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Ong RHS, Nurjono M, Oh HC, Lien CTC, Jumala J, Teo RCC, Gan P, Kan KLM, Rosle LF, Wee MK, Low SL. Factors Influencing the Implementation of a Fall Prevention Exercise Program for Community-Dwelling Older Adults: A Qualitative Study Guided by the PRECEDE-PROCEED Model. Clin Interv Aging 2024; 19:857-871. [PMID: 38770185 PMCID: PMC11104366 DOI: 10.2147/cia.s454043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/27/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose Multiple falls preventions exercise programs have been rolled out globally, however, few studies have explored the factors necessary for their implementation. This study aimed to investigate the factors influencing the implementation of "Steady Feet" (SF), a 12-week community fall prevention exercise intervention, for older adults living in Singapore. Material and Methods This study utilized purposive sampling to recruit two participant groups: (i) older adults who declined or withdrew from the program and (ii) providers of the program (eg, instructors). We conducted 22 semi-structured interviews, recordings were transcribed and translated, followed by thematic analysis. Data collection and analysis were informed by the PRECEDE-PROCEED framework, focusing on predisposing, enabling, and reinforcing factors. Results Findings revealed two predisposing, four enabling, and two reinforcing themes. Predisposing themes encompassed (i) knowledge, attitudes, and practices of older adults towards exercises and falls prevention, and (ii) perceptions and attitudes of providers towards SF. Both older adults and providers identified several enabling elements in implementing SF, emphasizing the significance of (i) accessibility, availability, and affordability. Providers highlighted (ii) tools and structural support for continual engagement, (iii) minimizing variations in capabilities through a competency development program, and (iv) fostering synergistic partnerships. Positive reinforcement included (i) the role of providers in engaging and promoting participation, (ii) family support, social networks, and (iii) incentives for older adults. Conversely, both groups highlighted negative reinforcements, including (iv) communication issues and (v) repetitive exercises, while providers specifically identified (vi) labor constraints as a deterrent for implementation. Conclusion Findings indicate that effective implementation necessitates a multifaceted approach. Promoting participation involves engaging instructors, emphasizing social bonds and family involvement, offering incentives, and providing subsidized or free classes. A competency development program proved effective in reducing variations in providers' capabilities. Strengthening community partnerships, with management support, was crucial for ensuring the availability and accessibility of falls prevention programs.
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Affiliation(s)
| | | | - Hong Choon Oh
- Health Services Research, Changi General Hospital, Singapore
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore
- Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | | | - Junisha Jumala
- Rehabilitative Services, Changi General Hospital, Singapore
| | | | - Peiying Gan
- Community Nursing, Changi General Hospital, Singapore
| | | | | | - Moi Kim Wee
- Community and Mental Health, Changi General Hospital, Singapore
| | - Shou Lin Low
- Geriatric Medicine, Changi General Hospital, Singapore
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Rana D, Westrop S, Jaiswal N, Germeni E, McGarty A, Ells L, Lally P, McEwan M, Melville C, Harris L, Wu O. Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta-analysis at intervention and component levels. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:387-445. [PMID: 38414293 DOI: 10.1111/jir.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Adults with intellectual disabilities (IDs) are susceptible to multiple health risk behaviours such as alcohol consumption, smoking, low physical activity, sedentary behaviour and poor diet. Lifestyle modification interventions can prevent or reduce negative health consequences caused by these behaviours. We aim to determine the effectiveness of lifestyle modification interventions and their components in targeting health risk behaviours in adults with IDs. METHODS A systematic review and meta-analysis were conducted. Electronic databases, clinical trial registries, grey literature and citations of systematic reviews and included studies were searched in January 2021 (updated February 2022). Randomised controlled trials and non-randomised controlled trials targeting alcohol consumption, smoking, low physical activity, sedentary behaviours and poor diet in adults (aged ≥ 18 years) with ID were included. Meta-analysis was conducted at the intervention level (pairwise and network meta-analysis) and the component-level (component network meta-analysis). Studies were coded using Michie's 19-item theory coding scheme and 94-item behaviour change taxonomies. Risk of bias was assessed using the Cochrane Risk of Bias (ROB) Version 2 and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I). The study involved a patient and public involvement (PPI) group, including people with lived experience, who contributed extensively by shaping the methodology, providing valuable insights in interpreting results and organising of dissemination events. RESULTS Our literature search identified 12 180 articles, of which 80 studies with 4805 participants were included in the review. The complexity of lifestyle modification intervention was dismantled by identifying six core components that influenced outcomes. Interventions targeting single or multiple health risk behaviours could have a single or combination of multiple core-components. Interventions (2 RCTS; 4 non-RCTs; 228 participants) targeting alcohol consumption and smoking behaviour were effective but based on limited evidence. Similarly, interventions targeting low physical activity only (16 RCTs; 17 non-RCTs; 1413 participants) or multiple behaviours (low physical activity only, sedentary behaviours and poor diet) (17 RCTs; 24 non-RCTs; 3164 participants) yielded mixed effectiveness in outcomes. Most interventions targeting low physical activity only or multiple behaviours generated positive effects on various outcomes while some interventions led to no change or worsened outcomes, which could be attributed to the presence of a single core-component or a combination of similar core components in interventions. The intervention-level meta-analysis for weight management outcomes showed that none of the interventions were associated with a statistically significant change in outcomes when compared with treatment-as-usual and each other. Interventions with core-components combination of energy deficit diet, aerobic exercise and behaviour change techniques showed the highest weight loss [mean difference (MD) = -3.61, 95% credible interval (CrI) -9.68 to 1.95] and those with core-components combination dietary advice and aerobic exercise showed a weight gain (MD 0.94, 95% CrI -3.93 to 4.91). Similar findings were found with the component network meta-analysis for which additional components were identified. Most studies had a high and moderate risk of bias. Various theories and behaviour change techniques were used in intervention development and adaptation. CONCLUSION Our systematic review is the first to comprehensively explore lifestyle modification interventions targeting a range of single and multiple health risk behaviours in adults with ID, co-produced with people with lived experience. It has practical implications for future research as it highlights the importance of mixed-methods research in understanding lifestyle modification interventions and the need for population-specific improvements in the field (e.g., tailored interventions, development of evaluation instruments or tools, use of rigorous research methodologies and comprehensive reporting frameworks). Wide dissemination of related knowledge and the involvement of PPI groups, including people with lived experience, will help future researchers design interventions that consider the unique needs, desires and abilities of people with ID.
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Affiliation(s)
- D Rana
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - S Westrop
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jaiswal
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - E Germeni
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A McGarty
- Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - P Lally
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Psychology, University of Surrey, Guildford, UK
| | - M McEwan
- People First (Scotland), Edinburgh, UK
| | - C Melville
- Mental Health and Wellbeing, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Harris
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - O Wu
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Westrop SC, Rana D, Jaiswal N, Wu O, McGarty AM, Melville C, Ells L, Lally P, McEwan M, Harris L, Germeni E. Supporting active engagement of adults with intellectual disabilities in lifestyle modification interventions: a realist evidence synthesis of what works, for whom, in what context and why. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:293-316. [PMID: 38379511 DOI: 10.1111/jir.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Lifestyle modification interventions for adults with intellectual disabilities have had, to date, mixed effectiveness. This study aimed to understand how lifestyle modification interventions for adults with intellectual disabilities work, for whom they work and in what circumstances. METHODS A realist evidence synthesis was conducted that incorporated input from adults with intellectual disabilities and expert researchers. Following the development of an initial programme theory based on key literature and input from people with lived experience and academics working in this field, five major databases (MEDLINE, EMBASE, CINAHL, PsycINFO and ASSIA) and clinical trial repositories were systematically searched. Data from 79 studies were synthesised to develop context, mechanism and outcome configurations (CMOCs). RESULTS The contexts and mechanisms identified related to the ability of adults with intellectual disabilities to actively take part in the intervention, which in turn contributes to what works, for whom and in what circumstances. The included CMOCs related to support involvement, negotiating the balance between autonomy and behaviour change, fostering social connectedness and fun, accessibility and suitability of intervention strategies and delivery and broader behavioural pathways to lifestyle change. It is also essential to work with people with lived experiences when developing and evaluating interventions. CONCLUSIONS Future lifestyle interventions research should be participatory in nature, and accessible data collection methods should also be explored as a way of including people with severe and profound intellectual disabilities in research. More emphasis should be given to the broader benefits of lifestyle change, such as opportunities for social interaction and connectedness.
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Affiliation(s)
- S C Westrop
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - D Rana
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jaiswal
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - O Wu
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A M McGarty
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - C Melville
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- Obesity Institute, School of Health, Leeds Beckett University, City Campus, Leeds, UK
| | - P Lally
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Psychology, University of Surrey, Guildford, UK
| | - M McEwan
- People First (Scotland), Edinburgh, UK
| | - L Harris
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - E Germeni
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Røstad-Tollefsen HK, Kolset SO, Retterstøl K, Hesselberg H, Nordstrøm M. Weight reduction and dietary improvements in a cluster-randomised controlled trial for adults with intellectual disabilities. Food Nutr Res 2023; 67:9505. [PMID: 38187792 PMCID: PMC10770699 DOI: 10.29219/fnr.v67.9505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 01/09/2024] Open
Abstract
Background People with intellectual disabilities (IDs) have an increased risk of obesity and health concerns related to their nutritional status and dietary intake. Objective To assess the effectiveness of a multi-component intervention on weight, waist circumference (WC), clinical health parameters and dietary habits in a group of overweight and obese adults with mild-to-moderate ID. Design A 7-month cluster-randomised trial and a 7-month follow-up of the intervention group after the end of intervention when the group received usual care. The intervention consisted of monthly dietary-group courses tailored to the participants' cognitive abilities and practical skills, monthly nutritional courses for staff, use of behaviour change techniques and nudging. The control group received usual care during the intervention. Results There were 32 participants aged 22-61 years: 15 in the intervention group and 17 in the control group. After 7 months, a non-significant weight difference (median difference = -1.25 kg; 95% confidence interval [CI] = -2.00; 0.95 vs. +1.00 kg; CI = -1.15; 3.00, P = 0.08) and a significant WC difference were observed between the intervention and control groups (median difference = -3.75 cm; CI: -7.68; 0.11 vs. 0 cm; CI = -3.99; 1.00, P = 0.03), respectively. The median reduction in WC continued in the intervention group during the 7-month follow-up (median difference = -7.50 cm; CI: -13.57; -3.16, P = 0.002). A significant difference in frequency intake of fruit (P = 0.03) and berries (P = 0.004) was observed between the groups after 7 months, supported by a significant increase in measured serum-carotenoid levels in the intervention group after 7 months (median difference = 0.26 mmol/L; CI: -0.12; 0.52, P = 0.007). Conclusions A significant difference in WC was observed between the groups, accompanied by changes in blood parameters and dietary habits.
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Affiliation(s)
- Helen K. Røstad-Tollefsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Baerum Municipality, Housing, Activity and Organized Work, Health, and Welfare, Baerum, Norway
| | - Svein O. Kolset
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Lipid Clinic, Oslo University Hospital, Oslo, Norway
| | - Heidi Hesselberg
- Baerum Municipality, Housing, Activity and Organized Work, Health, and Welfare, Baerum, Norway
| | - Marianne Nordstrøm
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Frambu Resource Centre for Rare Disorders, Siggerud, Norway
- Unit for Inborn and Hereditary Neuromuscular Disorders, Department of Neurology, Oslo University Hospital, Oslo, Norway
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Ramji R, Rämgård M, Carlson E, Shleev S, Awad E, Cirovic S, Kottorp A. Health and quality of life among women after participation in a CBPR-informed physical activity intervention: with a pandemic perspective. Sci Rep 2023; 13:17972. [PMID: 37863947 PMCID: PMC10589350 DOI: 10.1038/s41598-023-45239-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023] Open
Abstract
The lack of culturally and contextually oriented interventions promoting physical activity (PA) has led to increased physical inactivity among women living in disadvantaged neighbourhoods in Sweden. In this study one such intervention informed by community-based participatory research (CBPR) has been evaluated among 34 women from a disadvantaged neighbourhood before and during COVID-19. Health-related quality of life (HRQOL), behavioural and biomedical outcomes were assessed directly prior and post-intervention, followed by evaluations at 6-months and 18-months follow-up during COVID-19. The results revealed that HRQOL, particularly psychological, social, and environmental health significantly increased post-intervention compared to prior to intervention but reversed back at 6-months follow-up. Perceived health satisfaction and environmental health increased at 18-months follow-up during COVID-19. Participation in PA improved post-intervention and at 6-months follow-up. Everyday activities and fruit and vegetable intake continued to increase through all timepoints. Systolic blood pressure significantly decreased post-intervention and 6-months follow-up; blood flow rate increased significantly at all timepoints. Overall, the findings underscores the potential effectiveness of CBPR approaches in promoting and sustaining healthy lifestyles, even during acute situations such as the COVID-19. It may even serve as a future model for promoting health and addressing health disparities in similar groups.
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Affiliation(s)
- Rathi Ramji
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden.
| | - Margareta Rämgård
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Elisabeth Carlson
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Sergey Shleev
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Eman Awad
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Stefan Cirovic
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Anders Kottorp
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
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Hatzikiriakidis K, Ayton D, O'Connor A, Carmody S, Patitsas L, Skouteris H, Green R. The delivery of healthy lifestyle interventions for people with disability living in supported accommodation: a scoping review of intervention efficacy and consumer involvement. Disabil Health J 2023; 16:101444. [PMID: 36792486 DOI: 10.1016/j.dhjo.2023.101444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND People with disability living in supported accommodation experience health disparities that may be partly attributed to sedentary lifestyle behaviors and poor dietary quality. Healthy lifestyle interventions have been suggested as a method of health promotion for this population; however, a synthesis of their efficacy has not yet been conducted. OBJECTIVE The primary aims were to (1) identify healthy lifestyle interventions delivered to people with disability living in supported accommodation and (2) examine their efficacy in supporting health and well-being. A secondary aim was to explore whether people with disability have been involved in the codesign of these interventions. METHODS A scoping review was conducted following the Joanna Briggs Institute's guidance for conducting scoping reviews, and six databases were searched from January 2011 to November 2021. RESULTS Thirty-two studies were included. Identified intervention types included training and education, exercise programs, and multicomponent interventions. A broad range of outcomes were examined; however, findings regarding efficacy were overall mixed and limited due to significant heterogeneity and the underreporting of consistently measured outcomes. The codesign of interventions in consultation with people with disability was underexplored. CONCLUSIONS Health promotion training for staff and tailored education for people with disability hold promise in creating a care environment that supports a healthy lifestyle. The paucity of interventions developed in consultation with people with disability is concerning and highlights the importance of meaningful co-design. The development of a theoretically informed intervention that is codesigned and addresses the broader social determinants that influence health behavior is recommended.
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Affiliation(s)
- Kostas Hatzikiriakidis
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, UK.
| | - Darshini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, UK
| | - Amanda O'Connor
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, UK
| | - Sarah Carmody
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, UK
| | - Luke Patitsas
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, UK
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, UK; Warwick Business School, Warwick University, UK
| | - Rachael Green
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, UK
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Barriers and enablers to the implementation of healthy lifestyle interventions for people with disability living in supported accommodation: A systematic review using the consolidated framework for implementation research. Disabil Health J 2023; 16:101442. [PMID: 36740546 DOI: 10.1016/j.dhjo.2023.101442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND People with disability living in supported accommodation often experience significant health disparities, despite the availability of additional support. Healthy lifestyle interventions have been identified as one key health promotion strategy. Implementation science offers an opportunity to explore the factors that influence the efficacy and sustainability of these interventions, yet its application in this context has been underutilized. OBJECTIVE This systematic review synthesized the barriers and enablers to the implementation of healthy lifestyle interventions delivered to people with disability living in supported accommodation settings. METHODS A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search for relevant literature published between January 2011 and November 2021 was conducted across six databases. The findings of included studies were coded and analyzed according to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR) via deductive content analysis. RESULTS Five studies were included, and their findings were mapped to 21 out of 38 constructs under the CFIR. Interventions from each study delivered health promotion education and training to staff and/or people with disability. The most prominent determinants that influenced implementation success included an intervention's relevance and its flexibility to adapt to the needs of people with disability, alongside organizational resourcing, and stakeholder endorsement in supporting implementation. CONCLUSIONS The CFIR provided a systematic approach to explore the implementation of healthy lifestyle interventions. However, further research that is grounded in and guided by implementation science theories is warranted. Despite the scarcity of literature, several compelling, yet preliminary recommendations were drawn from the findings.
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Turnbull H, Dark L, Carnemolla P, Skinner I, Hemsley B. A systematic review of the health literacy of adults with lifelong communication disability: Looking beyond accessing and understanding information. PATIENT EDUCATION AND COUNSELING 2023; 106:151-162. [PMID: 36283904 DOI: 10.1016/j.pec.2022.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To determine the a) extent to which people with lifelong communication disability are included in health literacy research, b) level of health literacy of people with lifelong communication disability, c) methods applied to measure the health literacy of people with lifelong communication disability, d) barriers and facilitators mediating the health literacy of people with lifelong communication disability, and e) outcomes of health literacy interventions for people with lifelong communication disability. METHODS We searched for studies relating to health literacy, people with lifelong communication disability, and key areas of the Sørensen et al. (2012) health literacy model (i.e., accessing, understanding, appraising, applying health information, personal/environmental/systemic barriers and facilitators). RESULTS Analysis of 60 studies demonstrated that this population is not well represented. Insufficient research exists to inform statements on level of health literacy or methods used to measure health literacy of this population. Barriers and facilitators appear consistent with those applicable to the general population. Health literacy intervention outcomes were variable. CONCLUSION Significant gaps exist in the research which has primarily focused on people with intellectual disability accessing and understanding health information. PRACTICE IMPLICATIONS Findings can inform policies, practice, and future research on health literacy and people with lifelong communication disability.
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Affiliation(s)
- Harmony Turnbull
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia.
| | - Leigha Dark
- Communication & Inclusion Resource Centre (CIRC), Scope Australia, Hawthorn, Australia.
| | - Phillippa Carnemolla
- School of Built Environment, University of Technology Sydney, Ultimo, Australia.
| | - Ian Skinner
- School of Allied Health Exercise & Sports Sciences, Charles Sturt University, Port Macquarie, Australia.
| | - Bronwyn Hemsley
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia; Faculty of Education and the Arts, The University of Newcastle, Newcastle, Australia.
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9
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Nutsch N, Bruland D, Latteck ÄD. Promoting physical activity in everyday life of people with intellectual disabilities: An intervention overview. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:990-1014. [PMID: 34355583 DOI: 10.1177/17446295211026499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
People with intellectual disabilities show significantly lower levels of physical activity than the general population in respect to all consequences for health. A positive effect of physical activity on health preservation has been proven, but interventions for physical activity in everyday life seem to be rare for people with intellectual disabilities. Based on a previously conducted scoping review the Template for Intervention Description and Replication (TIDieR) checklist was prepared. This article describes and compares physical activity interventions in everyday life for individuals with intellectual disabilities with the aim to of identifying successful strategies and areas for improvement. The 12 included interventions are heterogeneous, but commonalities and similarities can be identified. There are suggestions for successful strategies to implement physical activity interventions. However, much information could not be found. The promotion of healthier lifestyles is important to improve the overall health in this population.
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Affiliation(s)
| | - Dirk Bruland
- Bielefeld University of Applied Sciences, Germany
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10
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Santos FH, Zurek J, Janicki MP. Efficacy of Healthy Aging Interventions for Adults With Intellectual and Developmental Disabilities: A Systematic Review. THE GERONTOLOGIST 2022; 62:e235-e252. [PMID: 33220058 DOI: 10.1093/geront/gnaa192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES There is a lack of information on intervention strategies employed for health promotion and disease prevention for older adults with intellectual and developmental disabilities (IDDs), who usually experience poorer health compared to their peers without IDDs. We carried out the first systematic review to scrutinize the impact of intrinsic factors (e.g., cognitive, mental, and physical health) on the health status of older adults with IDDs. RESEARCH DESIGN AND METHODS To assess the efficacy of such interventions, we examined 23 articles including prospective "healthy aging" interventions designed for adults with IDDs. Searches were carried out in the databases Web of Science, Scielo, and PsycINFO in April 2020. Articles were organized in thematic areas: (a) physical activity and health nutrition (n = 10), (b) health education and health screening (n = 6), (c) social inclusion and community participation (n = 3), and (d) multicomponents (n = 4). Except for 5 randomized controlled trial studies, the designs were mainly nonrandomized, involving small sample sizes (Nrange = 8-379 participants), and lacking follow-up. RESULTS The studies included 2,398 men and women with IDDs (ranging in age from 18 to 86 years [mean age: 44.3 years]). Overall, intervention outcomes were mostly positive; however, some negative outcomes were reported. DISCUSSION AND IMPLICATIONS In brief, healthy aging interventions for people with IDDs remain scarce, incipient, and sporadic. We recommend that more attention needs to be given to active health promotion with people with IDDs as a program practice among organizations and as a focal public policy among governments.
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Affiliation(s)
- Flavia H Santos
- UCD Centre for Disability Studies, University College Dublin, Ireland
| | | | - Matthew P Janicki
- Department of Disability and Human Development, University of Illinois at Chicago, USA
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11
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Dean S, Marshall J, Whelan E, Watson J, Zorbas C, Cameron AJ. A Systematic Review of Health Promotion Programs to Improve Nutrition for People with Intellectual Disability. Curr Nutr Rep 2021; 10:255-266. [PMID: 34893970 DOI: 10.1007/s13668-021-00382-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW To investigate the type and effectiveness of health promotion programs designed to improve nutrition for people with intellectual disability. This review also sought to highlight gaps in the evidence by mapping interventions to the socio-ecological model. RECENT FINDINGS To date, reviews on health promotion programs for people with intellectual disability have focused on individualised weight management interventions and behaviour change techniques. No reviews have focused solely on nutrition or considered a broader range of interventions and policies targeted beyond the individual. This review found that health promotion interventions to date were predominantly at the individual level of the socio-ecological model and of varying effectiveness. Of the non-individually focused interventions, those targeting the physical environment or considering multiple socio-ecological levels achieved the greatest improvements in nutrition outcomes. Nutrition and obesity prevention research and policy need to include intellectual disability as part of equity considerations, while intellectual disability policy needs to consider the broader food environment.
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Affiliation(s)
- Sarah Dean
- Faculty of Health, School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, 3220, Australia
| | - Josephine Marshall
- Faculty of Health, School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, 3220, Australia
| | - Erin Whelan
- Faculty of Health, School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, 3220, Australia
| | - Jo Watson
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, 3220, Australia
| | - Christina Zorbas
- Faculty of Health, School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, 3220, Australia
| | - Adrian J Cameron
- Faculty of Health, School of Health and Social Development, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, 3220, Australia.
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Obrusnikova I, Firkin CJ, Farquhar WB. A systematic review and meta-analysis of the effects of aerobic exercise interventions on cardiorespiratory fitness in adults with intellectual disability. Disabil Health J 2021; 15:101185. [PMID: 34452861 DOI: 10.1016/j.dhjo.2021.101185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/30/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adults with an intellectual disability (ID) have low cardiorespiratory fitness (CRF). Low CRF has been associated with a high risk of cardiovascular disease and all-cause mortality. Participation in regular exercise can help adults with ID increase their CRF. OBJECTIVE To perform a systematic review and meta-analysis of published, peer-reviewed clinical trials that evaluated the effects of aerobic exercise (AE) interventions on CRF in adults with ID, ages 18-65 years. METHODS English-language articles were searched up to June 2021 from 11 electronic databases. Data were extracted using an author-developed form. Two independent authors assessed the risk of bias using the Tool for the Assessment of Study Quality and reporting in Exercise (TESTEX). Meta-analysis was performed using the RevMan 5.3. RESULTS Of the 1870 article titles and abstracts screened, 16 articles were included. The average TESTEX score (out of 15) was 8.1 (SD = 3.5, range 2-14). The pooled effect was statistically significant (SMD = 0.41, 95% CI: 0.19 to 0.63, z = 3.59; p = .000) with moderate heterogeneity (I2 = 35%, p = .000). Both types of intervention produced statistically significant CRF gains, with interventions that combined AE with resistance, balance, and/or flexibility exercises being slightly more effective (SMD = 0.40, 95% CI: 0.11 to 0.70, p = .007) than non-combined interventions (SMD = 0.42, 95% CI: 0.05 to 0.79, p = .02). Heterogeneity was moderate but non-significant for both types of intervention. CONCLUSIONS The review supports the use of AE interventions in promoting CRF in adults with ID. The interpretation is limited by the quality of evidence and by poorly described and/or executed familiarization and measurement protocols.
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Affiliation(s)
- Iva Obrusnikova
- Department of Behavioral Health and Nutrition, University of Delaware, United States.
| | - Cora J Firkin
- Department of Behavioral Health and Nutrition, University of Delaware, United States
| | - William B Farquhar
- Kinesiology and Applied Physiology, University of Delaware, United States
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Genik LM, Aerts EL, Barata PC, Barney CC, Lewis SP, Newby-Clark I, McMurtry CM. A Randomized Controlled Trial Evaluating a Pain Assessment and Management Program for Respite Workers Supporting Children With Disabilities Part One: Pain-Related Knowledge and Perceptions. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:271-288. [PMID: 34161565 DOI: 10.1352/1944-7558-126.4.271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 01/13/2021] [Indexed: 06/13/2023]
Abstract
This parallel group randomized controlled trial tested effectiveness of the Let's Talk About Pain training on respite workers' (RW) pain-related knowledge and feasibility-confidence-skill ratings using between-group and within-group analyses. Fourteen children's respite organizations were randomized to pain or control training. Participants (nintervention = 66; ncontrol = 92) underwent a 3-3.5 hour training and completed measures at pre-, post-, and 4-6 week follow-up. Intention-to-treat (nintervention = 65; ncontrol = 92) and per-protocol (nintervention = 26-38; ncontrol = 40-57) analyses were conducted. Pain training participants demonstrated significantly higher pain knowledge and feasibility-confidence-skill ratings post-follow-up versus control group and significant increases in knowledge from pre-post. Significant gains were maintained from post-follow-up. Results represent a promising step towards enhancing pain-related care for children with IDD.
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Affiliation(s)
- Lara M Genik
- Lara M. Genik, Elisabeth L. Aerts, and Paula C. Barata, University of Guelph, Ontario, Canada
| | - Elisabeth L Aerts
- Lara M. Genik, Elisabeth L. Aerts, and Paula C. Barata, University of Guelph, Ontario, Canada
| | - Paula C Barata
- Lara M. Genik, Elisabeth L. Aerts, and Paula C. Barata, University of Guelph, Ontario, Canada
| | | | - Stephen P Lewis
- Stephen P. Lewis, Ian Newby-Clark, and C. Meghan McMurtry, University of Guelph, Ontario, Canada
| | - Ian Newby-Clark
- Stephen P. Lewis, Ian Newby-Clark, and C. Meghan McMurtry, University of Guelph, Ontario, Canada
| | - C Meghan McMurtry
- Lara M. Genik, Elisabeth L. Aerts, and Paula C. Barata, University of Guelph, Ontario, Canada
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14
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Taggart L, Doherty AJ, Chauhan U, Hassiotis A. An exploration of lifestyle/obesity programmes for adults with intellectual disabilities through a realist lens: Impact of a 'context, mechanism and outcome' evaluation. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:578-593. [PMID: 33342030 DOI: 10.1111/jar.12826] [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: 12/10/2019] [Revised: 07/16/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obesity is higher in people with intellectual disabilities. AIMS There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond 'what works' and examine the 'context, mechanisms and outcomes' (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these programmes could be implemented within practice. METHOD We explored six-review papers and the individual lifestyle/obesity programmes that these papers reviewed using the CMO framework. RESULTS There were few theoretically underpinned, multi-component programmes that were effective in the short to long-term and many failed to explore the 'context and mechanisms'. We developed a logic model and engaged in two co-production workshops to refine this model. DISCUSSION Using a realist approach, programmes need to be underpinned by both individual and systems change theories, be multi-component, have a closer understanding of the interplay of the 'context and mechanisms', and co-designed using a logic model framework.
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Affiliation(s)
- Laurence Taggart
- Institute of Nursing & Health Research, Ulster University, Co Antrim, UK
| | - Alison Jayne Doherty
- Faculty of Health & Wellbeing, University of Central Lancashire (UCLan), Preston, UK
| | - Umesh Chauhan
- Faculty of Health & Wellbeing, University of Central Lancashire (UCLan), Preston, UK
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15
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Røstad-Tollefsen HK, Kolset SO, Retterstøl K, Hesselberg H, Nordstrøm M. Factors influencing the opportunities of supporting staff to promote a healthy diet in adults with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:733-741. [PMID: 33274594 DOI: 10.1111/jar.12846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/13/2020] [Accepted: 11/19/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Adults with intellectual disabilities living in residential houses have a high prevalence of obesity which is related to poor dietary habits. AIM The aim of this study was to assess supporting staff`s thoughts and experiences on factors influencing their opportunities to promote a healthy diet in adults with intellectual disabilities. METHODS 13 supporting staff members were recruited from 11 different residential houses in a community. Concept Mapping methodology was used, including group interviews, sorting, rating statement and analysing the results. RESULTS Seven clusters most accurately captured the ideas of the supporting staff`. 'Attitudes', 'Facilitating a healthy diet', 'Practical cooking skills' and 'Applied dietary knowledge' were the four most important. CONCLUSIONS Multiple factors influence the opportunities of supporting staff to promote a healthy diet. A holistic approach addressing all relevant factors is necessary when developing interventions to address this complex issue in persons with intellectual disabilities.
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Affiliation(s)
- Helen K Røstad-Tollefsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Baerum Municipality, Health and Care Services, Community Housing and Services, Sandvika, Norway
| | - Svein O Kolset
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Lipid Clinic, Oslo University Hospital, Oslo, Norway
| | - Heidi Hesselberg
- Baerum Municipality, Health and Care Services, Community Housing and Services, Sandvika, Norway
| | - Marianne Nordstrøm
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Frambu Resource Centre for Rare Disorders, Siggerud, Norway.,Department of Neurology, Unit for Inborn and Hereditary Neuromuscular Disorders, Oslo University Hospital, Oslo, Norway
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16
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St John L, Borschneck G, Cairney J. A Systematic Review and Meta-Analysis Examining the Effect of Exercise on Individuals With Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:274-286. [PMID: 32609804 DOI: 10.1352/1944-7558-125.4.274] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 11/29/2019] [Indexed: 05/16/2023]
Abstract
This study examined the efficacy of exercise programs for individuals with intellectual disability (ID) based on experimental designs. Multiple databases were searched from inception up until March 2019. Randomized control trials were eligible for inclusion if they (a) included a population with ID; (b) used an exercise intervention; and (c) included performance, cardiovascular health, and/or psychological measures. All data were pooled using random effects models of standardized mean differences. The review included 18 studies which represented data from 799 individuals with ID. The largest effect was seen in relation to anxiety and depression symptoms (SMD = -3.07). This study represented the first comprehensive analysis on this topic area and illustrated that exercise can play an important therapeutic role for this population.
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Hunt M, Ponnusamy R, Goulet A, Anthonypillai C, Muthukaruppan SS, Bharathwaj A, Thomas A, Archambault PS, Garnett C, Storr C, Krishna D. An integrated knowledge translation project to develop, implement, and evaluate a train-the-trainer program at a community rehabilitation program in Tamil Nadu, India. Disabil Rehabil 2020; 43:3868-3877. [PMID: 32362162 DOI: 10.1080/09638288.2020.1752823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: This project aimed to develop, implement and evaluate a train-the-trainer initiative for community rehabilitation workers (CRWs) and rehabilitation specialists within a community rehabilitation program for children with delayed development in Tamil Nadu, India.Methods: Guided by the Knowledge to Action framework, non-governmental and academic partners collaboratively developed two 2-day workshops for (1) rehabilitation specialists and (2) CRWs. Outcomes were evaluated using mixed methods, with pre and 2.5-months post surveys (59 participants) and three focus groups (17 participants) involving trainers and trainees (including rehabilitation specialists and CRWs).Results: There were significant increases in the CRWs' self-perception of their capacity to assess comprehension, provide explanations, respond to questions, adjust teaching, motivate learners, communicate effectively, and provide feedback. Significant changes were noted for rehabilitation specialists in five of seven domains, and for rehabilitation specialist leads in six of seven domains. Participants appreciated the interactive training style, and the use of immersive methods such as role play, though noted challenges when instructions were unclear or when they felt that material was more theoretical.Conclusions: This collaboratively developed train-the-trainer project demonstrates the value of such an intervention, provides an example of how a tailored program can be developed, and suggests the importance of stakeholder-driven design processes.Implications for RehabilitationThe ability to provide effective training is a core skill set for people engaged in community-based rehabilitation (CBR) programs, yet examples of initiatives to train trainers are lacking, as is their evaluation.This project demonstrates the value of a collaborative and tailored train-the-trainer program to support community rehabilitation workers and rehabilitation specialists in their training roles within a CBR program in India.A stakeholder-driven design process supported by a collaboration between non-governmental organization and academic partners enhanced the capacity to develop, implement and evaluate the train-the-trainer program.
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Affiliation(s)
- Matthew Hunt
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
| | | | - Anik Goulet
- Villa Medica Rehabilitation Hospital, Montreal, QC, Canada
| | - Chamila Anthonypillai
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | | | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
| | - Crystal Garnett
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Caroline Storr
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Dinesh Krishna
- Amar Seva Sangam, Ayikudy, India.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Handi-Care International, Toronto, ON, Canada
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18
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Owens R, Earle S, McNulty C, Tilley E. What works in community health education for adults with learning disabilities: A scoping review of the literature. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1268-1283. [PMID: 32346968 DOI: 10.1111/jar.12746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/05/2020] [Accepted: 04/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Research suggests there is insufficient good quality information regarding the effectiveness of health education aimed at adults with intellectual disabilities. By analysing the literature, this review aimed to identify what constituted effectiveness in this context. METHOD Relevant evaluations were extracted from bibliographic databases according to pre-specified criteria. Papers were analysed using QSR NVivo 11 by developing a narrative synthesis and analytic framework that identified and explored text addressing the research question. RESULTS Twenty-two studies were included. The review identified two broad components of effective health education: mechanisms and context. Mechanisms included embedded programme flexibility, appropriate and accessible resources, and motivational delivery. An effective context included an accessible and supportive environment and longer term opportunities for reinforcement of learning. CONCLUSIONS Important gaps in the literature highlighted a need for further research addressing community learning experiences of adults with intellectual disabilities as well as the effectiveness of infection prevention programmes.
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19
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Porteny T, Alegría M, del Cueto P, Fuentes L, Markle SL, NeMoyer A, Perez GK. Barriers and strategies for implementing community-based interventions with minority elders: positive minds-strong bodies. Implement Sci Commun 2020; 1:41. [PMID: 32885198 PMCID: PMC7427860 DOI: 10.1186/s43058-020-00034-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND By 2040, one out of three older adults in the USA are expected to belong to a racial/ethnic minority group. This population has an increased risk of mental and physical disability with significant barriers to access care. Community-based organizations (CBOs) often provide programming to serve minority and immigrant elders. Limited resources and other barriers such as lack of trained staff make it difficult to implement evidence-based interventions (EBIs) in CBOs for long-term adoption. Yet little is known about what factors can facilitate adoption of EBIs in CBOs serving minority elders. METHODS Positive-Minds-Strong Bodies (PM-SB), an evidence-based intervention offered in four languages, aims to reduce mental and physical disability for minority and immigrant elders through the efforts of community health workers and exercise trainers. The intervention consists of cognitive behavior therapy and exercise training sessions delivered over 6 months. During a recent clinical trial of this intervention, we elicited feedback from CBO staff to determine how best to facilitate the implementation and long-term sustainability of PM-SB within their agencies. We surveyed 30 CBO staff members, held four focus groups, and conducted 20 in-depth interviews to examine staff perspectives and to reveal factors or changes needed to facilitate long-term adoption in prospective CBOs. RESULTS Participants reported that staff motivation and implementation could be improved through the following changes: increasing patient compensation for treatment sessions, decreasing levels of organizational accountability, and reducing staff demands embedded in the intervention. Although most staff perceived that PM-SB improved their agency's ability to address the health and well-being of elders, capacity-building strategies such as a "train-the-trainer" initiative were identified as priorities to address staff turnover for sustainability. Adapting the intervention to get financial reimbursement also emerged as vital. CONCLUSIONS Augmenting financial incentives, streamlining procedures, and simplifying staff accountability were suggested strategies for facilitating the transition from a disability prevention clinical trial in minority and immigrant elders to a scalable implementation in routine services at CBOs. TRIAL REGISTRATION ClinicalTrials.gov, NCT02317432.
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Affiliation(s)
- Thalia Porteny
- Interfaculty Initiative in Health Policy, Graduate School of Arts and Science, Harvard University, 1350 Massachusetts Avenue, Suite 350, Cambridge, MA 02138-3654 USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215 USA
| | - Paola del Cueto
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
| | - Larimar Fuentes
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
| | - Sheri Lapatin Markle
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
| | - Amanda NeMoyer
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114 USA
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115 USA
| | - Giselle K. Perez
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215 USA
- Health Policy Research Center at the Mongan Institute, Massachusetts General Hospital, 100 Cambridge Street, Boston, MA 02114 USA
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20
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Bondár RZ, di Fronso S, Bortoli L, Robazza C, Metsios GS, Bertollo M. The effects of physical activity or sport-based interventions on psychological factors in adults with intellectual disabilities: a systematic review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:69-92. [PMID: 31833138 DOI: 10.1111/jir.12699] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 10/10/2019] [Accepted: 10/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Inactivity is a major factor contributing to adverse health in people with intellectual disabilities (IDs). While it is generally agreed that physical activity (PA)/sport-based interventions promote cognitive and social development in the general population, little is known about their specific benefits in adults with ID. The aims of this systematic review were (a) to examine the effects of PA/sport-based interventions on intention, motivation and attitude regarding PA/sport participation in adults with ID and (b) to investigate the influence of these psychological factors on behavioural change (e.g. PA level) and quality of life. METHODS A systematic review has been conducted searching four electronic databases (i.e. SCOPUS, Web of Science, PubMed and Cochrane Library). Studies were included if written in English, peer reviewed, had primary research data, and measured intention, motivation, attitude, behavioural outcomes or quality of life. RESULTS Thirteen articles met our inclusion criteria of which 10 explored the effects of PA/sport as part of a multi-component intervention. Most investigated outcomes were exercise self-efficacy and quality of life. Five studies measured exercise self-efficacy, and four of them found significant changes. One study found a significant improvement in quality of life and another study in life satisfaction. We observed lack of sport-based interventions, few data about people with severe ID and limited psychological measures. CONCLUSIONS Personal and environmental factors are key components of behavioural change. Support of caregivers and individualised instructions may benefit exercise self-efficacy. There is lack of information about the effects of psychological factors on behavioural change and quality of life in adults with ID.
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Affiliation(s)
- R Z Bondár
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - S di Fronso
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - L Bortoli
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - C Robazza
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - G S Metsios
- Institute of Sport, Faculty of Education Health and Wellbeing, University of Wolverhampton, Walsall, UK
- Health Exercise and Activity Therapy (HEAT) Institution, Birmingham, UK
| | - M Bertollo
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
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Marks B, Sisirak J, Chang YC, Murphy R. Impact of the HealthMatters Train-the-Trainer Program on the Health and Health Behaviors of Staff Supporting Adults With Intellectual and Developmental Disabilities. Workplace Health Saf 2019; 67:423-435. [PMID: 31007138 PMCID: PMC8060074 DOI: 10.1177/2165079919828739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The health status and health behaviors among support staff providing daily support for people with intellectual and developmental disabilities (IDD-SS) in community-based organizations (CBOs) have not been systematically studied. This study examined the health impact of IDD-SS workers who participated in a HealthMatters Program: Train-the-Trainer Certified Instructor Workshop followed by implementing a 12-week HealthMatters Program for people with intellectual and developmental disabilities (IDD) that they care for as part of their employment. A total of 48 IDD-SS were enrolled into either an intervention (n = 28) or control group (n = 20). IDD-SS in the intervention group received an 8-hour HealthMatters Program: Train-the-Trainer Workshop immediately prior to teaching a 12-week HealthMatters Program for people with IDD. Assessments were conducted with IDD-SS before and after completing the 12-week HealthMatters Program to evaluate whether IDD-SS experienced any benefit of the training and teaching the program on their own health and health behaviors. Relative to the control group, the IDD-SS in the intervention group showed significant improvements in social/environmental supports for nutrition (F = 4.92, p = .032), exercise outcome expectations (F = 6.58, p = .014), nutrition outcome expectations (F = 8.87, p = .005), fruit and vegetable intake (F = 13.62, p = .001), knowledge of fruit and vegetable intake recommendations (F = 11.25, p = .002), and stages of change for eating fruits and vegetables (F = 6.86, p = .012). Results demonstrated that IDD-SS benefited from the health education programming. Findings support the need to develop programs and organizational policies for health promotion activities for direct care staff.
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Ailey SH, Miller AM, Paun O, Schoeny M, Johnson T, Moro T, Nezu A, Heller T, Melby J. Steps to Effective Problem-Solving in group homes. Contemp Clin Trials 2018; 72:62-72. [PMID: 30031089 PMCID: PMC9636718 DOI: 10.1016/j.cct.2018.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/25/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
Abstract
Aggressive/challenging behaviors (A/CB) are a major public health problem for individuals with intellectual disabilities (ID). A leading reason for psychiatric hospitalizations and incarcerations, such behaviors are costly to the health care system, agencies, and families. Social problem-solving (SPS) training programs for individuals with ID have had positive behavioral results, but most were conducted in clinical or forensic settings. None was a community-based preventive intervention, none examined whether the behaviors decreased in residential and work settings, and none addressed cost-effectiveness. In preliminary work, we modified an effective SPS training program (ADAPT: Attitude, Define, Alternatives, Predict, and Try out), using input from individuals with ID and residential staff, as a community-based preventive intervention that we delivered in group homes (STEPS: Steps to Effective Problem-solving). Individuals with ID have high rates of obesity, and our attention-control condition is a nutrition intervention: Food for Life. We describe the protocol for a randomized clinical trial to: (1) test the efficacy of the STEPS intervention for improving SPS skills and reducing A/CB compared to an attention-control nutrition intervention in group homes; (2) assess the mediating effect of residential staff SPS skills, group-home level SPS skills, and group cohesiveness on the improvement of SPS skills and reductions in A/CB; and (3) evaluate the cost-effectiveness of STEPS. We expect to show that STEPS is a preventive strategy to reduce A/CBs among individuals with ID and improve the cost-effectiveness of their care.
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Affiliation(s)
- Sarah H Ailey
- Rush University Medical Center, Chicago, IL, United States.
| | | | - Olimpia Paun
- Rush University Medical Center, Chicago, IL, United States
| | | | - Tricia Johnson
- Rush University Medical Center, Chicago, IL, United States
| | - Teresa Moro
- Rush University Medical Center, Chicago, IL, United States
| | - Arthur Nezu
- Drexel University, Philadelphia, PA, United States
| | - Tamar Heller
- University of Illinois at Chicago, Chicago, IL, United States
| | - Janet Melby
- Iowa State University, Ames, IA, United States
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Salomon C, Bellamy J, Evans E, Reid R, Hsu M, Teasdale S, Trollor J. 'Get Healthy!' A physical activity and nutrition program for older adults with intellectual disability: pilot study protocol. Pilot Feasibility Stud 2018; 4:144. [PMID: 30151237 PMCID: PMC6109457 DOI: 10.1186/s40814-018-0333-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/12/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Older adults with intellectual disability have high rates of lifestyle-related illness yet remain poorly engaged in physical activity and nutrition interventions. There is a need to clarify what types of healthy lifestyle interventions are feasible and effective to implement in this population and how outcome measures can best be tracked. This paper describes the pilot feasibility study protocol for implementing a 12-week physical activity and healthy eating program, 'Get Healthy!' with older adults with intellectual disability. METHODS The primary study aims are to assess the feasibility of implementing and monitoring the 'Get Healthy!' program with adults with mild to moderate intellectual disability, aged 40 years and over, and their carers. Secondary study aims are to assess the impact of the intervention across the following parametres: body mass index, waist circumference, cardiovascular fitness, physical activity (amount and intensity) and sedentary behaviours, resting blood pressure, functional strength/capacity, dietary intake (energy intake, food group consumption and diet quality), dietary and physical activity knowledge, and quality of life. Between 8 and 10 participants in total will be recruited into the 12-week program that will be run in metropolitan NSW, Australia. A combination of objective and subjective measures will be used to assess program feasibility and impact at set timepoints (baseline, mid and end-program). DISCUSSION Results from the feasibility pilot will be used to refine the study methodology and 'Get Healthy!' program content for future use in a sufficiently powered trial. Findings may be of interest to a broad range of disability and allied health workers engaged in supporting and monitoring healthy lifestyle change in adults with intellectual disability. TRIAL REGISTRATION ACTRN: ACTRN12618000349246. Registered March 8, 2018- Retrospectively registered, UTN: U1111-1209-3132.
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Affiliation(s)
- Carmela Salomon
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
| | - Jessica Bellamy
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
- Department of Exercise Physiology, School of Medical Sciences, Wallace Wurth Level 2, UNSW Sydney, Sydney, 2052 Australia
| | - Elizabeth Evans
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
| | - Renae Reid
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
| | - Michelle Hsu
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, 2006 Australia
| | - Scott Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, 26 Llandaff Street, Bondi Junction, 2022 Australia
- School of Psychiatry, UNSW, Hospital Road, Randwick, 2013 Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, 34 Botany St, UNSW Sydney, Sydney, 2052 Australia
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Willems M, Waninge A, Hilgenkamp TIM, van Empelen P, Krijnen WP, van der Schans CP, Melville CA. Effects of lifestyle change interventions for people with intellectual disabilities: Systematic review and meta-analysis of randomized controlled trials. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:949-961. [DOI: 10.1111/jar.12463] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Mariël Willems
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Thessa I. M. Hilgenkamp
- Department of General Practice; Intellectual Disability Medicine; Erasmus MC University Medical Center Rotterdam; Rotterdam The Netherlands
| | - Pepijn van Empelen
- Research Group Child Health; Netherlands Institute of Applied Scientific Research; Leiden The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Craig A. Melville
- Institute of Health and Wellbeing; College of Medical Veterinary and Life Sciences; Gartnavel Royal Hospital; University of Glasgow; Glasgow UK
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Healthy living: A health promotion program for adults with intellectual disability. Disabil Health J 2018; 11:606-611. [PMID: 29661683 DOI: 10.1016/j.dhjo.2018.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 02/18/2018] [Accepted: 03/28/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Adults with intellectual disability are more likely to experience a range of physical and mental health problems in comparison to the general population. However with access to appropriate health care and promotion, many of these health problems can be prevented. OBJECTIVE To explore the perspectives of stakeholders of a health promotion program established for adults with intellectual disability. METHODS Semi-structured interviews were conducted with 12 stakeholders of a health promotion program. Stakeholders included adults with intellectual disability (n = 6), their support persons (n = 4) and program presenters (n = 2). Adults with intellectual disability included three males and three females with a mean age of 45.5 years (range 37-51 years). Interviews were digitally recorded and transcribed verbatim. Transcripts were analysed using thematic analysis. RESULTS Four main themes emerged from the data. The first theme highlights the positive feedback all stakeholders, especially adults with intellectual disability, had for the program and the second focuses on suggestions for changes to improve it. The third and final themes explore how having input from adults with intellectual disability and their support persons, who have a unique understanding of their needs, could be better incorporated into the development of the program. CONCLUSIONS This health promotion program has been well received by people with intellectual disability when incorporated into their weekly social club meetings With encouragement and training, people with intellectual disability and their support workers could be more involved in the development of the program to ensure it is relevant to their needs.
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Li H, Fujiura G, Magaña S, Parish S. Health care expenditures of overweight and obese U.S. adults with intellectual and developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 75:1-10. [PMID: 29427860 PMCID: PMC9494707 DOI: 10.1016/j.ridd.2018.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 12/30/2017] [Accepted: 01/25/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND U.S. adults with intellectual and developmental disabilities (IDD) have poorer health status and greater risks for being overweight and obese, which are major drivers of health care expenditures in the general population. Health care expenditures and IDD have not been studied using nationally representative samples, and the impact of overweight and obesity have not been examined. AIM Using nationally representative data, we aimed to compare the health care expenditures of not-overweight, overweight and obese U.S. adults with IDD, and calculate model-adjusted expenditures. METHODS AND PROCEDURES Pooled data from the 2002-2011 Medical Expenditure Panel Survey linked to National Health Interview Survey (n = 1224) were analyzed. Two-part model regressions were conducted, with covariates being year of survey, age, sex, race/ethnicity, household income status, geographical region, urban/rural, marital status, insurance coverage, perceived health status, and perceived mental health status. OUTCOMES AND RESULTS Overall, obese adults with intellectual and developmental disabilities had higher expenditures than their non-obese peers. Being obese was associated with an estimated additional $2516 in mean expenditures and $1200 in median expenditures compared with the reference group, who were neither overweight nor obese. CONCLUSIONS AND IMPLICATIONS Obesity is an important predictor of higher health care costs among community-living adults with IDD Finding effective strategies and interventions to address obesity in this population has great financial and policy significance.
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Affiliation(s)
- Henan Li
- Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, USA.
| | - Glenn Fujiura
- Department of Disability and Human Development, The University of Illinois at Chicago, USA
| | - Sandra Magaña
- Steve Hicks School of Social Work, University of Texas at Austin, USA
| | - Susan Parish
- Bouvé College of Health Sciences, Northeastern University, USA
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27
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Flygare Wallén E, Ljunggren G, Carlsson AC, Pettersson D, Wändell P. High prevalence of diabetes mellitus, hypertension and obesity among persons with a recorded diagnosis of intellectual disability or autism spectrum disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:269-280. [PMID: 29280230 DOI: 10.1111/jir.12462] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 11/16/2017] [Accepted: 11/29/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Obesity and lack of physical activity are frequently reported in persons with intellectual disability (ID) or autism spectrum disorder (ASD). We hypothesised a higher prevalence of diabetes and hypertension in this population. METHOD We used administrative data for all primary and specialist outpatient and inpatient healthcare consultations for people with at least one recorded diagnosis of diabetes mellitus, hypertension or obesity from 1998 to 2015. Data were drawn from the central administrative database for Stockholm County, Sweden. It was not possible to separate data for type 1 and type 2 diabetes. We stratified 26 988 individuals with IDs or ASD into three groups, with Down syndrome treated separately, and compared these groups with 1 996 140 people from the general population. RESULTS Compared with the general population, men and women with ID/ASD had 1.6-3.4-fold higher age-adjusted odds of having a registered diagnosis of obesity or diabetes mellitus, with the exception of diabetes among men with Down syndrome. A registered diagnosis of hypertension was only more common among men with ID/ASD than in the general population. CONCLUSIONS Diabetes and blood pressure health screening, along with efforts to prevent development of obesity already in childhood, are necessary for individuals with IDs and ASD. We believe that there is a need for adapted community-based health promotion programmes to ensure more equitable health for these populations.
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Affiliation(s)
- E Flygare Wallén
- Academic Primary Health Care Centre, Stockholm County Council, Stockholm, Sweden
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - G Ljunggren
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Public Health Care Services Committee Administration, Stockholm County Council, Stockholm, Sweden
| | - A C Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - D Pettersson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - P Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Castro O, Ng K, Novoradovskaya E, Bosselut G, Hassandra M. A scoping review on interventions to promote physical activity among adults with disabilities. Disabil Health J 2018; 11:174-183. [DOI: 10.1016/j.dhjo.2017.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 09/21/2017] [Accepted: 10/07/2017] [Indexed: 11/29/2022]
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Pitchford EA, Dixon-Ibarra A, Hauck JL. Physical Activity Research in Intellectual Disability: A Scoping Review Using the Behavioral Epidemiological Framework. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:140-163. [PMID: 29480777 DOI: 10.1352/1944-7558-123.2.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Through a scoping review, the current state of physical activity research in people with intellectual disability was examined. A search of publications between 2000 and 2014 retrieved 362 articles that met inclusion criteria. Eligible studies were coded according to the Behavioral Epidemiological Framework. Of the articles identified, 48% examined associations between physical activity and health outcomes, 9% developed or tested methodology to measure physical activity, 34% examined factors that influence physical activity, 8% evaluated interventions to change physical activity, and 1% examined the dissemination of physical activity/health promotion programming. The categories with lower proportions of studies represent the need for greater population-specific research in physical activity measurement, interventional designs, and translational programs.
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Affiliation(s)
| | | | - Janet L Hauck
- Janet L. Hauck, Michigan State University. E. Andrew Pitchford is now at Iowa State University
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Hsieh K, Hilgenkamp TIM, Murthy S, Heller T, Rimmer JH. Low Levels of Physical Activity and Sedentary Behavior in Adults with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1503. [PMID: 29207570 PMCID: PMC5750921 DOI: 10.3390/ijerph14121503] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/26/2017] [Accepted: 11/29/2017] [Indexed: 11/30/2022]
Abstract
Adults with intellectual disabilities (ID) are more likely to lead sedentary lifestyles and have low levels of physical activity (LLPA). The present study investigated the prevalence of reported LLPA and time spent watching TV in adults with ID and identified the associated factors for these behaviors. The proxy informants of 1618 adults with ID completed the surveys regarding their health behaviors. Multiple logistic regressions were employed for LLPA and multiple linear regressions for time spent watching TV. About 60% of adults with ID had LLPA and average time spent watching TV was 3.4 h a day. Some characteristics and health and function variables were identified as associated factors. While engaging in community activities and involvement in Special Olympics were inversely associated with LLPA, they were not associated with time spent watching TV. Attending day/educational programs or being employed were associated with spending less time watching TV. Findings highlight differential factors associated with LLPA versus TV-watching behavior in adults with ID. Hence, a key strategy aimed at increasing physical activity includes promoting participation in social and community activities, while targeted activities for reducing sedentary behavior might focus on providing day programs or employment opportunities for adults with ID.
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Affiliation(s)
- Kelly Hsieh
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL 60609, USA.
| | - Thessa I M Hilgenkamp
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Sumithra Murthy
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL 60609, USA.
| | - Tamar Heller
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL 60609, USA.
| | - James H Rimmer
- School of Health Professions, University of Alabama at Birmingham, SHPB 331, Birmingham, AL 35294, USA.
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O'Leary L, Taggart L, Cousins W. Healthy lifestyle behaviours for people with intellectual disabilities: An exploration of organizational barriers and enablers. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:122-135. [DOI: 10.1111/jar.12396] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Lisa O'Leary
- Scottish Learning Disabilities Observatory, Academic Unit for Mental Health & Wellbeing; Gartnavel Royal Hospital, University of Glasgow; Glasgow UK
| | - Laurence Taggart
- Institute of Nursing and Health Research; School of Nursing, Ulster University, Jordanstown Campus; Newtownabbey Northern Ireland UK
| | - Wendy Cousins
- Institute of Nursing and Health Research; School of Nursing, Ulster University, Jordanstown Campus; Newtownabbey Northern Ireland UK
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Dixon-Ibarra A, Driver S, Nery-Hurwit M, VanVolkenburg H. Qualitative evaluation of a physical activity health promotion programme for people with intellectual disabilities in a group home setting. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:97-109. [PMID: 28833967 DOI: 10.1111/jar.12397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a lack of health promotion programming designed to change the physical activity environment of the group home setting. The Menu-Choice programme assists staff in creating physical activity goals alongside residents with intellectual disabilities and provides strategies to incorporate activity into the group home schedule. The purpose of this study was to complete a process evaluation of Menu-Choice utilizing qualitative methods. METHODS Twelve participants, who completed a 10-week pilot intervention (n = 7 staff, mean age 42; n = 5 residents, mean age 52), participated in face-to-face interviews. Participants represented five group home sites involved in the intervention. RESULTS Meta-themes included: (i) Programme training, (ii) Programme implementation, (iii) Programme physical activity, (iv) Programme barriers, (v) Programme facilitators and (vi) Programme feedback. CONCLUSIONS Changes in programme training and simplified programme materials are needed to accommodate identified barriers for implementation. The importance of obtaining increased agency support and policy change is highlighted.
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Affiliation(s)
- A Dixon-Ibarra
- College of Public Health and Human Sciences: Adapted Physical Activity, Oregon State University, Corvallis, OR, USA
| | - S Driver
- Rehabilitation Research, Baylor Institute for Rehabilitation, Dallas, TX, USA
| | - M Nery-Hurwit
- Department of Kinesiology, Pacific Lutheran University, Tacoma, WA, USA
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Friedman C, Owen AL. Sexual health in the community: Services for people with intellectual and developmental disabilities. Disabil Health J 2017; 10:387-393. [DOI: 10.1016/j.dhjo.2017.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/21/2017] [Accepted: 02/26/2017] [Indexed: 10/19/2022]
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Roll AE. Health promotion for people with intellectual disabilities - A concept analysis. Scand J Caring Sci 2017; 32:422-429. [DOI: 10.1111/scs.12448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/22/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Anne E. Roll
- University of Wisconsin-Madison School of Nursing; Madison WI USA
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35
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Dixon-Ibarra A, Nery-Hurwit M, Driver S, MacDonald M. Using health promotion guidelines for persons with disabilities to develop and evaluate a physical activity program for individuals with multiple sclerosis: A feasibility study. EVALUATION AND PROGRAM PLANNING 2017; 61:150-159. [PMID: 28103520 DOI: 10.1016/j.evalprogplan.2016.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/01/2016] [Accepted: 12/07/2016] [Indexed: 06/06/2023]
Abstract
The Health Education for Persons with Multiple Sclerosis (HEMS) program was developed in response to the need for interventions aimed at increasing physical activity for individuals with Multiple Sclerosis (MS). It was developed and evaluated using Drum and colleagues (2009) guidelines for implementing health promotion programs for individuals with disabilities. The purpose of this feasibility study is to describe the development, implementation, and evaluation of the HEMS program. Thirteen individuals with MS completed the 8-week health education program. A mixed method approach for evaluation was implemented (i.e., survey and focus groups). Process and resource feasibility demonstrated that over half of the participants attended at least 80% of the weekly sessions. Focus group data provided valuable feedback for future iterations of the program including critiques on the delivery, content, and group support provided. Outcome evaluation showed increases in self-efficacy (survey), improvements in theoretical constructs (focus groups), and increased physical activity (focus groups). Results show that health promotion programs for persons with MS can improve physical activity and related constructs. Next steps will be to revise, implement, and reevaluate the HEMS program in a larger randomized control trial.
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Affiliation(s)
- Alicia Dixon-Ibarra
- Oregon State University, Department of Public Health, 123 Women's Building, Corvallis, OR 97321, United States.
| | - Mara Nery-Hurwit
- Pacific Lutheran University, 12180 Park Ave S., Tacoma, WA 98447, United States.
| | - Simon Driver
- Baylor Institute for Rehabilitation, 909N. Washington Avenue, Dallas, TX 75246, United States.
| | - Megan MacDonald
- Oregon State University, Department of Public Health, 123 Women's Building, Corvallis, OR 97321, United States.
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36
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Nurse Practitioners Promoting Physical Activity: People With Intellectual and Developmental Disabilities. J Nurse Pract 2017. [DOI: 10.1016/j.nurpra.2016.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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37
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Graham L, Wright J, Walwyn R, Russell AM, Bryant L, Farrin A, House A. Measurement of adherence in a randomised controlled trial of a complex intervention: supported self-management for adults with learning disability and type 2 diabetes. BMC Med Res Methodol 2016; 16:132. [PMID: 27716063 PMCID: PMC5052902 DOI: 10.1186/s12874-016-0236-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 09/29/2016] [Indexed: 01/18/2023] Open
Abstract
Background Reporting adherence to intervention delivery and uptake is a detailed way of describing what was actually delivered and received, in comparison to what was intended. Measuring and reporting adherence is not routinely done well in complex interventions. The OK Diabetes trial (ISRCTN41897033) aimed to develop and subsequently test the feasibility of implementing a supported self-management intervention in adults with a learning disability and type 2 diabetes. A key study objective was to develop a measure of adherence to the intervention. Methods We conducted a systematic review of published literature, extracting data from included papers using a standardised proforma. We undertook a narrative synthesis of papers to determine the form and content of methods for adherence measurement for self-management interventions in this population that had already been developed. We used the framework and data extraction form developed for the review as the basis for an adherence measurement tool that we applied in the OK Diabetes trial. Results The literature review found variability in the quality and content of adherence measurement and reporting, with no standardised approach. We were able to develop an adherence measure based upon the review, and populate it with data collected during the OK Diabetes trial. The adherence tool proved satisfactory for recording and measuring adherence in the trial. Conclusion There remains a need for a standardised approach to adherence measurement in the field of complex interventions. We have shown that it is possible to produce a simple, feasible measure for assessing adherence in the OK Diabetes trial. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0236-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Liz Graham
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Rebecca Walwyn
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Amy M Russell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Louise Bryant
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amanda Farrin
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Allan House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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38
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Roll AE, Bowers BJ. Promoting Healthy Aging of Individuals With Developmental Disabilities: A Qualitative Case Study. West J Nurs Res 2016; 39:234-251. [PMID: 27621273 DOI: 10.1177/0193945916668329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative case study sought to examine an innovative community outreach nursing program designed to promote healthy aging for more than 250 individuals with intellectual or developmental disabilities living in the community. We analyzed 10 in-depth interviews, one focus group, and various documents using thematic analysis. We researched why the program emerged and found the reasons to be improving the communication with primary care providers, providing person-centered health care, and building on and contributing to existing community-based programs. Findings on what the daily work of community outreach nurses with individuals with intellectual or developmental disabilities entailed, included person-centered health education, advocacy for the safe return home, support for staff to understand that health issues can lead to behavior changes, and enabling social participation. This case study may inspire further research or help others develop similar programs.
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Affiliation(s)
- Anne E Roll
- 1 University of Wisconsin-Madison, WI, Madison, WI, USA
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Scott HM, Havercamp SM. Systematic Review of Health Promotion Programs Focused on Behavioral Changes for People With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:63-76. [PMID: 26824134 DOI: 10.1352/1934-9556-54.1.63] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
People with intellectual disability (ID) experience high rates of chronic health problems and poor overall health compared to people without disabilities. Recent attention to health risk behaviors such as poor diet, lack of physical activity, and underuse of health care has led to the development of several programs intended to reduce disparities in this population through health promotion programs. A review of the literature was conducted focusing on programs developed to target behavioral changes in the person with ID. Thirteen studies, evaluating 10 different health promotion programs, were found. Programs varied significantly in design, targeted health change, and demonstrated effectiveness. Components of each program are systematically reviewed and recommendations made for future programs based upon the current evidence.
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Affiliation(s)
- Haleigh M Scott
- Hayleigh M. Scott and Susan M. Havercamp, The Ohio State University, Columbus, Ohio
| | - Susan M Havercamp
- Hayleigh M. Scott and Susan M. Havercamp, The Ohio State University, Columbus, Ohio
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40
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Hsieh K, Heller T, Bershadsky J, Taub S. Impact of adulthood stage and social-environmental context on body mass index and physical activity of individuals with intellectual disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 53:100-113. [PMID: 25860448 DOI: 10.1352/1934-9556-53.2.100] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Individuals with intellectual disability (ID) are at risk for obesity and physical inactivity. We analyzed a subset of 2009-2010 National Core Indicators (NCI) database to examine (1) the impact of three adulthood stages- younger (20-39 years), middle (40-59 years), and older (60 years and older) on Body Mass Index (BMI) and physical activity (PA); and (2) the relationship between social-environmental context (i.e., residence type, everyday choices, and community participation) and BMI and PA, with adjustment for individual characteristics of the adults with ID. Findings highlight the need to pay more attention to obesity by providing health education and emphasizing healthy choices. Results also suggest the importance of community participation as a way of promoting more physical activity.
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Irish DE, Lyman DM, Squillace HA, Geyer EM, Cosgrove TD, Hagzan A, Leinung J, Tosh T. Educating K-12 Professionals and Parents: Finding Health Information for Special Needs Children .. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2015; 19:25-39. [PMID: 25983666 PMCID: PMC4430108 DOI: 10.1080/15398285.2014.982051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A successful partnership model between an academic health sciences library and a K-12 school district to provide librarians, nurses, and special education staff with access to health information to support special needs children and their parents is presented. Train-the-trainer staff sessions and a parent session were collaboratively developed. Funding support was used to purchase iPads for librarians and nurses to deliver mobile support. The results indicate the resources taught are being used to find health information and the school librarians and nurses are being sought after to assist in finding health information. Positive feedback from the school district indicates this model could be replicated in similar settings.
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Affiliation(s)
- D. Elizabeth Irish
- Schaffer Library of Health Sciences, Albany Medical College, MC 63, 47 New Scotland Ave., Albany, NY, 12208
| | - Deborah M. Lyman
- Columbia High School, 962 Luther Road, East Greenbush, NY, 12061
| | - Helen A. Squillace
- East Greenbush Central School District, 29 Englewood Avenue, East Greenbush, NY, 12061
| | - Enid M. Geyer
- Albany Medical College, MC 63, 47 New Scotland Ave., Albany, NY, 12208
| | | | - Amanda Hagzan
- Schaffer Library of Health Sciences, Albany Medical College, MC 63, 47 New Scotland Ave., Albany, NY, 12208
| | - Jill Leinung
- Green Meadow Elementary School, 234 Schuurman Road, Castleton, NY, 12033
| | - Traci Tosh
- Research, Schaffer Library of Health Sciences, Albany Medical College, MC 63, 47 New Scotland Ave., Albany, NY, 12208
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Havercamp SM, Scott HM. National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities. Disabil Health J 2014; 8:165-72. [PMID: 25595297 DOI: 10.1016/j.dhjo.2014.11.002] [Citation(s) in RCA: 147] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 09/29/2014] [Accepted: 11/04/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND People with disabilities experience worse health and poorer access to health care compared to people without disability. Large-scale health surveillance efforts have largely excluded adults with intellectual and developmental disability. This study expands knowledge of health status, health risks and preventative health care in a representative US sample comparing the health of adults with no disability to adults with intellectual and developmental disability and to adults with other types of disability. OBJECTIVES The purposes of this study were (1) to identify disparities between adults with intellectual and developmental disability and adults with no disability and (2) compare this pattern of disparities to the pattern between adults with other types of disability and adults without disability. METHODS This study compares health status, health risks and preventative health care in a national sample across three groups of adults: No Disability, Disability, and Intellectual and Developmental Disability. Data sources were the 2010 Behavior Risk Factor Surveillance Survey and the National Core Indicators Consumer Survey. RESULTS Adults with disability and with intellectual and developmental disability were more likely to report being in poor health compared to adults without disability. Disability and intellectual and developmental disability conferred unique health risks and health care utilization patterns. CONCLUSIONS Significant disparities in health and health care utilization were found for adults with disability and developmental disability relative to adults without disability. Disability training for health care providers and health promotion research that identifies disability as a demographic group is needed.
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Affiliation(s)
- Susan M Havercamp
- The Ohio State University Nisonger Center, 1581 Dodd Dr, Columbus, OH 43210, USA.
| | - Haleigh M Scott
- The Ohio State University Nisonger Center, 1581 Dodd Dr, Columbus, OH 43210, USA
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Hsieh K, Rimmer JH, Heller T. Obesity and associated factors in adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:851-63. [PMID: 24256455 DOI: 10.1111/jir.12100] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2013] [Indexed: 05/27/2023]
Abstract
BACKGROUND We examined the prevalence of obesity in adults with intellectual disabilities (ID) compared with the general population, and the factors associated with obesity and weight management status, comparing individuals with ID who were overweight or obese to those who were not. METHODS We analysed baseline data (n = 1450) from the ongoing 4-year Longitudinal Health and Intellectual Disabilities Study (LHIDS) using a multivariate approach. Measures included body mass index (BMI), demographics, level of ID, diagnoses related to ID, health behaviours (i.e. physical activity, dietary habits, smoking, and alcohol consumption), various health parameters (e.g. mobility limitation, medications), and residential type and location. RESULTS Compared with the general population, adults (≥ 18 years) with ID had a higher prevalence of obesity (38.3% vs. 28%) and morbid obesity (7.4% vs. 4.2%). Being female (AOR = 1.40, 95% CI = 1.09-1.81), having Down syndrome (AOR = 2.53, 95% CI = 1.86-3.45), taking medications that cause weight gain (AOR = 1.80, 95% CI = 1.38-2.37), engaging in less moderate physical activity (AOR = 0.89, 95% CI = 0.79-0.99), and drinking greater amounts of soda (AOR = 1.20, 95% CI = 1.02-1.42) were associated with higher rates of obesity. CONCLUSION Adults with ID, in general, have a high risk of developing obesity, and women with ID have a high risk of developing morbid obesity. Health promotion initiatives should target individuals with the greatest risk.
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Affiliation(s)
- K Hsieh
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, Illinois, USA
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Hubbard KL, Bandini LG, Folta SC, Wansink B, Must A. The Adaptation of a School-based Health Promotion Programme for Youth with Intellectual and Developmental Disabilities: A Community-Engaged Research Process. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2014; 27:576-90. [DOI: 10.1111/jar.12104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Kristie L. Hubbard
- Friedman School of Nutrition Science and Policy; Tufts University; Boston MA USA
| | - Linda G. Bandini
- Eunice Kennedy Shriver Center; University of Massachusetts Medical School; Waltham MA USA
- Department of Health Sciences; Boston University; Boston MA USA
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy; Tufts University; Boston MA USA
| | - Brian Wansink
- Dyson School of Applied Economics and Management; Cornell University; Ithaca NY USA
| | - Aviva Must
- Department of Public Health and Community Medicine; Tufts University School of Medicine; Boston MA USA
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Hahn JE. Using Nursing Intervention Classification in an Advance Practice Registered Nurse-Led Preventive Model for Adults Aging With Developmental Disabilities. J Nurs Scholarsh 2014; 46:304-13. [DOI: 10.1111/jnu.12085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Joan Earle Hahn
- Eta Iota; Associate Professor; Department of Nursing; College of Health and Human Services; University of New Hampshire; Durham NH USA
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Carmeli E, Imam B. Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities. Front Public Health 2014; 2:31. [PMID: 24783190 PMCID: PMC3995041 DOI: 10.3389/fpubh.2014.00031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 03/28/2014] [Indexed: 02/04/2023] Open
Abstract
The rapid growth in the number of individuals living with intellectual and developmental disabilities (IDD) along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD. This is considered to be challenging given the continued shrinkage in the overall health care and welfare system services due to the cut in the governmental budget in some of the western countries. The ideal health promotion and disease prevention strategies for older adults with IDD should be tailored to the individuals' health risks, address primary and secondary disease prevention, and prevent avoidable impairments that cause premature institutionalization. Domains of intervention should include cognitive, mental and physical health, accommodations, workplace considerations, assistive technology, recreational activities, and nutrition.
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Affiliation(s)
- Eli Carmeli
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa , Haifa , Israel
| | - Bita Imam
- Rehabilitation Research Lab, GF Strong Rehab Centre, University of British Columbia , Vancouver, BC , Canada
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Anderson LL, Humphries K, McDermott S, Marks B, Sisarak J, Larson S. The state of the science of health and wellness for adults with intellectual and developmental disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2013; 51:385-98. [PMID: 24303825 PMCID: PMC4677669 DOI: 10.1352/1934-9556-51.5.385] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater attention to the training of health care providers. Gaps in the literature include the lack of intervention trials, replications of successful approaches, and data that allow for better comparisons between people with IDD and without IDD living in the same communities. Implications for future research needed to reduce health disparities for people with IDD include: better monitoring and treatment for chronic conditions common in the general population that are also experienced by people with IDD, an enhanced understanding of how to promote health among those in the IDD population who are aging, addressing the health needs of people with IDD who are not part of the disability service system, developing a better understanding of how to include people with IDD in health and wellness programs, and improving methods for addressing the health care needs of members of this group in an efficient and cost-effective manner, either through better access to general medical care or specialized programs.
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Affiliation(s)
| | - Kathy Humphries
- Montana Disability and Health Program, University of Montana Rural Institute
| | - Suzanne McDermott
- Department of Family and Preventive Medicine, University of South Carolina
| | - Beth Marks
- Department of Disability and Human Development, University of Illinois at Chicago
| | - Jasmina Sisarak
- University of Illinois-Chicago Department of Disability and Human Development, University of Illinois at Chicago
| | - Sheryl Larson
- Research and Training Center on Community Living, University of Minnesota
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