PROJECT SUMMARY
Adults with serious mental illness (SMI) are disproportionately affected by medical comorbidity, earlier onset of
disease, and 10 to 25 years reduced life expectancy compared to the general population. These high rates of
morbidity and early mortality are associated with inadequately managed medical and psychiatric illnesses. Our
systematic review found nine effective self-management interventions that address medical and psychiatric
illnesses in adults with SMI. However, there has been limited adoption of these interventions due to both
provider and consumer-based factors. Provider-based barriers consist of the lack of an adequate workforce
with the capacity, time, and knowledge of effective approaches to self-management support for adults with SMI
and chronic health conditions. Consumer-based barriers associated with limited participation in self-
management programs include lack of access, engagement, and ongoing community-based support for
persons with SMI. Peer support specialists have the potential to address these barriers as they comprise one
of the fastest growing sectors of the mental health workforce, have “lived experience” in self-management
practices, and offer access to support in the community. However, challenges need to be resolved for peers to
be effective providers of evidence-based interventions. For example, peers are frequently trained to provide
“peer support” described as “giving and receiving help founded on key principles of respect, shared
responsibility, and mutual agreement of what is helpful”. Peer support has been associated with increased
sense of control, ability to make changes, and decreased psychiatric symptoms. Despite benefits, peer support
does not adhere to evidence-based practices for psychiatric and medical self-management and does not follow
protocols that ensure fidelity and systematically monitor outcomes. We hypothesize that mobile technology has
the potential to overcome these limitations of peer support by providing real-time guidance in fidelity adherent
delivery of a peer-delivered, technology-assisted evidence-based self-management intervention (PDTA-IIMR).
The purpose of this K01 award is to build the necessary expertise to pursue a career developing and testing
novel approaches to peer-delivered evidence-based self-management interventions. Training will include:
development of peer-delivered interventions; development and design of mobile health-supported
interventions; and intervention clinical trials research. Concurrently, I propose to refine the intervention protocol
with input from peers and consumers; then, I will enhance this protocol through user-centered design; and
lastly, I will conduct a pilot study evaluating the feasibility and potential effectiveness of PDTA-IIMR compared
to routine peer support for N=6 peers and N=40 adults with SMI and chronic health conditions. Outcomes
include feasibility, medical and psychiatric self-management skills, and functional ability. We will explore
mortality risk factors and examine self-efficacy and social support as mechanisms on outcomes.