Specifically, all potential participants will be given the Physical Activity Readiness Questionnaire (PAR-Q), a screening tool often used in weight management trials. If they endorse symptoms or major signs suggestive of cardiopulmonary disease (i.e., angina, anginal equivalent, dyspnea, syncope, orthopnea, edema, palpitations or claudication), which is a score \>=1 on the PAR-Q, they will need clearance from a VA physician before enrolling.

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, 15240, United States

Location

Related Publications (1)

• Chinman M, Wang T, Dodge JR, Frank DA, McCoy JL, Cohen AN. Tailored Weight Loss Programs for Adults With Serious Mental Illness: A Randomized Clinical Trial. JAMA Psychiatry. 2026 Feb 1;83(2):139-148. doi: 10.1001/jamapsychiatry.2025.3828.

  PMID: 41405896 RESULT

MeSH Terms

Conditions

Weight Loss; Mental Disorders; Motor Activity

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Body Weight Changes; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavior

Study Officials

• Matthew J Chinman, PhD

  VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: Methodology: The study design includes a randomized controlled trial to test the efficacy of CoachToFit and assess the hypothesized mechanisms of action. This will include enrollment of obese Veterans with SMI from the mental health clinics at one VA medical center (n=256). Individuals will be randomized to CoachToFit or usual care. Those in CoachToFit will have access to the app and coaching for 6 months. Outcomes are assessed at 6- and 12-months. Efficacy outcomes utilize objective measures. The design also includes a multi- stakeholder qualitative post-intervention evaluation guided by the RE-AIM framework to characterize factors that will inform future implementation and maintenance of CoachToFit. This will include interviews with Veterans randomized to CoachToFit (n=30); interviews with staff stakeholders (n=18); a discussion with Veterans in local Veteran groups (n=2 groups; n=11 Veterans), and interviews with national leadership (n=3).

Study Record Dates

• First Submitted: September 16, 2020
• First Posted: September 23, 2020
• Study Start: August 2, 2021
• Primary Completion: September 30, 2025
• Study Completion: March 31, 2026
• Last Updated: April 9, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)