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Letts E, Freeman M, Gambino C, Di Rezze B. A scoping review of measures examining the environments of persons with neurodevelopmental disorders in a supported housing setting. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:559-570. [PMID: 38983484 PMCID: PMC11229748 DOI: 10.1080/20473869.2022.2099508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/05/2022] [Indexed: 07/11/2024]
Abstract
Introduction: Having a neurodevelopmental disorder (NDD) can impact the abilities of an individual in many areas of life, including the ability to live independently. The environment of an individual impacts their day-to-day life throughout their lifespan. To improve supported housing experiences, it is important to map the evidence, especially relating to quality and satisfaction with the environment (as defined by the International Classification of Functioning, Disability and Health (ICF) framework). This has been exacerbated by COVID-19 pandemic restrictions, therefore more insight is needed in measuring this. Objective and methods: This scoping review searched 5 health and social science databases with the objective to identify and examine the outcome measures that integrate aspects of the environment that examine supported housing in individuals with NDD. Results and discussion: Fifteen studies met the inclusion criteria. We found that most measures targeted the satisfaction of individuals about their environment, with the ICF Support and Relationships factor of the environment assessed most. Measures were most often completed by a proxy through an interview. This work enhances our understanding of aspects of the environments of supported housing that are currently measured, laying an essential base for future research to improve the lives of individuals with NDDs.
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Affiliation(s)
- Elyse Letts
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Matt Freeman
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Caterina Gambino
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada
| | - Briano Di Rezze
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Michalsen H, Wangberg SC, Hartvigsen G, Henriksen A, Pettersen G, Jaccheri L, Jahnsen RB, Thrane G, Arntzen C, Anke A. Mobile health support to stimulate physical activity in individuals with intellectual disability: Protocol for mixed methods pilot study (Preprint). JMIR Res Protoc 2022; 11:e37849. [PMID: 36107473 PMCID: PMC9523523 DOI: 10.2196/37849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background Several studies have shown that individuals with intellectual disabilities (IDs) have low levels of physical activity (PA), and intervention studies on PA suggest inconsistent evidence. The use of technology as a means of motivation for PA has yet to be extensively explored and needs to be further investigated. Objective We aim to assess the feasibility and acceptability of procedures for an intervention arm in a future trial on mobile health (mHealth) to support PA for individuals with IDs. In addition, we aim to examine how the use of technology can influence motivation for PA among participants, their caregivers, and staff members. Methods A mixed methods pilot study of an intervention arm will be carried out in a planned randomized controlled trial (RCT). Ten participants with ID and their caregivers or a staff member will be included. Information will always be provided by a caregiver or a staff member, or participants with ID if possible. Assessments will be carried out at baseline, follow-up after 4 weeks, and 12 weeks, and include questionnaires on PA, social support, self-efficacy, and challenging behavior. PA will be measured with 2 different activity trackers (Fitbit and Axivity) for 1 week at all assessments. Feasibility will be assessed as recruitment and adherence rate, missing data, usability of the motivational mHealth tool, and estimates of effectiveness. Acceptability of study procedures, activity measures, and motivation for participation in PA will be additionally assessed with qualitative methods at the end of the intervention. Results Enrollment commenced in May 2021. Data collection was completed in March 2022. Conclusions This pilot study will evaluate the feasibility and acceptability of study procedures of the intervention arm of a planned RCT to address feasibility issues, improve study procedures, and estimate effectiveness of the study measures. How the use of technology can influence motivation for PA will also be examined, which can help guide and improve future PA interventions involving the use of technology. Trial Registration ClinicalTrials.gov NCT04929106; https://clinicaltrials.gov/ct2/show/NCT04929106 International Registered Report Identifier (IRRID) DERR1-10.2196/37849
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Affiliation(s)
- Henriette Michalsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Silje C Wangberg
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Narvik, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, Faculty of Science and Technology, UiT - The Artic University of Norway, Tromsø, Norway
| | - André Henriksen
- Department of Computer Science, Faculty of Science and Technology, UiT - The Artic University of Norway, Tromsø, Norway
| | - Gunn Pettersen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Letizia Jaccheri
- Department of Computer Science, Faculty of Information Technology and Electrical Engineering, NTNU, Trondheim, Norway
| | - Reidun Birgitta Jahnsen
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Cathrine Arntzen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UIT - The Arctic University of Norway, Tromsø, Norway
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Lifshit HB, Bustan N, Shnitzer-Meirovich S. Intelligence trajectories in adolescents and adults with down syndrome: Cognitively stimulating leisure activities mitigate health and ADL problems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:491-506. [PMID: 33058453 DOI: 10.1111/jar.12813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
GOALS This study examined: (a) crystallized/fluid intelligence trajectories of adolescents and adults with Down syndrome; and (b) the contribution of endogenous (health, activities of daily living-ADL) and exogenous (cognitively stimulating leisure activities) factors on adults' intelligence with age. METHOD Four cohorts (N = 80) with Down syndrome participated: adolescents (ages 16-21) and adults (ages 30-45, 46-60 and 61+). All completed Vocabulary and Similarities (crystallized) and Block Design and Raven (fluid) intelligence tests (WAIS-IIIHEB , Wechsler, 2001). RESULTS The 30-45 cohort significantly outperformed the 16-21 cohort. Except for Vocabulary, which remained stable, onset of decline was at 40-50. Age-related declining health and ADL correlated with participants' lower fluid intelligence, but cognitive leisure activities mitigated this influence. CONCLUSIONS Intelligence development into adulthood supported the continuous trajectory and compensation age theory, rather than accelerated or stable trajectories. Not only endogenous factors but also exogenous factors determined intelligence levels in adults with Down syndrome, supporting cognitive activity theory.
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Affiliation(s)
- Hefziba Batya Lifshit
- Special Education Department, Machado Chair for Research on Cognitive Modifiability and Human Development, School of Education, Bar-Ilan University, Ramat Gan, Israel
| | - Noa Bustan
- Kibbutzim-Seminar College, Tel-Aviv, Israel
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Michalsen H, Wangberg SC, Hartvigsen G, Jaccheri L, Muzny M, Henriksen A, Olsen MI, Thrane G, Jahnsen RB, Pettersen G, Arntzen C, Anke A. Physical Activity With Tailored mHealth Support for Individuals With Intellectual Disabilities: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19213. [PMID: 32437328 PMCID: PMC7367531 DOI: 10.2196/19213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/26/2022] Open
Abstract
Background Individuals with intellectual disabilities (IDs) have lower levels of physical activity (PA) and greater barriers for participation in fitness activities compared with members of the general population. As increased PA has positive effects on cardiovascular and psychosocial health, it is exceedingly important to identify effective interventions for use in everyday settings. Mobile health (mHealth) methods such as motion sensor games (exergames) and smartphone reminders for PA have been explored and found to be promising in individuals with IDs. Objective The purpose of this study is to examine the effectiveness of an individually tailored PA program with motivational mHealth support on daily levels of PA in youth and adults with IDs. Methods The trial uses a randomized controlled design comprising 30 intervention participants and 30 control group participants, aged 16 to 60 years, with sedentary lifestyles or low PA levels. While the controls will receive standard care, the intervention aims to increase the level of PA, measured as steps per day, as the primary outcome. Secondary outcome variables are body mass index, blood pressure, physical performance, social support for PA, self-efficacy in a PA setting, behavior problems, and goal attainment. The intervention involves the delivery of tailored mHealth support, using smartphones or tablets to create structure with focus on the communicative abilities of individual participants. Rewards and feedback are provided in order to motivate individuals to increase participation in PA. Participants in the intervention group, their close relatives, and care staff will be invited to participate in a preintervention goal-setting meeting, where goal attainment scaling will be used to select the participants’ PA goals for the intervention period. All participants will be assessed at baseline, at 3 months, and at 6 months. Results Enrollment was planned to start in April 2020 but will be delayed due to the pandemic situation. The main contribution of this paper is a detailed plan to run our study, which will produce new knowledge about tailored mHealth to support PA in individuals with intellectual disabilities. Conclusions We expect the new intervention to perform better than standard care in terms of improved PA, improved self-efficacy, and social support for activities. Technology offers new opportunities to promote healthy behaviors. The results of the study will determine the effectiveness and sustainability of a tailored mHealth support intervention to increase PA in youth and adults with IDs. Trial Registration ClinicalTrials.gov NCT04079439; https://clinicaltrials.gov/ct2/show/NCT04079439 International Registered Report Identifier (IRRID) PRR1-10.2196/19213
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Affiliation(s)
- Henriette Michalsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Silje Camilla Wangberg
- Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Narvik, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, University of Tromsø - The Artic University of Norway, Tromsø, Norway
| | - Letizia Jaccheri
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Miroslav Muzny
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - André Henriksen
- Department of Community Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Monica Isabel Olsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Reidun Birgitta Jahnsen
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Research Centre for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway
| | - Gunn Pettersen
- Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Cathrine Arntzen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.,Research Centre for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway
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Alcedo MÁ, Fontanil Y, Solís P, Pedrosa I, Aguado AL. People with intellectual disability who are ageing: Perceived needs assessment. Int J Clin Health Psychol 2017; 17:38-45. [PMID: 30487879 PMCID: PMC6236326 DOI: 10.1016/j.ijchp.2016.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/27/2016] [Indexed: 01/14/2023] Open
Abstract
Background/Objective: Ageing and progressive increase in life expectancy in people with intellectual disability present significant challenges. The present study is to examine the needs that arise in the aging process of this population. To detect these needs is fundamental to ensure personal wellbeing; almost no psychometrically sound instruments have been developed. Method: A structured interview was developed and evaluated by a panel of 20 experts to obtain evidence of content validity. The interview was then applied to 1,173 people with intellectual disability. The ages ranged from 35 to 80 (M = 52.27; SD = 7.5). Results: The interview consisted of 93 items evaluating four areas: perceived needs, personal problems, future perspectives, and solutions required. The results demonstrated the proximity and relationship of the various needs evaluated. In addition it was observed that those with intellectual disability who were older, male and users of residential services tended to indicate more needs, problems, and required more solutions. Conclusions: The instrument has adequate evidence of validity, allowing the evaluation of specific needs of people with intellectual disability. The results advocate the design of transversal intervention policies in order to effectively meet the needs and requirements of this population.
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Lifshitz-Vahav H, Shnitzer S, Mashal N. Participation in recreation and cognitive activities as a predictor of cognitive performance of adults with/without Down syndrome. Aging Ment Health 2016; 20:955-64. [PMID: 26032637 DOI: 10.1080/13607863.2015.1047322] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The Cognitive Activity Theory suggests an association between participation in cognitive activities during midlife and cognitive functioning in the short term. We examined the impact of participation in cognitively stimulating activities conveyed during leisure activities on crystallized and fluid tests' performance among adults with intellectual disabilities (ID). METHOD Adults (n = 32; chronological age = 25-55) with non-specific ID and with Down syndrome rated the frequency of their participation in leisure activities. Pursuits included more cognitively involving (reading, participating in academic courses) and less cognitively involving (cooking, dancing) activities. Three judges ranked activities according to their cognitive load on a 1 (few cognitive components) to 5 (many cognitive components) points scale. The findings indicate two new scales: cognitively stimulating activities and recreational stimulating activities. The crystallized battery included phonemic fluency, synonyms, idioms, and verbal metaphors. The fluid battery included the Homophone Meaning Generation Test, Metaphoric Triad Test, Novel Metaphors Test, and Trail Making Test. RESULTS Hierarchal regression with chronological and mental age, recreational, and cognitively stimulating activities indicated that participation in recreational activities contributed significantly to the explained variance of word fluency. Participation in cognitive activities contributed significantly to the explained variance of most of the crystallized and fluid tests. CONCLUSIONS The findings support the Cognitive Activity Theory in populations with ID. The findings also support the Compensation Age Theory: not only endogenous factors (age, etiology, IQ level), but also exogenous factors such as life style determining the cognitive functioning of adults with ID. However, frequency and the cognitive load of the activities influenced their cognitive functioning.
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Affiliation(s)
- Hefziba Lifshitz-Vahav
- a Department of Special Education , School of Education , Bar-Ilan University , Ramat-Gan , Israel
| | - Shlomit Shnitzer
- b School of Education , Bar-Ilan University , Ramat-Gan , Israel
| | - Nira Mashal
- b School of Education , Bar-Ilan University , Ramat-Gan , Israel.,c Gonda Multidisciplinary Brain Research Center , Bar-Ilan University , Ramat-Gan , Israel
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Bergström H, Hagströmer M, Hagberg J, Elinder LS. A multi-component universal intervention to improve diet and physical activity among adults with intellectual disabilities in community residences: a cluster randomised controlled trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3847-3857. [PMID: 24021393 DOI: 10.1016/j.ridd.2013.07.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/10/2013] [Accepted: 07/10/2013] [Indexed: 06/02/2023]
Abstract
People with ID have an increased risk for unhealthy diets, physical inactivity and weight disturbances. The aim of the current study was to investigate the effectiveness of a novel and complex intervention to improve diet and physical activity, targeting both caregivers and residents, in community residences for people with ID. A three component intervention based on Social Cognitive Theory was developed, including: (1) appointment of a health ambassador in each community residence attending network meetings, (2) a study circle for caregivers, and (3) a health course for the residents. The intervention lasted for 12-16 months and allowed for some local tailoring. A cluster randomised controlled trial, randomised at residence level, was conducted to evaluate the effects of the intervention. Thirty community residences for people with mild or moderate ID in Stockholm County, Sweden, were included. A total of 130 participants, 74 women and 56 men aged 20-66 years, entered, and 129 participants completed the study. The primary outcome was physical activity, measured by pedometry. Secondary outcomes were BMI, waist circumference, dietary quality measured by digital photography, satisfaction with life assessed with a scale, and work routines assessed with a questionnaire. Outcomes were related to intervention fidelity. A positive intervention effect was found on physical activity, with an average increase of 1608 steps/day among participants in the intervention group (P=0.045). The effect size was 0.29 (Cohen's d). The type of residence was found to be an effect moderator. A positive intervention effect was found as well on work routines, with an average increase of 7.1 percentage points on a self-assessment scale among residences in the intervention group (P=0.016). No significant effects were found on BMI, waist circumference, dietary quality, or satisfaction with life. In conclusion, this innovative intervention was effective in improving physical activity and work routines. It is likely that even greater effects could be achieved by improvements in implementation strategies, leading to higher fidelity.
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Affiliation(s)
- Helena Bergström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 3, 141 83 Huddinge, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Box 1497, 171 29 Solna, Sweden.
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