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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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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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Overwijk A, Hilgenkamp TIM, van der Schans CP, Krijnen WP, Vlot-van Anrooij K, van der Putten AAJ, Waninge A. Implementation of a program to support direct support professionals to promote a healthy lifestyle for people with moderate to profound intellectual disabilities. BMC Health Serv Res 2022; 22:15. [PMID: 34974836 PMCID: PMC8722211 DOI: 10.1186/s12913-021-07389-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a lack of theory-based interventions for direct support professionals (DSPs) to support a healthy lifestyle for people with moderate to profound intellectual disabilities (ID) despite their major role in this. This study aims to evaluate the preparation, implementation, and preliminary outcomes of a theory-based training and education program for DSPs to learn how to support these individuals. METHODS The program consisting of e-learning, three in-person sessions, and three assignments was implemented. The implementation process was evaluated with a mixed method design with the following components: preparation phase, implementation phase, and the outcomes. These components were measured with project notes, questionnaires, interviews, reflections, assignments, food diaries, Actigraph/Actiwatch, and an inventory of daily activities. RESULTS Regarding the preparation phase, enough potential participants met the inclusion criteria and the time to recruit the participants was 9 months. The program was implemented in four (residential) facilities and involved individuals with moderate to profound ID (n = 24) and DSPs (n = 32). The e-learning was completed by 81% of the DSPs, 72-88% attended the in-person sessions, and 34-47% completed the assignments. Overall, the fidelity of the program was good. DSPs would recommend the program, although they were either negative or positive about the time investment. Mutual agreement on expectations were important for the acceptability and suitability of the program. For the outcomes, the goals of the program were achieved, and the attitudes of DSPs towards a healthy lifestyle were improved after 3 months of the program (nutrition: p = < 0.01; physical activity: p = 0.04). A statistically significant improvement was found for food intake of people with ID (p = 0.047); for physical activity, no statistically significant differences were determined. CONCLUSIONS The theory-based program consisting of a training and education section for DSPs to support a healthy lifestyle for people with moderate to profound ID was feasible to implement and, despite some barriers regarding time capacity and mutual expectations, it delivered positive changes in both persons with moderate to profound ID and DSPs. Thus, the program is a promising intervention to support DSPs.
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Affiliation(s)
- A Overwijk
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands.
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - T I M Hilgenkamp
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Physical Therapy, University of Nevada, Las Vegas, USA
| | - C P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - W P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | - K Vlot-van Anrooij
- Department of Primary and Community Care, Research group Intellectual Disabilities and Health, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A A J van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, the Netherlands
| | - A Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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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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Hanzen G, Waninge A, Nispen RMA, Vlaskamp C, Putten AAJ. Effects of the “Care for Participation+” Intervention on the Participation of Adults With Visual and Severe or Profound Intellectual Disabilities: A Nonrandomized Controlled Trial. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Gineke Hanzen
- Royal Dutch Visio—de Brink Vries The Netherlands
- Department of Pedagogy and Educational Sciences, Unit of Special Needs Education and Youth Care, Faculty of Behavioural and Social Sciences University of Groningen Groningen The Netherlands
| | - Aly Waninge
- Royal Dutch Visio—de Brink Vries The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing Hanzehogeschool Groningen Groningen The Netherlands
| | - Ruth M. A. Nispen
- Ophthalmology Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute Amsterdam The Netherlands
| | - Carla Vlaskamp
- Department of Pedagogy and Educational Sciences, Unit of Special Needs Education and Youth Care, Faculty of Behavioural and Social Sciences University of Groningen Groningen The Netherlands
| | - Annette A. J. Putten
- Department of Pedagogy and Educational Sciences, Unit of Special Needs Education and Youth Care, Faculty of Behavioural and Social Sciences University of Groningen Groningen The Netherlands
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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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Hanzen G, Waninge A, van Nispen RMA, Vlaskamp C, Post WJ, van der Putten AAJ. Intervention effects on professionals' attitudes towards the participation of adults with visual and severe or profound intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:129-139. [PMID: 32789929 PMCID: PMC7818188 DOI: 10.1111/jar.12792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/25/2020] [Accepted: 07/16/2020] [Indexed: 11/30/2022]
Abstract
Background We investigated the effects of the “Care for Participation+” (CFP+) intervention on direct support professionals’ (DSPs’) attitudes regarding the participation of adults with visual and severe or profound intellectual disabilities (VSPID). Methods We implemented a pilot non‐randomized controlled trial with two control groups to compare DSPs’ attitudes towards CFP+ using the Attitudes towards Participation Questionnaire (APQ) and DSPs’ written profiles of adults with VSPID. Results CPP+ and the Participation Mind Map control group showed a positive trend for the “leisure/recreation,” “social relations,” and “ability to act” APQ domains compared to the usual care control group. The CFP+ group described significantly fewer disabilities at 6 months, reflecting a more positive attitude than controls. Conclusion CFP+ had positive effects on DSPs’ attitudes towards the participation of adults with VSPID. The small sample size, ceiling effects, measurement instruments used, and implementation difficulties may have hampered understanding the full potential of CFP+.
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Affiliation(s)
- Gineke Hanzen
- Royal Dutch Visio - de Brink, Vries, The Netherlands.,Faculty of Behavioural and Social Sciences, Department of Pedagogy and Educational Sciences, unit of special needs education and youth care, University of Groningen, Grote Rozenstraat 38, Groningen, The Netherlands
| | - Aly Waninge
- Royal Dutch Visio - de Brink, Vries, The Netherlands.,Research group Healthy Ageing, Allied Health Care and Nursing, Hanzehogeschool Groningen, Petrus Driessenstraat 3, Groningen, The Netherlands
| | - Ruth M A van Nispen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Boelelaan 1117, Ophtalmology Amsterdam, The Netherlands
| | - Carla Vlaskamp
- Faculty of Behavioural and Social Sciences, Department of Pedagogy and Educational Sciences, unit of special needs education and youth care, University of Groningen, Grote Rozenstraat 38, Groningen, The Netherlands
| | - Wendy J Post
- Faculty of Behavioural and Social Sciences, Department of Pedagogy and Educational Sciences, unit of special needs education and youth care, University of Groningen, Grote Rozenstraat 38, Groningen, The Netherlands
| | - Annette A J van der Putten
- Faculty of Behavioural and Social Sciences, Department of Pedagogy and Educational Sciences, unit of special needs education and youth care, University of Groningen, Grote Rozenstraat 38, Groningen, The Netherlands
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10
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Hanzen G, van Nispen RMA, Vlaskamp C, Korevaar EL, Waninge A, van der Putten AAJ. Improving the participation of adults with visual and severe or profound intellectual disabilities: a process evaluation of a new intervention. BMC Health Serv Res 2020; 20:319. [PMID: 32299453 PMCID: PMC7164344 DOI: 10.1186/s12913-020-05161-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 03/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While the participation of adults with visual and severe or profound intellectual disabilities (VSPID) in society and community life is important, evidence-based interventions to improve their participation are lacking. We conducted a process evaluation of the implementation of 'Care for Participation+' (CFP+), a new intervention targeting the attitudes of direct support professionals (DSPs) toward the participation of adults with VSPID, within a residential facility in the Netherlands. METHODS CFP+ was inspired by the Boston Psychiatric Rehabilitation Approach and adapted by adopting a new definition and operationalization of the concept of participation for adults with VSPID. Following systematic training, 16 DSPs of adults with VSPID were able to apply key elements of CFP+ to explore diverse roles and activities for this population, facilitating their self-management, teaching them necessary skills for participation, and organizing support. Our process evaluation entailed an investigation of the delivered dose, reach, fidelity, and adaptation of CFP+ during and after the CFP+ intervention. We also evaluated the mechanisms of impact and context using questionnaires, assignments, documentation, interviews, and a logbook. RESULTS The intended dose, reach, and fidelity relating to the implementation of CFP+ were not achieved. Despite this fact, an assessment of the mechanisms of impact indicated that assignments of CFP+ were well (75%) or reasonably well (17%) understood by DSPs. CFP+ was applied by DSPs to stimulate self-management (83% of DSPs), new activities (100%), enhanced involvement in existing activities (67%) and to explore new roles (50%) for adults with VSPID. A negative contextual factor mentioned by the trainer and manager was the DSPs' lack of commitment to the training program. Another negative contextual factor mentioned by DSPs was the lack of time for implementing CFP+. CONCLUSIONS CFP+ provides new opportunities to improve the participation of adults with VSPID. Despite the non-optimal conditions for implementing CFP+ and the DSPs' general reluctance to apply the new intervention, some have actively used CFP+ within the residential facility. Future studies should focus on the outcomes of CFP+ regarding attitudinal changes among DSPs relating to the participation of adults with VSPID and their quality of life.
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Affiliation(s)
- Gineke Hanzen
- Royal Dutch Visio - de Brink, Groningerstraat 15, Vries, the Netherlands. .,Faculty of Behavioural and Social Sciences, department of Pedagogy and Educational Sciences, unit of special needs education and youth care, University of Groningen, Grote Rozenstraat 38, Groningen, the Netherlands.
| | - Ruth M A van Nispen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health research institute de Boelelaan 1117, Amsterdam, the Netherlands
| | - Carla Vlaskamp
- Faculty of Behavioural and Social Sciences, department of Pedagogy and Educational Sciences, unit of special needs education and youth care, University of Groningen, Grote Rozenstraat 38, Groningen, the Netherlands
| | - Eliza L Korevaar
- Hanze University of Applied Sciences Groningen, Zernikeplein 23, Groningen, the Netherlands
| | - Aly Waninge
- Royal Dutch Visio - de Brink, Groningerstraat 15, Vries, the Netherlands.,Research group Healthy Ageing, Allied Health Care and Nursing, Hanzehogeschool Groningen, Petrus Driessenstraat 3, Groningen, the Netherlands
| | - Annette A J van der Putten
- Faculty of Behavioural and Social Sciences, department of Pedagogy and Educational Sciences, unit of special needs education and youth care, University of Groningen, Grote Rozenstraat 38, Groningen, the Netherlands
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