Community Health Screenings in Four States: Prevalence and Predictors of Chronic Medical Conditions Among Adults in Mental Health Recovery

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Community Health Screenings in Four States
Prevalence and Predictors of Chronic Medical
Conditions Among Adults in Mental Health
Recovery

• Peggy Swarbrick
• Director, Collaborative Support Programs of New
  Jersey, Rutgers University
• Lisa A. Razzano
• Associate Professor, University of Illinois at
  Chicago

UIC Center on Psychiatric Disability and
Co-Occurring Medical Conditions State of the
Science Summit on Integrated Health Care
October 2014
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Acknowledgments

• The views and ideas expressed herein do not
  reflect the policy or position of any Federal
  Agency or private corporation.
• Grateful to all the service programs.

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Research Team

• UIC
• Judith A. Cook
• Jessica A. Jonikas
• Larissa Burke
• Tina M. Carter
• Dennis D. Grey
• Marie M. Hamilton
• Pamela J. Steigman
• Chantelle Yost

• CSP-NJ
• Jennifer Cohn
• Christina Fitzgerald
• Maureen Kenny
• Betty Redman
• Jay Yudof

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Why a Health Fair

• People are experiencing a health disparity (25
  years loss of life) and many experience poor
  quality of life
• We started organizing health screenings at peer
  events in 2009
• UIC, CSPNJ other partners on 4 states
  collaborated through a part of the UIC Center on
  Psychiatric Disability Co-Occurring Medical
  Conditions

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Take a Look!
Free download http//www.cmhsrp.uic.edu/health/in
dex.asp
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Body Mass Index Dialogue Desires and Struggles
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A1C Diabetes Test Dialogue Awareness of Personal
Risks
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Cholesterol Dialogue Awareness of Personal Risks
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Blood Pressure- BP Dialogue Lifestyle Habits
Can Help Manage BP
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Drug Abuse Screening/ Alcohol Abuse
Screening Dialogue Honesty
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Smoking Risk Assessment Dialogue Benefits of
Quitting
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Heart Attack Risk Assessment Dialogue Surprise
Intrigue
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Dialogue Peer Support for Health Wellness
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Program Results

• Community Health Screenings in Four States

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Health Fair Attendees

• Total of 457 individuals in recovery
• 4 collaborating sites
• New Jersey (n121) CSP-NJ
• Illinois (n122) - Thresholds
• Maryland (n106) Way Station St. Lukes
• Georgia (n108) - Highland Rivers
• Few differences between site
• subsamples, controlled
• for in analyses

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Total Sample N 457

• 51 Male, 49 Female
• Diverse samples across sites most are White
  (49) and African American (39)
• High School Education or less 51
• 31 participating in work
• Most supported by public insurance
• 89 using medication for mental health

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Self-Reported Health Risks vs. Population
NHANES Health Condition Sample Prevalence National Prevalence
Asthma 28.0 (127) 2.7 (.001)
Stroke 4.4 (20) 2.7 (.05)
Chronic Bronchitis 15.0 (68) 4.3 (.001)
Emphysema 4.0 (18) 1.9 (.01)
Diabetes 21.3 (96) 7.7 (.001)
Ulcer 11.8 (53) 6.5 (.001)
Weak/Failing Kidneys 7.3 (33) 1.7 (.001)
Non-Viral Liver Diseases 6.8 (31) 1.4 (.001)
Congestive Heart Failure 2.6 (12) 1.0 (.001)
Other Heart Conditions 17.3 (79) 11.5 (.001)
Hypertension 44.1 (197) 25.9 (.001)
Any Cancers 5.1 (23) 8.5 (.01)
Hyperlipidemia 45.0 (197) 38.4 (.05)
Hepatitis A, B, or C 5.5 (25) 1.9 (.001)
Arthritis, Tuberculosis, HIV/AIDS not listed non-significant, small (n) Arthritis, Tuberculosis, HIV/AIDS not listed non-significant, small (n) Arthritis, Tuberculosis, HIV/AIDS not listed non-significant, small (n)
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Self-Reported Health Risks vs. Treatment
NHANES Health Condition Sample Prevalence Reported Treatment1
Asthma 28.0 (127) 81.1 (77)
Stroke 4.4 (20) 42.1 (8)
Chronic Bronchitis 15.0 (68) 71.1 (27)
Emphysema 4.0 (18) 61.5 (8)
Diabetes 21.3 (96) 94.5 (86)
Ulcer 11.8 (53) 55.5 (10)
Weak/Failing Kidneys 7.3 (33) 66.6 (18)
Non-Viral Liver Diseases 6.8 (31) 30.0 (6)
Congestive Heart Failure 2.6 (12) 100 (11)
Other Heart Conditions 17.3 (79) 93.1 (54)
Hypertension 44.1 (197) 89.2 (150)
Any Cancers 5.1 (23) 50 (3)
Hyperlipidemia 45.0 (197) 82.8 (135)
Hepatitis A, B, or C 5.5 (25) 33.3 (5)
1Treatment rates among those reporting still having the health condition AND in treatment. 1Treatment rates among those reporting still having the health condition AND in treatment. 1Treatment rates among those reporting still having the health condition AND in treatment.
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Screened Health Risks vs. General Population
Health Risk Sample Screened at Risk General Population1
Obesity/BMI 25.0-29.9 Overweight 30 Obese 22 (100) 60 (270) 33 36
Hyperlipidemia/Total Cholesterol 240 mg/dL 7 (28) 13
Diabetes/Hemoglobin A1c 6.5 or higher 14 (62) 2
Hypertension/High Blood Pressure 140/90 (Hypertensive) 32 (145) 29
Smokers Medium/High Nicotine Dependence 44 (200) 62 (121) 19 57
Audit-C Alcohol Abuse Risk 17 (75) 7
DAST Drug Abuse Risk 11 (48) 3
Framingham Heart Disease Risk gt 20 10 (44) 3
1 Population estimates from NHANES NSDUH (SAMHSA) 1 Population estimates from NHANES NSDUH (SAMHSA) 1 Population estimates from NHANES NSDUH (SAMHSA)
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Effects on Health Attitudes Results of Random
Regression Analyses
Health Attitude Mean Pre-Event Mean Post-Event Estimate (SE) Z score Sig
Self-Rated Abilities for Health Practices 14.6 15.4 0.71 (0.22) 3.26 .001
Perceived Competence for Health Maintenance 21.2 22.5 1.27 (0.25) 5.04 lt .001
Multidimensional Health Locus of Control Subscales Internal Control Powerful Others Chance 27.5 23.0 19.2 28.0 24.7 19.4 0.56 (0.24) 1.73 (0.34) 0.28 (0.29) 2.29 .02 5.11 lt .001 0.95 NS
Regression controlling for sex, age, race, education study site Regression controlling for sex, age, race, education study site Regression controlling for sex, age, race, education study site Regression controlling for sex, age, race, education study site Regression controlling for sex, age, race, education study site
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Manuscripts In Press or Under Review

• Physical Health Screening of Adults with Serious
  Mental Illnesses Prevalence of Health Risks and
  Change in Health Attitudes
• Health Screening Dialogues
• Co-Occurring Physical Health Conditions Among
  Adults with Serious Mental Illness Factors
  Associated with Prevalence and Treatment

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Discussion Questions

• Community Health Screenings in Four States

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• Peggy Swarbrick, PhD, CPRP, FAOTA
• Collaborative Support Programs of New Jersey -
  www.cspnj.org
• Associate Professor, Rutgers University
• pswarbrick_at_cspnj.org
• Lisa A. Razzano, PhD, CPRP
• Associate Professor Deputy Director
• UIC Center on Mental Health Services Research
  Policy
• Razzano_at_psych.uic.edu