Examining Place-Based Neighborhood Factors in a Multisite Peer-Led Healthy Lifestyle Effectiveness Trial for People with Serious Mental Illness

Deborah Salvo (), Eugen Resendiz, Ana Stefancic and Leopoldo J. Cabassa
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Deborah Salvo: Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA
Eugen Resendiz: Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA
Ana Stefancic: Department of Psychiatry, Columbia University, New York, NY 10032, USA
Leopoldo J. Cabassa: Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA

IJERPH, 2023, vol. 20, issue 9, 1-25

Abstract: People with severe mental illness (SMI) experience significantly higher obesity-related comorbidities and premature mortality rates than healthy populations. The physical and social characteristics of neighborhoods where people with SMI reside can play an important role in promoting or hindering healthy eating and physical activity. However, this is seldom considered when designing and testing health behavior interventions for these populations. This study used baseline data from an obesity control trial for low-income, minority people with SMI to demonstrate the utility of assessing neighborhood- and city-level place-based factors within the context of lifestyle interventions. GIS was used to create a zip-code-level social and built environment geodatabase in New York City and Philadelphia, where the trial occurred. Chi-square and t-tests were used to assess differences in the spatial distribution of health-related built and social environment characteristics between and within cities and diet and physical activity outcomes. All types of neighborhood characteristics showed significant environmental differences between and within cities. Several neighborhood characteristics were associated with participants’ baseline healthy eating and physical activity behaviors, emphasizing that place-based factors may moderate lifestyle interventions for SMI patients. Future behavioral interventions targeting place-dependent behaviors should be powered and designed to assess potential moderation by place-based factors.

Keywords: serious mental illness; obesity; healthy lifestyle interventions; physical activity; geographic information systems; built environment; social environment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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