Authors
Bartels SJ, Aschbrenner KA, Pratt SI et al.
Purpose
To evaluate the fidelity and effectiveness of a virtual learning collaborative (VLC) compared to routine technical assistance (TA) for implementation of a cardiovascular risk reduction health promotion program in mental health settings for persons with serious mental illness (SMI).
Methods
A cluster randomized controlled trial was conducted to compare VLC to TA for implementation of the evidence-based InSHAPEhealth promotion program in mental health settings. Fifty-five mental health organizations were randomly assigned to the VLC or TA implementation strategy condition. Both conditions received training and access to the treatment manual prior to assignment. The InSHAPEprogram consists of weekly one-on-one meetings with a certified health mentor, a gym membership, and group motivational celebrations. The VLC implementation strategy included monthly 90-minute virtual learning group sessions over 18 months. The TA strategy consisted of 4 individual site technical assistance calls with additional as needed over 18 months. Program fidelity was measured at the health mentor level using the InSHAPEFidelity scale at 6, 12, and 24 months. Program participation and clinical outcomes were measured at the participant level on attendance at sessions, weight loss, and cardiorespiratory fitness at 3, 6, 9, and 12 months.
Findings
- At 12 months, average program fidelity was higher in VLC sites (N=27, mean=91) compared to TA sites (N=28, mean=79).
- Majority of participants in both arms reduced cardiovascular risk at 6-month (VLC=51%; TA=54%) and 12-month follow-ups (VLC and TA=62%).
- At 12 months, VLC sites had significantly greater client program participation (VLC=70%, TA=56%), caseloads of individuals receiving the intervention (VLC=16, TA=11), reach (45% greater), and number of participants with cardiovascular risk reduction (58% greater) than TA sites.
Relevance
- Results indicate that relative to technical assistance only, a virtual learning collaborative implementation strategy resulted in similar intervention effectiveness, but greater fidelity, participation, and overall reach to participants with SMI receiving and benefitting from evidence-based programs.
- Future research is needed to evaluate the cost-effectiveness of VLC and TA implementation strategies.
Read More
Bartels SJ, Aschbrenner KA, Pratt SI et al. Virtual Learning Collaborative Compared to Technical Assistance as a Strategy for Implementing Health Promotion in Routine Mental Health Settings: A Hybrid Type 3 Cluster Randomized Trial. Adm Policy Ment Health 49, 1031–1046 (2022). https://doi.org/10.1007/s10488-022-01215-0