NEW-R for a New You: Bringing a Weight and Well-Being Program to Scale Statewide
University of Illinois at Chicago (UIC)
Rehabilitation Research and Training Center: Center on Integrated Health Care & Self-Directed Recovery
Submitted by Judith A. Cook, PhD, and Jessica A. Jonikas, MA
Staff of the University of Illinois at Chicago (UIC) Center on Integrated Health Care and Self-Directed Recovery are participating in an academic–state agency collaborative partnership to bring Nutrition and Exercise for Wellness and Recovery (NEW-R) to scale statewide. NEW-R is an online course designed to help people in mental health recovery acquire knowledge and skills for healthier eating and increased physical activity.
The UIC Center on Integrated Health Care and Self-Directed Recovery designs and evaluates self-directed models of medical care and mental health services that promote recovery, health, and employment for people with psychiatric disabilities. One of the Center’s goals is to enhance the health and well-being of adults with serious mental illnesses and co-occurring medical conditions.
Obesity is far more prevalent among adults with psychiatric disabilities than adults in the general population. Obesity increases their vulnerability to such health risks as type 2 diabetes, heart disease, stroke, high blood pressure, high cholesterol, and premature death. Factors associated with obesity for this group include use of psychotropic medication, poverty, lack of physical activity and exercise, high volume of food intake, and diets high in fat and low in ﬁber.
NEW-R is an 8-session course during which participants meet weekly for 90 minutes; 20 of those minutes are spent doing mild-to-moderate exercise. Participants examine their eating and exercise habits to identify what they would most like to change, and set achievable goals each week to make these changes. A pilot study of NEW-R showed that participants lost an average of 10 pounds through nutritious meal planning, reduced portion sizes, and increased daily exercise. Peer support and intentionality also are used to help participants stay on track.
Knowledge Translation Strategies
Working in a collaborative partnership with the Illinois Department of Human Services’ Division of Mental Health (DMH), the Center is participating in a multipronged knowledge translation effort to bring NEW-R to scale statewide. This collaborative effort will help adults served by the public mental health system achieve healthier lifestyles. Widespread use of NEW-R supports the state’s goals of enhancing physical health and employment among adults with psychiatric disabilities in Illinois, especially since poor health poses a significant barrier to employment.
The first knowledge translation strategy employed to scale up NEW-R was to establish a partnership between the Center and other statewide funding opportunities. The Center included NEW-R in the Transforming Lives through Supported Employment Initiative, which is funded through a state grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). This initiative is designed to promote and sustain supported employment services in Illinois, using NEW-R as a key ancillary service. Including NEW-R in this way significantly increases the likelihood of its adoption, because DMH is monitoring the implementation of each service included in the federal initiative. The project’s two demonstration sites are the first to offer NEW-R after training their mental health peer staff to deliver it to supported employment clients.
Simultaneously, DMH and the Center began planning for a statewide roll-out of NEW-R to meet the goals of the scale-up initiative. This effort began with the formation of a statewide NEW-R Committee, which meets monthly to set and monitor scale-up goals. The Center held an initial NEW-R facilitator training in Chicago, which was delivered by NEW-R’s lead developer, Dr. Catana Brown. This was followed by trainings in additional regions of the state; refresher trainings are now being planned. The mental health peer specialists who facilitated NEW-R at the SAMHSA demonstration sites served as presenters at these regional trainings. In 2017, two additional regions will receive the initial and refresher trainings.
DMH leadership is encouraging each of its regional network directors to ensure that local provider agencies receive NEW-R training and offer NEW-R at their agencies. To support scale-up, the Center created a NEW-R repository about wellness in the workplace (see: http://bit.ly/2iQ23EY) on the web portal that was developed as part of the Transforming Lives through Supported Employment Initiative. The online repository includes free access to:
- the NEW-R facilitator and participant manuals;
- a webinar on how to use NEW-R;
- a flyer to promote the use of NEW-R statewide;
- a questionnaire that provider agencies complete upon starting a NEW-R group, to help the state track scale-up; and
- a NEW-R participant satisfaction survey designed by the Center to measure weight loss and evaluate NEW-R.
The Center is measuring its knowledge translation activities in partnership with the state, by tracking NEW-R’s adoption and evaluating participant satisfaction. Regional network directors and provider agencies are showing strong interest in offering NEW-R to help clients achieve healthier lifestyles. Through this knowledge translation effort, the Center has confirmed that providers and clients need a variety of strategies and formats to learn a new practice and to apply it in real-world settings. Stakeholders need access to free learning opportunities, along with web-based refreshers and resources, to improve their knowledge and skills. Active participation of state and regional leadership in partnership with the Center increases the likelihood that new practices will be adopted on a large scale in public human service settings.
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