Adapting an Evidenced-based Weight Management Intervention and Testing Strategies to Increase Implementation in Community Mental Health Programs (ACHIEVE-D)

August 18, 2025 updated by: Johns Hopkins University
This is a pilot randomized clinical trial testing an implementation intervention to support delivery of a behavioral weight loss program at community mental health programs.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This is a pilot randomized clinical trial testing an implementation intervention to support delivery of a behavioral weight loss program at community mental health programs. Investigators will conduct a pilot trial testing a standard and an enhanced implementation intervention. The evidenced based intervention investigators are basing the behavioral weight loss program on is ACHIEVE, and investigators are calling the translated weight loss program ACHIEVE-D. The standard version of the implementation intervention, which will train community mental health program staff to become ACHIEVE-D coaches and peers to become ACHIEVE-D peer-leaders, will include in-person and online training and avatar-assisted motivational interviewing practice, as well as organizational strategy meetings. The enhanced implementation intervention will include all of these strategies + performance coaching for ACHIEVE-D coaches.

Study Type

Interventional

Enrollment (Actual)

92

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Maryland
      • Baltimore, Maryland, United States, 21224
        • Joseph Gennusa

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Coaches -

  • Adult staff or peer at community mental health program
  • Willing and able to participate in training and delivery of intervention

Consumers-

Inclusion Criteria:

  • Age 18 and older
  • Enrolled in a psychiatric rehabilitation program
  • BMI ≥ 25 kg/m2
  • Willing to make changes in diet and exercise to lose weight
  • Willing to attend the ACHIEVE group sessions virtually or in-person at least once per week
  • Ability to use a computer or tablet
  • Competent and willing to give informed oral consent
  • Completion of baseline data collection

Exclusion Criteria:

  • Any underlying medical conditions that could seriously reduce life expectancy, ability to participate in the study, or for which dietary change/physical activity/weight loss may be contraindicated e.g., Lung disease requiring supplemental oxygen Liver failure History of anorexia nervosa or bulimia Stage V kidney disease on dialysis Cardiovascular event in the last 6 months including unstable angina, myocardial infarction, congestive heart failure, transient ischemic attack, or stroke
  • Insulin dependent diabetes
  • Inability to walk unassisted (e.g., uses a cane, walker, etc)
  • Pregnant, breastfeeding, or planning a pregnancy during study period
  • Prior or planned bariatric surgery
  • Use of a prescription anti-obesity medication or over-the-counter orlistat within the past 3 months
  • Self-reported weight loss of >20 lbs in the last 3 months
  • Active substance use disorder, alcohol use disorder, or problem drinking (more than 14 drinks per week for women, more than 21 drinks per week for men)
  • Planning to leave mental health program or move out of geographic area within 12 months
  • Weight greater than 440 pounds (so as not to exceed capacity of study scale)
  • Investigator judgment (e.g., for concerns over safety, adherence or follow-up)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Standard Implementation Intervention
The standard version will train community mental health program staff to become ACHIEVE-D coaches and peers to become ACHIEVE-D peer-leaders, will include in-person and online training and avatar-assisted motivational interviewing practice as well as organizational strategy meetings.
training, motivational interviewing practice
meetings with leadership to optimize implementation of evidence-based practices
Active Comparator: Enhanced Implementation Intervention
The enhanced version will train community mental health program staff to become ACHIEVE-D coaches and peers to become ACHIEVE-D peer-leaders, will include in-person and online training and avatar-assisted motivational interviewing practice as well as organizational strategy meetings. The enhanced version will also include performance coaching.
training, motivational interviewing practice
meetings with leadership to optimize implementation of evidence-based practices
to enhance ability to deliver the weight management intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Knowledge of ACHIEVE Intervention Topics
Time Frame: Baseline and 6 months
Knowledge to deliver the intervention using a measure developed by the study team with questions related to weight management and group exercise, 22 questions, each either correct or incorrect. Score range 0-22 will reflect number of questions answered correctly. Higher score indicates better performance.
Baseline and 6 months
Self-efficacy to Deliver ACHIEVE Intervention
Time Frame: Baseline and 6 months
Self-efficacy to deliver the intervention using a measure developed by the study team with a score range of 1-10. A higher score is better and indicates higher confidence to deliver the intervention.
Baseline and 6 months
Fidelity to ACHIEVE Intervention
Time Frame: Baseline (after initial training) and 6 months
Fidelity to the intervention using a tool rating minimal competencies in delivering the intervention. This is a closed ended rating form where coaches are observed and rated. Total scores ranged from 0 to 34 with higher scores indicating higher fidelity.
Baseline (after initial training) and 6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Added Sugar Consumption as Measured by National Health Interview Survey (NHIS) Five Factor Dietary Screener Survey
Time Frame: Baseline and 6 months
Participants self reported responses to the NHIS five factor dietary screener. The potential values range from 0 servings to no upper limit with higher numbers indicating higher amounts of food product consumed.
Baseline and 6 months
Fruit and Vegetable Consumption as Measured by National Health Interview Survey (NHIS) Five Factor Dietary Screener Survey
Time Frame: Baseline and 6 months
Participants self reported responses to the NHIS five factor dietary screener. The potential values range from 0 servings to no upper limit with higher numbers indicating higher amounts of food product consumed.
Baseline and 6 months
Consumer Sedentary Behavior
Time Frame: Baseline and 6 months

CARDIA-EARLY Sedentary Behavior questionnaire. 12-item sedentary behavior measure which separately estimates the amount of time (None,15 minutes or less, 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 5 hours, 6 hours or more) spent on six categories of sedentary behaviors for an average weekday or weekend day. These responses are then summed to create separate estimates of average weekday and weekend day total sedentary behavior. A weekly estimate of sedentary behavior these scores are weighted and then summed for a total score which ranges from 0 to 168 hours and an average day estimate is calculated by dividing this weekly estimate by 7 (0 to 24).

Scores reported below reflect the average day estimate of sedentary behavior with a possible score range of 0 to 24 hours. For all scoring a higher score indicates more sedentary activity completed in the day. Higher score is worse.

Baseline and 6 months
Client Weight
Time Frame: Baseline and 6 months
Weight measured in kilograms (kg) using a calibrated scale and standardized procedures
Baseline and 6 months
Continued Site Implementation
Time Frame: 12 months (6 months after original study period of Baseline to 6 months)
Sites reported whether program was still being delivered six months after original study period.
12 months (6 months after original study period of Baseline to 6 months)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Gail Daumit, Johns Hopkins University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 16, 2021

Primary Completion (Actual)

February 1, 2023

Study Completion (Actual)

March 30, 2023

Study Registration Dates

First Submitted

February 13, 2018

First Submitted That Met QC Criteria

February 23, 2018

First Posted (Actual)

March 6, 2018

Study Record Updates

Last Update Posted (Actual)

August 20, 2025

Last Update Submitted That Met QC Criteria

August 18, 2025

Last Verified

August 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB00156866

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

We will follow National Institute of Mental Health (NIMH) guidelines.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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