Evaluating the Impact of a Lifestyle‐Focused Approach on Cardiovascular Risk in Inpatients With Mental Illness: Analyzing Effectiveness and Fidelity in a Stepped Wedge Cluster Randomized Trial (MULTI+ Study V) | Psychiatric Research and Clinical Practice
Objective People with mental illness have worse health outcomes and up to 20 years shorter life expectancy than the general population. Lifestyle interventions are promising to improve their physical and mental health but implementing these in real‐world practice remains challenging. This study evaluated the impact of a multidisciplinary lifestyle‐focused approach (MULTI+) on cardiovascular risk among inpatients with mental illness. Methods In an open‐cohort stepped wedge cluster randomized controlled trial, we compared changes in estimated 10‐year risk of a cardiovascular event (QRISK3) between MULTI+ and care as usual (CAU) across inpatient wards at GGz Centraal (the Netherlands). Using linear mixed models, we assessed intervention effectiveness and explored whether implementation fidelity influenced outcomes. Results We included 3603 individuals, with an unadjusted mean QRISK3 score of 15.1% in CAU and 15.4% in MULTI+. After adjusting for confounders, there was a small but statistic
