A qualitative exploration of participants’ experiences of taking part in a walking programme: Perceived benefits, barriers, choices and use of intervention resources

Understanding capabilities, opportunities and motivations to engage in physical activity for adults with intellectual disabilities: A qualitative evidence synthesis

BACKGROUND

There is a paucity of theory-informed physical activity research with adults with intellectual disabilities. This study aimed to address this by synthesising existing literature and applying the COM-B model to understand capabilities, opportunities and motivations.

METHODS

A qualitative evidence synthesis was conducted and reported in accordance with PRISMA guidelines and the ENTREQ. Three databases were systematically searched up to and including February 2022. Qualitative research relating to the physical activity of adults with intellectual disabilities were included. Thematic synthesis was conducted with themes mapped onto the COM-B model.

RESULTS

Twenty-five studies were included. Influences of physical activity were identified and mapped onto the COM-B model, which also included COM-B influences of social support provided by caregivers.

CONCLUSIONS

There are many complex influences of physical activity for adults with intellectual disabilities. Researchers should consider the influences contributing to caregivers' capacity to support physical activity.

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

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.

Synergizing the Behavior Change Wheel and a Cocreative Approach to Design a Physical Activity Intervention for Adolescents and Young Adults With Intellectual Disabilities: Development Study

BACKGROUND

There is a need for physical activity promotion interventions in adolescents and young adults with intellectual disabilities. Current interventions have shown limited effectiveness, which may be attributed to the absence of theory and a population-specific development. Combining a planning model (including theory) and cocreation with the target audience during intervention development could potentially address this gap.

OBJECTIVE

This study aimed to report the systematic development of the Move it, Move ID! intervention by describing how the 8 different steps of the Behavior Change Wheel (BCW) were applied and present the results that emerged from those steps. In doing so, the (theoretical) content of the intervention is described in detail.

METHODS

A total of 23 adolescents and young adults (aged 14-22 years) with mild to moderate intellectual disabilities were designated as cocreators of the intervention. Across 2 groups, 6 similar cocreation sessions were organized in each. The content and sequence of the sessions were structured to align with the 8 steps of the BCW. All sessions were recorded and transcribed verbatim. Both a deductive (ie, steps of the BCW) and inductive (ie, resonating the voice of the participants) analysis approach were applied specifically focusing on identifying and describing the findings within each of the BCW steps.

RESULTS

After behavioral analysis (steps 1-4), 10 intervention goals were chosen and linked to Capability, Opportunity, and Motivation-Behavior components (theory within the BCW) that needed to be addressed. Psychological capability, social opportunity, and reflective motivation were emphasized as the first targets to focus on. A key finding was the urge for real-life social connectedness and social integration, which makes the social component as part of physical activity a central theme to focus on within intervention development. Judgments on the most suitable intervention functions (step 5) and behavior change techniques (step 7) were explained. When discussing the mode of delivery of the intervention (step 8), it was underscored that solely relying on a mobile health app would not fulfill participants' social needs. Hence, the chosen intervention adopts a dyadic approach in which young individuals with intellectual disabilities are matched with peers without intellectual disabilities to engage in physical activities together, with a mobile app playing a supportive role in this partnership.

CONCLUSIONS

The transparent description of the development process highlights why certain intervention components and behavior change techniques were chosen and how they are intertwined by means of the selected intervention design. This paper provides a detailed blueprint for practitioners wanting to integrate the BCW and its associated behavior change techniques, in combination with actively involving the target group, into their intervention development for people with intellectual disabilities.

A systematic review of physical activity: benefits and needs for maintenance of quality of life among adults with intellectual disability

The inactivity of people with intellectual disabilities (PwID) is a major contributor to ill health. Probably because people with intellectual disabilities are not adequately informed about physical activity and intervention programs required to enhance their fitness. This study critically reviewed physical activity: benefits and needs for maintenance of quality of life among adults with intellectual disability. An extensive search of bibliographic databases such as PubMed, PsycINFO, BioMed Central and Medline identified 735 academic papers. The research rigour was evaluated, and the validity of the findings was established. Based on the inclusion criteria, 15 studies were included in the review. Various forms of physical activity were studied as interventions. The results of a critical review indicate that physical activity has a moderate to strong positive impact on weight loss, sedentary behaviour, and disability-related quality of life. Adults with ID may benefit from physical activity as a non-pharmaceutical method of improving their health needs. However, this study's results may only apply to some adults with intellectual disabilities. The sample size needs to be increased in future studies in order to draw generalizable conclusions.

Co-creating an intervention to promote physical activity in adolescents with intellectual disabilities: lessons learned within the Move it, Move ID!-project

BACKGROUND

Co-creation is a method to develop acceptable, contextually appropriate and potentially more effective interventions. Adolescents with intellectual disabilities (ID) seldomly participate in research and program development due to the assumption that they lack the capacity to understand and discuss the related topics.

OBJECTIVE

This study describes reflections on a co-creation process with adolescents with ID from the point of view of the researchers in developing an intervention to increase physical activity. It was the aim to highlight elements that must be considered when implementing co-creation and consequently formulate important lessons learned.

METHODS

Twenty-three adolescents (14-22 y) with mild to moderate ID participated in six co-creation sessions at their school. The objectives and working methods in each session are described. Inductive thematic analysis was conducted on the researchers' reflection forms, which were completed after each session.

RESULTS

Seven main themes could be distinguished from the data: experiences related to assistance (i.e., teacher presence) during sessions, the importance of building rapport, co-decision making power, the impact of different group dynamics, the relevance of adapted questioning, the influence of co-creative working methods and required characteristics of a co-creation researcher.

CONCLUSION

Seven lessons learned were formulated when preparing and conducting co-creation with adolescents with ID. Innovative, concrete (non-abstract) and creative working methods are highly needed. Describing the entire process transparently could be a first step to turn co-creative research into an evidence-based methodology.

[Theory of change implemented in the program to promote physical activity "La Ribera Camina"]

OBJECTIVE

To develop a theory of change of a program to promote physical activity in eleven health districts, in order to improve its design and plan its evaluation.

METHOD

Four focus groups were carried out, to develop a participatory theory of change, to identify the expected changes (long, medium and short term) of "La Ribera Camina" program, according to the following stakeholders: primary healthcare professionals, local government representatives and community members. A thematic analysis was used to identify the actions to be taken to achieve these changes, as well as the difficulties and facilitators to enhance the sustainability of the program.

RESULTS

The identified changes were classified into four themes: 1) changes in physical and social health (improved physical condition, healthy habits, self-esteem and perceived well-being); 2) organizational and relational changes (better coordination between institutions); 3) specific changes to the program (incorporation of more "assets" and local associations, especially male participants, more trails and schedules); and 4) changes in the environment (improved trails' infrastructures and safety).

CONCLUSIONS

The theory of change allows to identify and classify the changes that are expected, the actions to be carried out and the links between elements of the program. This will serve as the basis for its evaluation. This methodology could be applied to other programs interested in incorporating intersectorality and community engagement in their design and evaluation.

Evaluating a multi-component intervention to reduce and break up office workers' sitting with sit-stand desks using the APEASE criteria

Objective

Sedentary workplace interventions have had success in reducing excessive sitting time in office workers, but barriers to implementation and uptake remain. This study formally assessed a theory-derived, sit-stand desk intervention using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side-effects, Equity) criteria.

Methods

Thirteen adults (eight female, mean age 38 ± 10 years) from the treatment arm of a sedentary behaviour intervention participated in semi-structured interviews. Thematic codes were inductively assigned to data items followed by deductive charting using the APEASE criteria.

Results

The intervention was highly acceptable, practicable, safe to deploy, and helped workers reduce workplace sitting time, though individual preferences and workload mediated engagement. Affordability of sit-stand desks and Equity of access were potential barriers to uptake.

Conclusions

Through the lens of the APEASE criteria, this theory-derived, multi-component sit-stand desk intervention showed acceptability, practicability and effectiveness in reducing and breaking up sedentary time at work with minimal side effects. Using this approach with further tailoring and personalisation may help workers achieve greater reductions in workplace sitting, though affordability and equity should be considered further.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12794-w.

Participants' experiences and impressions of a group-based positive psychology intervention programme for rural adults in Ghana

Introduction: There is growing evidence that group-based mental health intervention programmes can encourage the development of peer support, psychosocial skills, and collaborative therapeutic relationships with longer lasting effects. This study explored participants' experiences of, perceived benefits of, and recommendations to improve a 10-session group-based multicomponent positive psychology intervention (mPPI)-the Inspired Life Programme (ILP)-designed to promote positive mental health and reduce symptoms of depression and negative affect in a sample of rural Ghanaian adults.Method: Face-to-face semi-structured individual interviews were conducted with 18 randomly selected programme participants three months after their participation in the ILP. Data were analysed thematically with an inductive approach.Results: Participants described their experience of the ILP as a forum for growth that granted them the opportunity to introspect, practicalise and situate everyday life challenges, connect with others, and to develop a sense of mutual accountability. Results indicate that the ILP  led participants to develop a stronger sense of positivity and well-being, fructify their ideas, and to cultivate stronger social networks and relationships that led to increased vocational productiveness. Participants recommended that researchers include facets of physical health promotion in the programme and invite close relations of participants to participate in the programme.Conclusion: This study provides the first insight into participants' experiences of a group-based mPPI in Ghana. These findings may provide useful information to inform the design of context-appropriate community-based mental health interventions to fit participants' specific needs, capacities, and circumstances.

Planning for active office intervention in Thailand: survey and in-depth interview of university employees

Purpose

This study aimed to explore knowledge, attitude, behavior and causes of sedentary behavior (SB) among office workers and guidelines for active office intervention.

Design/methodology/approach

The study was comprised of a survey and an interview. In total, 39 nonacademic office workers responded to the Past-day Adults Sedentary Time-University (PAST-U) and workplace sitting break (SITBRQ) questionnaire to measure SB level, sitting bout, frequency and duration of sitting interrupted in 1 h and in whole working hours. Eleven executives and staffs participated in in-depth interviews to understand knowledge, attitude, behavior and cause of SB and guidelines for active office intervention.

Findings

Participants commonly spend most of their working time in SB (383.85 ± 93.03 min or 6 h 23 min). The interview indicated that at an individual level, participants lack knowledge and understanding of SB. The most common causes of SB are huge workload, personal characteristics and the weather. At the organizational level, there is no policy, no support from colleagues or organizations, while the physical environment is not conducive to reducing SB.

Originality/value

The outcomes of the study are used as basic information and guidelines for establishing an active office intervention in accordance with the culture and context of Thai society. There have been studies in Thailand that examine SB but no studies that have been conducted to study basic information on knowledge, attitudes, behaviors and causes of SB to be used in planning active office intervention to reduce SB.

Pedometers, the frustrating motivators: a qualitative investigation of users' experiences of the Yamax SW-200 among people with multiple sclerosis

Purpose: Self-monitoring may represent a mechanism to enhance physical activity among people with multiple sclerosis. To optimise activity monitoring as a behavioural tool to increase physical activity, user experience must be understood. This study evaluated user experience of the Yamax SW-200 Digi-walker pedometer in a group of people with MS.Methods: Semi-structured interviews were conducted with 15 adults who participated in a 12-week pedometer-supported behavioural change intervention, the iStep-MS trial. Interviews were audio-recorded and transcribed verbatim. Data were analysed using the Framework Method.Results: An overarching theme Pedometers, the frustrating motivators captures the complex and often contradictory experience of the pedometer. Sub-themes include: Increasing activity awareness, which describes the pedometer's utility in raising activity consciousness; Numeric motivation provides insight into dual motivating and demotivating experiences of using an objective feedback device; (Un) usability focuses on practical concerns encountered in the day-to-day use of the monitor.Conclusion: The Yamax SW-200 Digi-walker raised awareness and enhanced participant motivation to engage in physical activity. Accuracy and usability concerns highlighted warrant consideration in the selection of this pedometer within a population with multiple sclerosis. Trial registration: Changing physical activity behaviour in people with MS: the iStep-MS trial; ISRCTN15343862; https://doi.org/10.1186/ISRCTN15343862Implications for rehabilitationUse of self-monitoring tools such as pedometers can enhance physical activity awareness.Objective, numeric step count feedback is an effective motivational tool for physical activity.Accuracy and usability concerns may limit the value of the Yamax SW-200 Digiwalker for people with MS.Identification of individualised, reliable, usable and acceptable tools is important to ensure engagement with self-monitoring.