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Nicholson E, Mimmo L, Christophers L, Costa Sa ME, MacKeogh T. Facilitating choice when engaging young people with disabilities: reflections from co-researcher training. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:90. [PMID: 39187898 PMCID: PMC11348645 DOI: 10.1186/s40900-024-00626-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/13/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND A collaborative approach is critical in inclusive research and should incorporate taking time to build relationships with co-researchers based on trust and shared understanding. Involvement can often be seen as tokenistic and in order to avoid this, it is important to provide opportunities for people to exercise choice throughout the research process. MAIN BODY The current paper outlines learnings from a co-researcher training process for young people with disabilities to identify the ways in which meaningful choice can be facilitated with this group. While conducting training of co-researchers in topics such as research methods, we were continuously led by the group with regards to the directions that the sessions took and promoted problem solving with the group to accommodate the unique needs of all members. The overall aim of a wider project was to develop research capacity in a group of young people with disabilities through co-researcher training and this paper will report on learnings from this work with regards to how we sought to provide opportunities for the co-researchers to exercise choice within research projects. Feedback from the group of young people highlighted the variety of needs and expectations that must be accommodated in such a process and therefore, allowing them to dictate the extent and manner of their engagement is key. Young people with disabilities are a heterogeneous group and therefore, some methodologies and ways of working required adaptation in order to facilitate meaningful choice and engagement for all. CONCLUSION Providing meaningful opportunities for demonstrating their choices, in relation to elements of research projects, is a critical component of facilitating a rights-based approach when conducting co-research and requires researchers to cede some level of control over the research process to co-researchers. This can be difficult to achieve in practice and researchers must continuously reflect on their own practice and be willing to change and adapt throughout the process.
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Affiliation(s)
- Emma Nicholson
- School of Psychology, Faculty of Health and Science, Dublin City University, Glasnevin Campus, Dublin 9, Ireland.
| | - Laurel Mimmo
- Sydney Children's Hospital Network, High St, Randwick, NSW, 2031, Australia
| | - Lauren Christophers
- UCD School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | | | - Trish MacKeogh
- Central Remedial Clinic, Vernon Ave, Clontarf East, Dublin, D03 R973, Ireland
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Hatzikiriakidis K, Ayton D, O'Connor A, Cox R, MacRae A, Gulline H, Callaway L. Biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation: A systematic review of qualitative research. Disabil Health J 2024; 17:101618. [PMID: 38548523 DOI: 10.1016/j.dhjo.2024.101618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND People with disability living in supported accommodation experience ongoing health disparities. Physical activity and dietary quality are factors that may minimise the risk of chronic disease, however this population may experience a range of biopsychosocial barriers to physical activity and healthy eating. OBJECTIVE The aim of this review was to synthesise the biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation, as reported by existing qualitative research. METHODS A systematic review of qualitative evidence was conducted according to the JBI's methodological guidance. In September 2023, five academic databases were searched for relevant literature published since database inception. A secondary analysis of the results of included studies was guided by the International Framework for Functioning, Disability, and Health (ICF), using the ICF Linking Rules. RESULTS A total of 31 articles were included. The analysis identified 154 determinants of physical activity and 112 determinants of healthy eating. Determinants were most prominently representative of environmental factors that captured the health promoting role and attitudes of staff, alongside the influence of the organisational context. CONCLUSION This review provided evidence for the complex interactions between body functions and structures, activities and participation, personal factors, and the environment that influence physical activity and healthy eating within supported accommodation. Although there is a limited body of evidence to guide practice, the findings highlight the multifactorial nature of interventions that can be utilised by direct care professionals and adapted to the individual needs and interests of people with disability.
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Affiliation(s)
- Kostas Hatzikiriakidis
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Darshini Ayton
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Amanda O'Connor
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Rachael Cox
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Ann MacRae
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Hannah Gulline
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Libby Callaway
- Rehabilitation, Ageing, and Independent Living (RAIL) Research Centre, School of Allied Health and Primary Care, Monash University, Australia; Occupational Therapy Department, School of Primary and Allied Health Care, Monash University, Australia.
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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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McDermott S, McCarron M, Burke E, McCallion P, O'Donovan MA. Enabling older adults with intellectual disability to become physical activity leaders in their community: Pilot study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231177190. [PMID: 37406191 DOI: 10.1177/17446295231177190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
People with intellectual disabilities (ID) have high levels of sedentary behaviour and co-morbid health conditions. There is also increased longevity for this group which is an incredible success story but one which also poses challenges to the health system. For the first time, the mainstream health system needs to plan for and address age related health needs of people with ID. It also demands consideration of age-appropriate health-promotion efforts to support this ageing population with life-long disability. A physical activity programme, People with Intellectual Disability as Physical Activity Leaders (PPALs), was co-designed and co-developed with older adults (40+ years) with intellectual disability (ID). The process, content and outcomes of the pilot are presented in this paper. Expertise from three sectors: non-statutory academic and people with intellectual disabilities and their supporters worked collaboratively for successful completion of the project.
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Affiliation(s)
- Sonia McDermott
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin, Ireland
| | - Mary McCarron
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin, Ireland
| | - Eilish Burke
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin, Ireland
| | - Philip McCallion
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Mary-Ann O'Donovan
- Centre for Disability Studies, Affiliate of the University of Sydney, Sydney, NSW, Australia
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Houck EJ, Dracobly JD. Trauma-Informed Care for Individuals with Intellectual and Developmental Disabilities: From Disparity to Policies for Effective Action. Perspect Behav Sci 2023; 46:67-87. [PMID: 37006597 PMCID: PMC10050265 DOI: 10.1007/s40614-022-00359-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 11/25/2022] Open
Abstract
People with intellectual disabilities (ID) are an often overlooked minority population. They experience significant health disparities and a high risk of exposure to traumatic events that can lead to stress-related disorders. Access to effective treatments for stress-related disorders is limited for people with ID due to a lack of appropriate assessments and common communication deficits. We discuss and analyze four factors that have led to these disparities: (1) historical segregation; (2) society's response to identification of trauma in vulnerable populations; (3) lack of accessible assessments and treatments for stress disorders in people with ID; and (4) communication deficits common in people with ID. Based on this analysis, we suggest behavior analysts advocate for policy development that would (1) increase acknowledgement of trauma in people with ID and mandate sharing of information about trauma across providers; (2) require observable and measurable goals be included in the assessment and treatment of trauma-related behavior change; and (3) increase funding for services and research in this area.
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Affiliation(s)
- Elizabeth J. Houck
- University of North Texas, 1155 Union Circle, Box 310919, Denton, TX 76201 USA
| | - Joseph D. Dracobly
- University of North Texas, 1155 Union Circle, Box 310919, Denton, TX 76201 USA
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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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Flynn R, Stevens B, Bains A, Kennedy M, Scott SD. Identifying existing approaches used to evaluate the sustainability of evidence-based interventions in healthcare: an integrative review. Syst Rev 2022; 11:221. [PMID: 36243760 PMCID: PMC9569065 DOI: 10.1186/s13643-022-02093-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is limited evidence to evaluate the sustainability of evidence-based interventions (EBIs) for healthcare improvement. Through an integrative review, we aimed to identify approaches to evaluate the sustainability of evidence-based interventions (EBIs) and sustainability outcomes. METHODS Following Whittemore and Knafl's methodological process: (1) problem identification; (2) literature search; (3) data evaluation; (4) data analysis; and (5) presentation, a comprehensive search strategy was applied across five databases. Included studies were not restricted by research design; and had to evaluate the sustainability of an EBI in a healthcare context. We assessed the methodological quality of studies using the Mixed Methods Appraisal Tool. RESULTS Of 18,783 articles retrieved, 64 fit the inclusion criteria. Qualitative designs were most commonly used for evaluation (48%), with individual interviews as the predominant data collection method. Timing of data collection varied widely with post-intervention data collection most frequent (89%). Of the 64 studies, 44% used a framework, 26% used a model, 11% used a tool, 5% used an instrument, and 14% used theory as their primary approach to evaluate sustainability. Most studies (77%) did not measure sustainability outcomes, rather these studies focused on sustainability determinants. DISCUSSION It is unclear which approach/approaches are most effective for evaluating sustainability and what measures and outcomes are most commonly used. There is a disconnect between evaluating the factors that may shape sustainability and the outcomes approaches employed to measure sustainability. Our review offers methodological recommendations for sustainability evaluation research and highlights the importance in understanding mechanisms of sustainability to advance the field.
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Affiliation(s)
- Rachel Flynn
- Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.
| | - Bonnie Stevens
- Lawrence S Bloomberg Faculty of Nursing and Faculties of Medicine and Dentistry, University of Toronto, Toronto, Canada.,Associate Chief Nursing Research & Senior Scientist, Research Institute, The Hospital for Sick Children, 686 Bay St., Toronto, ON, M5G 0A4, Canada
| | - Arjun Bains
- Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada
| | - Megan Kennedy
- John W. Scott Health Sciences Library, 2K312 WMC University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Shannon D Scott
- Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada
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Spassiani NA, Becaj M, Miller C, Hiddleston A, Hume A, Tait S. 'Now that I am connected this isn't social isolation, this is engaging with people': Staying connected during the COVID-19 pandemic. BRITISH JOURNAL OF LEARNING DISABILITIES 2022; 51:BLD12478. [PMID: 35602322 PMCID: PMC9111751 DOI: 10.1111/bld.12478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/27/2022] [Accepted: 04/02/2022] [Indexed: 06/15/2023]
Abstract
Background The COVID-19 global pandemic has put adults with intellectual/developmental disabilities at greater risk of being socially excluded due to physical distancing. Technology has been looked at as a tool for adults with intellectual/developmental disabilities to stay connected, however, little is known about this topic. The purpose of this study was to explore how a grassroots disability organisation used technology to help adults with intellectual/developmental disabilities feel socially connected during the pandemic. Methods Data were collected through questionnaires, attendance records, and field notes; and analysed through trend and thematic analysis. Findings Four main themes emerged from the data: active leadership, mental wellbeing, technology/digital inclusion, and safety. Conclusion These findings suggest that when participants overcome technological barriers they found it easy to socially connect online during lockdown.
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Affiliation(s)
| | - Mojca Becaj
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
| | - Clare Miller
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
| | - Andrew Hiddleston
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
| | - Aaron Hume
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
| | - Stephan Tait
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
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Vlot-van Anrooij K, Naaldenberg J, Hilgenkamp TIM, Overwijk A, van der Velden K, Leusink GL. Gaining actionable knowledge to improve local health-promoting capacities in long-term care support settings for people with intellectual disabilities. PATIENT EDUCATION AND COUNSELING 2022; 105:407-415. [PMID: 34045091 DOI: 10.1016/j.pec.2021.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/29/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE People with intellectual disabilities (ID) are largely dependent on their environment to live healthily and, in this, ID-support organizations play a vital role. An environmental asset mapping tool for ID-support settings has been developed. This study aims to provide insight into whether or not the tool can provide a comprehensive view on assets in the system and actionable knowledge to improve health-promoting capacities in ID-support settings. METHODS Fifty-seven users from four setting completed the tool on availability, user satisfaction, and dreams regarding social, physical, organizational, and financial assets. RESULTS The findings provide a comprehensive view of available assets. Together with user satisfaction and dreams for improvements, they provide actionable knowledge for improving the health-promoting capacities of the settings, including: (1) how use of available assets can be improved, (2) the type of assets that should be enriched, and (3) the assets that can be added to the system. CONCLUSION The asset mapping tool provides a comprehensive view on assets in the system and actionable knowledge to improve health-promoting capacities in ID-support settings. PRACTICE IMPLICATIONS ID-support organizations can use the tool to generate actionable bottom-up knowledge for priority setting and implementing interventions to improve their health-promoting capacities.
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Affiliation(s)
- Kristel Vlot-van Anrooij
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Thessa I M Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas, USA; Department of General Practice, Intellectual Disability Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Annelies Overwijk
- Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, The Netherlands; Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Geraline L Leusink
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
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Washington SE, Johnson KR, Hollenbeck JM. Environmental Modifications and Supports for Participation Among Adults Aging With Intellectual and Developmental Disabilities: A Scoping Review. Am J Occup Ther 2021; 75:12531. [PMID: 34780618 DOI: 10.5014/ajot.2021.045336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Adults aging with intellectual and developmental disabilities (IDD) continue to face barriers to participation in meaningful occupation; moreover, the increased life expectancy of adults with IDD intensifies the need for age- and environment-specific support. OBJECTIVE To map and categorize transdisciplinary literature on environmental modifications and supports for adults aging with IDD. DATA SOURCES Studies published between January 1, 2000, and January 1, 2019, identified through PubMed and Scopus. Study Selection and Data Collection: Eleven articles met the inclusion criteria and contained information specific to occupational participation based on environmental modification (e.g., physical space, technology, universal design, type of living setting), social supports (e.g., family members, caretakers, peer groups, health care professionals, policies, organizational infrastructure), or both and adults age ≥35 yr with IDD. FINDINGS Eleven studies met the criteria for this scoping review. Thematic coding was used to examine the articles within one or more themes: definition of need, environmental risk and assessment, environmental setting, intervention and program planning, use of technology, and bureaucracy. CONCLUSIONS AND RELEVANCE This review highlights collective and individual outcomes in the areas of assessment, intervention, and advocacy. Further research is needed within the scope of occupational therapy and disability studies that examines environmental factors and participation outcomes in this population. What This Article Adds: The authors define the interconnectedness of adults aging with IDD and environmental factors, identify barriers to participation, and guide occupational therapy practitioners' logic on how to positively affect environmental change and supports through intervention.
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Affiliation(s)
- Selena E Washington
- Selena E. Washington, PhD, OTR/L, is Assistant Professor, Department of Occupational Science and Occupational Therapy, Saint Louis University, St. Louis, MO;
| | - Khalilah R Johnson
- Khalilah R. Johnson, PhD, OTR/L, is Assistant Professor, Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel Hill
| | - Jesse M Hollenbeck
- Jesse M. Hollenbeck, MPH, is Graduate Assistant, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO
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St John B, Gray M, Malzacher A, Hladik L, Lurie S, Ausderau K. Using photovoice with people with intellectual disability to illuminate definitions of health and factors influencing participation in health promotion. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:866-876. [PMID: 33660422 DOI: 10.1111/jar.12868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding the daily health experiences of people with intellectual disability is necessary to illuminate factors that may be influencing health and health disparities. The objective of this study is to understand how people with intellectual disability participate in and access health promotion. METHODS Ten adults with intellectual disability engaged in an adapted photovoice study. RESULTS Four themes emerged: Health Is Who We Are; Health is What We Do; Health Is Our Body, Mind, and Place; and Barriers and Facilitators. Participants communicated an understanding of health, a strong identity of themselves as being healthy, and diverse participation in health promotion. Additionally, participants identified specific resources and support necessary to pursue health. Participants' broad description of health aligns with understandings of the social determinants of health. CONCLUSION Participant's holistic view of health and experienced factors of health promotion should inform the development and implementation of inclusive health programming for people with intellectual disability.
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Affiliation(s)
| | - Megan Gray
- University of Wisconsin-Madison, Madison, WI, USA
| | | | - Libby Hladik
- University of Wisconsin-Madison, Madison, WI, USA
| | - Savanna Lurie
- University of Southern California, Los Angeles, CA, USA
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Nielsen MBD, Mølbak ML, Hvass LR, Folker AP. Healthy settings: supported housing for people with mental and intellectual disabilities in Denmark. Health Promot Int 2021; 36:1413-1424. [PMID: 33576398 DOI: 10.1093/heapro/daab002] [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: 11/14/2022] Open
Abstract
Supported housing for people with mental and intellectual disabilities (IDs) is an important setting for health and may contribute positively and negatively to residents' health. The aim of this study was to explore health promotion practices and services in supported housing in Denmark using a mixed-methods design comprising qualitative group interviews with managers and employees (n = 12) and a nationwide survey among managers (n = 276) and employees from supported housing facilities (n = 315). This study showed that employees tried to integrate health promotion in the daily work with residents, but efforts primarily focused on individual behavior and motivation. Findings points to several challenges and barriers, including ambivalent attitudes towards smoking and beliefs that health promotion undermines self-determination and empowerment. To build supportive environments for people with mental and IDs, we need to focus on the attitudes, values and competences of managers and employees to tackle misconceptions about smoking, raise awareness about the wider determinants and promote structural changes.
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Affiliation(s)
- Maj Britt Dahl Nielsen
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
| | | | - Line Raahauge Hvass
- Preparedness and Infectious Diseases, The Danish Health Authority, Islands Brygge 67, 2300 Copenhagen, Denmark
| | - Anna Paldam Folker
- The National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark
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13
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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: 5] [Impact Index Per Article: 1.3] [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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Vlot‐van Anrooij K, Koks‐Leensen MCJ, van der Cruijsen A, Jansen H, van der Velden K, Leusink G, Hilgenkamp TIM, Naaldenberg J. How can care settings for people with intellectual disabilities embed health promotion? JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1489-1499. [PMID: 32627935 PMCID: PMC7689850 DOI: 10.1111/jar.12776] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/07/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with intellectual disabilities (ID) depend on their environment to live healthily. Asset-based health promotion enhances a settings' health-promoting capacity starting with identifying protective or promotive factors that sustain health. METHOD This inclusive mixed-methods study used group sessions to generate and rank ideas on assets supporting healthy nutrition and physical activity in Dutch intellectual disability care settings. Participants included people with moderate intellectual disabilities and family and care professionals of people with severe/profound intellectual disabilities. RESULTS Fifty-one participants identified 185 assets in group sessions. They include the following: (i) the social network and ways "people" can support, (ii) assets in/around "places," and person-environment fit, and (iii) "preconditions": health care, prevention, budget, and policy. CONCLUSION This inclusive research provides a user perspective on assets in the living environment supporting healthy living. This gives insight in contextual factors needed for development and sustainable embedment of health promotion in the systems of intellectual disability support settings.
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Affiliation(s)
- Kristel Vlot‐van Anrooij
- Department of Primary and Community Care, Intellectual Disabilities and HealthRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Monique C. J. Koks‐Leensen
- Department of Primary and Community Care, Intellectual Disabilities and HealthRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Anneke van der Cruijsen
- Department of Primary and Community Care, Intellectual Disabilities and HealthRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Henk Jansen
- Department of Primary and Community Care, Intellectual Disabilities and HealthRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Koos van der Velden
- Department of Primary and Community CareRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Geraline Leusink
- Department of Primary and Community Care, Intellectual Disabilities and HealthRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Thessa I. M. Hilgenkamp
- Department of General Practice, Intellectual Disability MedicineErasmus MC, University Medical CenterRotterdamThe Netherlands
- Department of Physical TherapyUniversity of NevadaLas VegasNVUSA
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Intellectual Disabilities and HealthRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
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