The effect of peer support on

knowledge and self-efficacy in weight

management: a prospective clinical

trial in a mental health setting

Ontario Shores Mental Health Conference

Tuesday February 27th 2018

Team Member

Credentials Institution

Claire Hibbert (PI) RD Ontario Shores

Emilie Trottier RD Ontario Shores

Marlie Boville RN Ontario Shores

Dr. Margaret Hahn Psychiatrist, PhD CAMH

Alexandra Hernandez PhD Ontario Shores

Alifa Siddiqui Research assistant, BScH

(candidate) Ontario Shores

Acknowledgements: Steve Mann, Melanie Stuckey, Angie Yan Yee

Tse, Ontario Shores Research Dpt.

What is Metabolic Syndrome?

Diabetes

High blood

pressure

Low HDL – “good”

cholesterol

High

triglycerides

Abdominal

Obesity

SMI

Metabolic

Syndrome

The Mental Health – Metabolic Connection

CVD

Social Determinants

Symptoms Biology

The Metabolic and Weight Management

Clinic (MWMC)

Who we are and what we do:

• Minimize the impact of metabolic syndrome on clients with mental illness

• Focus on modifiable risk factors

• Self-management approach

• Staffing and model of care

• Outcome measures

Study Rationale

__ % of clients who have been

attending MWMC for at least six

months have not achieved and/or

maintained 5% weight reduction

since their initial enrollment

63

Literature Review

What else can we do?

• There are benefits to group therapy

• There are also benefits to individual therapy

• No harms from either modality

• Frequent follow up is important

• Follow up for a longer period of time

**No literature examines group versus individual therapy for clients

with metabolic illness in a mental health setting**

Study Design

• Incorporate peer support groups into existing model of care

• Two-hour group sessions every 2 weeks for 1 year

• Prospective clinical trial

• Within subject, single group pre- & post-test design

• Grant from the Ontario Shores: 2016 Inter-Professional Clinical Trials Research Seed Grant

Study Participants

• Recruitment

o Goal was N = 20

o Initial recruitment N = 19

o Start of study N = 14

• Inclusion & exclusion criteria

• Approved by full board REB at Ontario Shores

Intervention - Group Education and

Peer Support Sessions

• Facilitated by RN and RD

• Review of action plans

• Education – nutrition, physical activity, sleep, managing mood, medication, working with your healthcare team, action planning

• Healthy snack break

• Develop new action plans

• $5 cash per visit

Measures Baseline, 3, 6, and 12 months

• Weight

• Health-related quality of

life (SF-36)

• Diet Quality (DSQ)

• Confidence and

Conviction (C&C)

Research Objectives

Primary: To determine the effects of incorporating

frequent group peer support on body weight and C&C

Secondary: To examine the relationship between C&C and

weight change and maintenance, as well as health-related

quality of life and diet quality

Hypotheses

1) Group peer support will result in more clients losing and

maintaining 5% weight loss in the one-year study period

2) C&C at three months will predict the change in body

weight over the one-year study period

Results – Study Participants

• Age 51.7 ± 12.2 years;

29%

64%

7%

Gender

Male

Female

Transgender

Final Results - Weight

122.19 124.66 120.15 123.10

-10.00

10.00

30.00

50.00

70.00

90.00

110.00

130.00

150.00

170.00

Baseline 3 month 6 month 12 month

Mean

Weig

ht

(kg

)

Time Period

Final Results - Weight

-12

-7

-2

3

8

AAA001 AAA002 AAA004 AAA005 AAA006 AAA007 AAA008 AAA009 AAA010 AAA011 AAA013 AAA014 AAA015 AAA016 mean

Weig

ht

Ch

an

ge (

%)

Participant

% Weight Change at 3, 6 and 12 months

3 months

6 months

12months

Final Results – Conviction

9.32 8.92 9.18 9.25 0.00

2.00

4.00

6.00

8.00

10.00

Baseline 3 month 6 month 12 month

Mean

Co

nv

icti

on

Time Period

Final Results – Confidence

6.64 7.15 7.55 8.13 0.00

2.00

4.00

6.00

8.00

10.00

Baseline 3 month 6 month 12 month

Mean

Co

nfi

den

ce

Time Period

Final Results – SF-36

0

10

20

30

40

50

60

70

80

90

Physical Functioning Physical Health - Role Emotional Health - Role Energy/Fatigue Emotional Well-being Social Functioning Pain General HealthPerception

Mean

Sco

re

Subscales

Medical Outcomes Questionnaire SF-36

Baseline

3 months

6 months

12 months

Discussion

• No significant weight change

• High C&C scores were maintained

• Pain improved and physical functioning worsened

Barriers and Next Steps

• Pilot study

• Logistics

• Attendance

• Unanticipated benefits

• Next steps

Contact Information

Emilie Trottier, RD

(905) 430-4055 ext 6465

trottiere@ontarioshores.ca

Metabolic and Weight Management Clinic

Ontario Shores Centre for Mental Health Sciences

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