# Achieving Cardiovascular Health Equity in Community Mental Health: Optimizing Implementation Strategies

> **NIH NIH UG3** · JOHNS HOPKINS UNIVERSITY · 2022 · $1,214,341

## Abstract

People with serious mental illness (SMI) comprise 5% of the US population and experience one of the largest
CVD-related mortality disparities of any group with rates 2 times higher, and dying 10-20 years earlier, than the
overall US population. Underpinning this wide disparity is marked elevation in prevalence of all CVD risk
factors in persons with SMI, with low rates of risk factor control. Interventions addressing CVD risk factors
require tailoring for persons with SMI who often have substantial barriers related to psychiatric symptoms and
cognitive impairment. There is an urgent need for scale-up of efficacious interventions shown to address the
high burden of multiple CVD risk factors in SMI, however, organizational and provider-level barriers impede
implementation. To improve care of persons with SMI and overcome fragmentation of the US general medical
and specialty mental health systems, behavioral health homes, programs where specialty mental health
organizations are responsible for coordinating primary care services, have proliferated. While they have shown
improved access to primary care and screening for CVD risk factors, to-date behavioral health homes have not
resulted in improvement in CVD risk factors, likely because they are not implementing evidence-based
interventions. Two effective interventions, the NHLBI-funded IDEAL and NIMH-funded Life Goals interventions,
have been shown to reduce CVD risk in persons with SMI. The overarching goal of this UG3/UH3 is to partner
with communities in Michigan and Maryland serving persons with SMI to refine, tailor and test provision of
different implementation strategies to improve uptake of these evidenced-based practices for reducing CVD
risk in SMI in behavioral health homes. Replicating Effective Programs (REP) Framework components (e.g.,
community working group, packaging, training, technical support) will lay the groundwork for uptake and
sustainment, alongside two additional implementation strategies, Coaching and Facilitation, which address
provider and organizational barriers, respectively. The Specific Aims are to (1) Establish a highly collaborative
and productive partnership with 24 Michigan and Maryland community mental health program sites to tailor
IDEAL/Life Goals evidence-based practices and implementation strategies to fit site needs; (2) Determine
effectiveness of two implementation strategy augmentations to REP, Coaching and Facilitation, on a) uptake
and delivery of IDEAL/Life Goals at 18-months (primary outcome), and b) quality of care for CVD risk factors
and CVD risk factors among persons with SMI, (secondary outcomes) and (3) To assess mechanisms (e.g.,
provider self-efficacy), moderators (e.g., implementation climate), and other relevant measures (e.g., fidelity,
costs) to inform an adaptive implementation intervention to further scale up IDEAL/Life Goals in the behavioral
health home setting. This innovative work will inform which combination of implementation strate...

## Key facts

- **NIH application ID:** 10476461
- **Project number:** 5UG3HL154280-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Gail L. Daumit
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,214,341
- **Award type:** 5
- **Project period:** 2020-09-10 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10476461

## Citation

> US National Institutes of Health, RePORTER application 10476461, Achieving Cardiovascular Health Equity in Community Mental Health: Optimizing Implementation Strategies (5UG3HL154280-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10476461. Licensed CC0.

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