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Salomon C, Bellamy J, Evans E, Reid R, Hsu M, Teasdale S, Trollor J. 'Get Healthy!' physical activity and healthy eating intervention for adults with intellectual disability: results from the feasibility pilot. Pilot Feasibility Stud 2023; 9:48. [PMID: 36949532 PMCID: PMC10032022 DOI: 10.1186/s40814-023-01267-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/27/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND People with intellectual disabilities (ID) experience high rates of lifestyle related morbidities, in part due to lack of access to tailored health promotion programmes. This study aimed to assess the feasibility and preliminary efficacy of a tailored healthy lifestyle intervention, Get Healthy! METHODS Get Healthy! is a 12-week physical activity and healthy eating programme designed to address lifestyle-related risks for adults with mild-moderate ID. The feasibility pilot was designed to assess subjective participant experience and programme feasibility across: recruitment and screening, retention, session attendance and engagement, adverse events, and practicality and reliability of outcome procedures. Exploratory programme efficacy was assessed across the following measures: anthropometry (body mass index, weight, waist circumference), cardiovascular fitness, physical strength, dietary intake, healthy literacy, and quality of life. RESULTS Six participants with moderate ID and two carer participants completed the feasibility trial, representing a 100% retention rate. Qualitative data indicated the programme was well received. Participants with ID attended 75% of sessions offered and displayed a high level of engagement in sessions attended (91% mean engagement score). While most data collection procedures were feasible to implement, several measures were either not feasible for our participants, or required a higher level of support to implement than was provided in the existing trial protocol. Participants with ID displayed decreases in mean waist circumference between baseline and endpoint (95% CI: - 3.20, - 0.17 cm) and some improvements in measures of cardiovascular fitness and physical strength. No changes in weight, body mass index, or objectively measured knowledge of nutrition and exercise or quality of life were detected from baseline to programme endpoint. Dietary intake results were mixed. DISCUSSION The Get Healthy! programme was feasible to implement and well received by participants with moderate ID and their carers. Exploratory efficacy data indicates the programme has potential to positively impact important cardiometabolic risk factors such as waist circumference, cardiovascular fitness, and physical strength. Several of the proposed data collection instruments will require modification or replacement prior to use in a sufficiently powered efficacy trial. TRIAL REGISTRATION ACTRN: ACTRN12618000349246. Registered March 8th 2018-retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374497 UTN: U1111-1209-3132.
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Affiliation(s)
- Carmela Salomon
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia
| | - Jessica Bellamy
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia
- School of Medical, Indigenous & Health Sciences, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, 2522, Australia
| | - Elizabeth Evans
- Council for Intellectual Disability, 418A Elizabeth St, Surry Hills, NSW, 2010, Australia
| | - Renae Reid
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia
| | - Michelle Hsu
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 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, Sydney, 2022, Australia
- Discipline of Psychiatry and Mental Health, UNSW Sydney, Kensington, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia.
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2
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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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3
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Fjellstrom S, Hansen E, Hölttä J, Zingmark M, Nordström A, Lund Ohlsson M. Web-based training intervention to increase physical activity level and improve health for adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:967-977. [PMID: 36217301 PMCID: PMC9828805 DOI: 10.1111/jir.12984] [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: 10/28/2021] [Revised: 09/22/2022] [Accepted: 09/27/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND Individuals with intellectual disability (ID) are less physically active, have a higher body mass index (BMI) and are at greater risk for cardiovascular diseases (CVDs) than people without ID. The purpose of the study was to explore the effectiveness of a web-based training programme, consisting of 150 min of activity per week, on the health of people with ID. METHOD Participants with ID living in supported accommodation (n = 28, 48% female, age = 36.4 ± 9.56 years) participated in a web-based training programme, consisting of a combination of exercises (endurance, strength balance and flexibility) of moderate intensity, 50 min, three times per week for 12 weeks. The body composition and waist circumference (WC) were measured, and questionnaires were used to assess enjoyment, quality of life (QoL) and physical activity (PA) level. Descriptive statistics and pairwise comparison pre and post intervention were carried out. RESULTS A total of 22 out of 28 participants completed the 12-week training intervention with 83% mean attendance of training sessions. The intensity of the PA level increased and a decrease in fat mass of 1.9 ± 2.4 kg, P < 0.001 and WC of 3 ± 5 cm, P = 0.009 were observed. Enjoyment of training sessions was 3.9 out of 5, and no differences in QoL were found. CONCLUSION A web-based training programme is an effective tool for improving health parameters of people with ID and offers a new way for caregivers to enhance the PA for the target group.
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Affiliation(s)
- S. Fjellstrom
- Department of Health Sciences, The Swedish Winter Sport Research CentreMid Sweden UniversityÖstersundSweden
| | - E. Hansen
- Department of Health Sciences, The Swedish Winter Sport Research CentreMid Sweden UniversityÖstersundSweden
- The Faculty of Education and ArtsNord UniversityBodøNorway
| | - J. Hölttä
- Department of Health Sciences, The Swedish Winter Sport Research CentreMid Sweden UniversityÖstersundSweden
| | - M. Zingmark
- Health and Social Care Administration, Municipality of ÖstersundÖstersundSweden
- Department of Epidemiology and Global Health, Faculty of MedicineUmeå UniversityUmeåSweden
- Department of Health Sciences, Faculty of MedicineLund UniversityLundSweden
| | - A. Nordström
- Department of Health Sciences, The Swedish Winter Sport Research CentreMid Sweden UniversityÖstersundSweden
- Department of Public Health and Clinical Medicine, Section for Sustainable HealthUmeå UniversityUmeåSweden
- School of Sports ScienceUiT The Arctic University of NorwayTromsøNorway
| | - M. Lund Ohlsson
- Department of Health Sciences, The Swedish Winter Sport Research CentreMid Sweden UniversityÖstersundSweden
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Burns J, Carter A, Draper S, Foad A. Engaging and sustaining people with intellectual disabilities in physical activity: a narrative review of existing evidence. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:803-813. [PMID: 39131751 PMCID: PMC11308968 DOI: 10.1080/20473869.2022.2149096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 08/13/2024]
Abstract
Background: People with intellectual disabilities (ID) experience many health and social inequalities. Increasing physical activity is a proven intervention to address such inequalities, yet the physical activity rates of this population are substantially lower than the general population. Aim: Research has been growing to understand why this is and how to intervene to increase the physical activity levels of people with ID. Method: Using a behavioural epidemiological framework, the research in this area from barriers and facilitators of physical activity to translational research testing interventions within natural settings is reviewed. Findings from a total of 14 reviews and eight empirical studies and protocols were included. Results: Whilst there are multiple investigations into what promotes or enhances physical activity for people with ID, findings from intervention studies show few successful outcomes. Gaps within the existing research are identified and recommendations about how intervention efficacy might be improved are provided to inform future research and practice. Conclusion: Findings from previous research on barriers and facilitators can be further capitalised on and intervention studies should be underpinned by better links to theory and more systemic approaches.
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Affiliation(s)
- Jan Burns
- Centre for Sport, Physical Education and Activity Research (Spear), Canterbury Christ Church University, Canterbury, Kent, UK
| | - Annabel Carter
- Centre for Sport, Physical Education and Activity Research (Spear), Canterbury Christ Church University, Canterbury, Kent, UK
| | - Stacey Draper
- Centre for Sport, Physical Education and Activity Research (Spear), Canterbury Christ Church University, Canterbury, Kent, UK
| | - Abby Foad
- Centre for Sport, Physical Education and Activity Research (Spear), Canterbury Christ Church University, Canterbury, Kent, UK
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5
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"With Enthusiasm and Energy throughout the Day": Promoting a Physically Active Lifestyle in People with Intellectual Disability by Using a Participatory Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312329. [PMID: 34886054 PMCID: PMC8656824 DOI: 10.3390/ijerph182312329] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/14/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
People with intellectual disabilities have a comparatively low level of physical activity and are affected by associated numerous impairments and diseases. However, target group specific interventions and concepts aiming at sustainable physical activity-related behavior change in everyday life are rare and the needs and perspectives of the target group have hardly been considered so far. Therefore, a target-group oriented intervention was developed. The research and developmental process was characterized by a participatory approach, involving people with intellectual disabilities throughout the whole process. For example, the interview guideline, design of the interview situation and ways of communicating were developed in a participatory manner. Twenty-four qualitative interviews with people with intellectual disabilities were conducted to explore individual physical activity-related experiences and strategies. Individual and contextual influences on physical activity were identified. Interview results were used to conceptualize an intervention that aims at promoting physical activity in the everyday life of people with intellectual disabilities by strengthening their self-management strategies. The intervention was tested in practice and modified based on communicative validation methods. Good acceptance in the long term is also expected, as the intervention takes place in people’s living environment, is socially embedded and builds upon the needs of the target group.
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6
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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: 7] [Impact Index Per Article: 1.8] [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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Okoye EC, Onwuakagba IU, Ani KU, Babatunde JK, Akosile CO, Okeke MC, Aronu AE. Body image, physical activity, quality of life, and community reintegration of individuals with acquired mobility disability in a Nigerian population. Disabil Rehabil 2020; 44:2002-2010. [PMID: 32924653 DOI: 10.1080/09638288.2020.1817159] [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] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the quality of life (QOL), physical activity (PA), community reintegration (CR), and body image (BI) among adults with acquired mobility disabilities. Relationships between the constructs were also assessed in order to ascertain how a change in one construct could influence the other. MATERIALS AND METHODS This cross-sectional survey involved 157 adults (mean age = 47.51 ± 21.08 years) consecutively recruited from conveniently selected centers in South-east Nigeria. The Short-Form 36-Item Health Survey, the Multidimensional Body Self Relations, the Reintegration to Normal Living Index, and the Short-Form 7-Day International Physical Activity questionnaires were used to assess participants' QOL, BI, CR, and PA respectively. Participants' scores and socio-demographic information were summarised using descriptive statistics while the Spearman test analysed the relationships between constructs. RESULTS Participants' mean QOL (43.23 ± 13.07), CR (48.09 ± 22.84), and BI (2.91 ± 0.51) scores were poor while their mean PA score (4.39 ± 4.56 × 103 MET-min/week) was high. PA had significant positive relationships with CR (rho = 0.25; p < 0.01) and QOL (rho = 0.33; p < 0.01). BI had a significant positive relationship with CR (rho = 0.28; p = 0.01). CONCLUSIONS PA was high for this sample of individuals with mobility disability receiving physiotherapy but QOL, CR, and BI were poor. Based on observed correlations, rehabilitation interventions for enhancing PA may help improve QOL and CR.IMPLICATIONS FOR REHABILITATIONMobility disabilities are very common and burdensome in Nigeria and other African countries.Quality of life, physical activity, community reintegration, and body image can be adversely affected among individuals with mobility disabilities.Understanding relationships between these constructs among individuals with mobility disabilities could help in enhancing rehabilitation planning and outcomes.Physical activity relates to both community reintegration and life quality, whereas body image relates to community integration.
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Affiliation(s)
- Emmanuel Chiebuka Okoye
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Ifeoma Uchenna Onwuakagba
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Kenneth Umezulike Ani
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Jacob Kolawole Babatunde
- Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | | | - Monique Chinyere Okeke
- Department of Environmental Health Sciences, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Ann Ebele Aronu
- Department of Paediatrics, College of Medicine, University of Nigeria, Enugu, Nigeria
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Michalsen H, Wangberg SC, Hartvigsen G, Jaccheri L, Muzny M, Henriksen A, Olsen MI, Thrane G, Jahnsen RB, Pettersen G, Arntzen C, Anke A. Physical Activity With Tailored mHealth Support for Individuals With Intellectual Disabilities: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19213. [PMID: 32437328 PMCID: PMC7367531 DOI: 10.2196/19213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/26/2022] Open
Abstract
Background Individuals with intellectual disabilities (IDs) have lower levels of physical activity (PA) and greater barriers for participation in fitness activities compared with members of the general population. As increased PA has positive effects on cardiovascular and psychosocial health, it is exceedingly important to identify effective interventions for use in everyday settings. Mobile health (mHealth) methods such as motion sensor games (exergames) and smartphone reminders for PA have been explored and found to be promising in individuals with IDs. Objective The purpose of this study is to examine the effectiveness of an individually tailored PA program with motivational mHealth support on daily levels of PA in youth and adults with IDs. Methods The trial uses a randomized controlled design comprising 30 intervention participants and 30 control group participants, aged 16 to 60 years, with sedentary lifestyles or low PA levels. While the controls will receive standard care, the intervention aims to increase the level of PA, measured as steps per day, as the primary outcome. Secondary outcome variables are body mass index, blood pressure, physical performance, social support for PA, self-efficacy in a PA setting, behavior problems, and goal attainment. The intervention involves the delivery of tailored mHealth support, using smartphones or tablets to create structure with focus on the communicative abilities of individual participants. Rewards and feedback are provided in order to motivate individuals to increase participation in PA. Participants in the intervention group, their close relatives, and care staff will be invited to participate in a preintervention goal-setting meeting, where goal attainment scaling will be used to select the participants’ PA goals for the intervention period. All participants will be assessed at baseline, at 3 months, and at 6 months. Results Enrollment was planned to start in April 2020 but will be delayed due to the pandemic situation. The main contribution of this paper is a detailed plan to run our study, which will produce new knowledge about tailored mHealth to support PA in individuals with intellectual disabilities. Conclusions We expect the new intervention to perform better than standard care in terms of improved PA, improved self-efficacy, and social support for activities. Technology offers new opportunities to promote healthy behaviors. The results of the study will determine the effectiveness and sustainability of a tailored mHealth support intervention to increase PA in youth and adults with IDs. Trial Registration ClinicalTrials.gov NCT04079439; https://clinicaltrials.gov/ct2/show/NCT04079439 International Registered Report Identifier (IRRID) PRR1-10.2196/19213
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Affiliation(s)
- Henriette Michalsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Silje Camilla Wangberg
- Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Narvik, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, University of Tromsø - The Artic University of Norway, Tromsø, Norway
| | - Letizia Jaccheri
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Miroslav Muzny
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - André Henriksen
- Department of Community Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Monica Isabel Olsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Reidun Birgitta Jahnsen
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Research Centre for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway
| | - Gunn Pettersen
- Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Cathrine Arntzen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway.,Research Centre for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway
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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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Scifo L, Chicau Borrego C, Monteiro D, Matosic D, Feka K, Bianco A, Alesi M. Sport Intervention Programs (SIPs) to Improve Health and Social Inclusion in People with Intellectual Disabilities: A Systematic Review. J Funct Morphol Kinesiol 2019; 4:E57. [PMID: 33467372 PMCID: PMC7739438 DOI: 10.3390/jfmk4030057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/05/2019] [Accepted: 08/10/2019] [Indexed: 11/16/2022] Open
Abstract
Inactivity is a major issue that causes physical and psychological health problems, especially in people with intellectual disability (ID). This review discusses the beneficial effects of sport intervention programs (SIPs) in people with ID, and aims to provide an overview of the scientific literature in order to identify the main factors influencing the participation of people with ID in SIPs. Twelve papers were analyzed and compared. The results show a large variety in examined SIPs, concerning participants' age and disability, intervention characteristics and context, as well as measures and findings. The main factors essential for people with ID partaking in SIPs appeared to be suitable places for the SIP development, adequate implementation of physical activity (PA) programs in school and extra-school contexts, education, and the training of teachers and instructors. The literature review highlights the relevance of using SIPs in order to improve physical and psychological health, as well as increase social inclusion in populations with ID. SIPs should be included in multifactor intervention programs. Nevertheless, the need is recognized for stakeholders to adopt specific practice and policy in promoting social inclusion in order to organize intervention strategies which are able to provide quality experiences in sport and physical activity for people with ID.
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Affiliation(s)
- Lidia Scifo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
| | - Carla Chicau Borrego
- Escola Superior de Rio Maior, CIEQV, Av. Mário Soares, 2040-413 Rio Marior, Portugal
| | - Diogo Monteiro
- Escola Superior de Desporto de Rio Maior (ESDRM-IPSantarem), Centro de Investigação em Desporto, Saúde e Desenvolvimento Humano (CIDESD), 2040-413 Rio Marior, PORTUGAL
| | - Doris Matosic
- Faculty of Kinesiology, University of Split, Teslina 6, 21000 Split, Croatia
| | - Kaltrina Feka
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
| | - Antonino Bianco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
| | - Marianna Alesi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, IT, V.le delle Scienze Edificio 15, 90100 Palermo, Italy
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11
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House A, Bryant L, Russell AM, Wright-Hughes A, Graham L, Walwyn R, Wright JM, Hulme C, O'Dwyer JL, Latchford G, Meer S, Birtwistle JC, Stansfield A, Ajjan R, Farrin A. Managing with Learning Disability and Diabetes: OK-Diabetes - a case-finding study and feasibility randomised controlled trial. Health Technol Assess 2019; 22:1-328. [PMID: 29845932 DOI: 10.3310/hta22260] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity and type 2 diabetes are common in adults with a learning disability. It is not known if the principles of self-management can be applied in this population. OBJECTIVES To develop and evaluate a case-finding method and undertake an observational study of adults with a learning disability and type 2 diabetes, to develop a standardised supported self-management (SSM) intervention and measure of adherence and to undertake a feasibility randomised controlled trial (RCT) of SSM versus treatment as usual (TAU). DESIGN Observational study and an individually randomised feasibility RCT. SETTING Three cities in West Yorkshire, UK. PARTICIPANTS In the observational study: adults aged > 18 years with a mild or moderate learning disability, who have type 2 diabetes that is not being treated with insulin and who are living in the community. Participants had mental capacity to consent to research and to the intervention. In the RCT participants had glycated haemoglobin (HbA1c) levels of > 6.5% (48 mmol/mol), a body mass index (BMI) of > 25 kg/m2 or self-reported physical activity below national guideline levels. INTERVENTIONS Standardised SSM. TAU supported by an easy-read booklet. MAIN OUTCOME MEASURES (1) The number of eligible participants identified and sources of referral; (2) current living and support arrangements; (3) current health state, including level of HbA1c, BMI and waist circumference, blood pressure and lipids; (4) mood, preferences for change; (5) recruitment and retention in RCT; (6) implementation and adherence to the intervention; (7) completeness of data collection and values for candidate primary outcomes; and (8) qualitative data on participant experience of the research process and intervention. RESULTS In the observational study we identified 147 eligible consenting participants. The mean age was 54.4 years. In total, 130 out of 147 (88%) named a key supporter, with 113 supporters (77%) being involved in diabetes management. The mean HbA1c level was 54.5 mmol/mol [standard deviation (SD) 14.8 mmol/mol; 7.1%, SD 1.4%]. The BMI of 65% of participants was > 30 kg/m2 and of 21% was > 40 kg/m2. Many participants reported low mood, dissatisfaction with lifestyle and diabetes management and an interest in change. Non-response rates were high (45/147, 31%) for medical data requested from the primary care team. In the RCT, 82 participants were randomised. The mean baseline HbA1c level was 56 mmol/mol (SD 16.5 mmol/mol; 7.3%, SD 1.5%) and the mean BMI was 34 kg/m2 (SD 7.6 kg/m2). All SSM sessions were completed by 35 out of 41 participants. The adherence measure was obtained in 37 out of 41 participants. The follow-up HbA1c level and BMI was obtained for 75 out of 82 (91%) and 77 out of 82 (94%) participants, respectively. Most participants reported a positive experience of the intervention. A low response rate and difficulty understanding the EuroQol-5 Dimensions were challenges in obtaining data for an economic analysis. LIMITATIONS We recruited from only 60% of eligible general practices, and 90% of participants were on a general practice learning disability register, which meant that we did not recruit many participants from the wider population with milder learning disability. CONCLUSIONS A definitive RCT is feasible and would need to recruit 194 participants per arm. The main barrier is the resource-intensive nature of recruitment. Future research is needed into the effectiveness of obesity treatments in this population, particularly estimating the longer-term outcomes that are important for health benefit. Research is also needed into improving ways of assessing quality of life in adults with a learning disability. TRIAL REGISTRATION Current Controlled Trials ISRCTN41897033. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 26. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Allan House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Louise Bryant
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amy M Russell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Liz Graham
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Rebecca Walwyn
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Judy M Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Claire Hulme
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - John L O'Dwyer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Gary Latchford
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Shaista Meer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | - Ramzi Ajjan
- Division of Cardiovascular and Diabetes Research, University of Leeds, Leeds, UK
| | - Amanda Farrin
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
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12
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Elinder LS, Sundblom E, Zeebari Z, Bergström H. Effect and Process Evaluation of a Structural Health Intervention in Community Residences for Adults With Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jppi.12262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Elinor Sundblom
- Department of Public Health Sciences; Karolinska Institutet; Solna Sweden
| | - Zangin Zeebari
- Department of Public Health Sciences; Karolinska Institutet; Solna Sweden
| | - Helena Bergström
- Department of Public Health Sciences; Karolinska Institutet; Solna Sweden
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13
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Kuijken NMJ, Vlot-van Anrooij K, van Schrojenstein Lantman-de Valk HMJ, Leusink G, Naaldenberg J, Nijhuis-van der Sanden MW. Stakeholder expectations, roles and responsibilities in Dutch health promotion for people with intellectual disabilities. Health Promot Int 2018; 34:e59-e70. [DOI: 10.1093/heapro/day059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Summary
This two-phase, qualitative study aims to obtain an overview of stakeholders in the network of people with intellectual disabilities (ID) and their perceived facilitating and hindering factors, expectations, and perceived roles and responsibilities with regard to health promotion. In phase 1, four workshops were conducted to provide insight into involved stakeholders. In phase 2, 29 semi-structured interviews were conducted with stakeholders regarding their views on health promotion. Data were analysed using stakeholder matrices and a combination of domain and thematic analysis. Daily caregivers were identified as the most important and influential stakeholders. Interviewed stakeholders perceived barriers to a healthy lifestyle as relating mainly to the person with ID and, although they stated that people with ID need support to be able to live healthily, there was ambiguity about roles and responsibilities for providing this support. Daily caregivers are not properly facilitated to support a healthy lifestyle. Stakeholders expressed the need for a culture change towards a greater health promotion ethos in care for people with ID. A facilitating context is needed in which the social network supports autonomy and offers opportunities to adapt to physical, social and emotional challenges. Stakeholders see the importance of, and are willing to support, healthy behaviour. They are hindered by a lack of a shared vision and united system in which all stakeholders know their roles and responsibilities. Promotion of a healthy lifestyle should be part of every service provider employee’s job and propagated throughout the organization as part of its mission and vision.
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Affiliation(s)
- N M J Kuijken
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - K Vlot-van Anrooij
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - H M J van Schrojenstein Lantman-de Valk
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - G Leusink
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - J Naaldenberg
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Route 68, 6500 HB Nijmegen, The Netherlands
| | - M W Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of healthcare (IQ healthcare), Nijmegen, The Netherlands
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14
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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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15
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Hamzaid NH, Flood VM, Prvan T, O'Connor HT. General nutrition knowledge among carers at group homes for people with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:422-430. [PMID: 29484759 DOI: 10.1111/jir.12480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 01/06/2018] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Good nutrition knowledge among carers of people with intellectual disability (ID) living in group homes is essential as they have a primary role in food provision for residents. Research on the nutrition knowledge of carers is limited. METHOD This cross-sectional study assessed the level of general nutrition knowledge in a convenience sample of Australian carers (C) of people with ID and compared this to the general Australian community (CM). Nutrition knowledge was evaluated using the validated General Nutrition Knowledge Questionnaire. Total knowledge score as well as performance on instrument sub-sections (dietary guidelines, nutrient sources, healthy food choices and diet disease relationships) were assessed (expressed as %). Knowledge scores were adjusted for known confounders (age, sex, education level, BMI, living arrangement and English spoken at home) using generalised linear modelling. RESULTS A total of 589 participants were recruited (C: n = 40; CM: n = 549). Age (C: 40.8 ± 12.1 year; CM: 37.8 ± 13.3 years; P = 0.145), sex distribution (C: 62.5%; CM: 67.2% female; P = 0.602) and English spoken at home (C: 82.5%; CM: 89.6%; P = 0.183) were similar between groups, but BMI (C: 28.5 ± 5.7 kgm-2 ; CM: 25.3 kgm-2 ; P = 0.002) was significantly lower and tertiary education (C: 52.5%; CM: 85.1%; P < 0.0005) significantly higher for CM. Total knowledge score (C: 56.6 ± 12.6%; CM: 67.2 ± 12.6%; P < 0.0005) and performance on all instrument sub-sections (P ≤ 0.004) were significantly lower for carers. This remained after confounder adjustment except for the knowledge of dietary guidelines sub-section (P = 0.116). CONCLUSION Limited carer nutrition knowledge may compromise their ability to plan and adapt meals to support a healthy and appropriate diet for people with ID in group homes.
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Affiliation(s)
- N H Hamzaid
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe, New South Wales, Australia
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Program of Dietetics, Kuala Lumpur, Malaysia
| | - V M Flood
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe, New South Wales, Australia
- Westmead Hospital, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - T Prvan
- Department of Statistics, Faculty of Science and Engineering, Macquarie University, New South Wales, Australia
| | - H T O'Connor
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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16
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Doherty AJ, Jones SP, Chauhan U, Gibson JME. An integrative review of multicomponent weight management interventions for adults with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31 Suppl 1:39-51. [PMID: 28631874 PMCID: PMC5811836 DOI: 10.1111/jar.12367] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obesity is more prevalent in people with intellectual disabilities and increases the risk of developing serious medical conditions. UK guidance recommends multicomponent weight management interventions (MCIs), tailored for different population groups. METHODS An integrative review utilizing systematic review methodology was conducted to identify the types of MCIs delivered to adults with intellectual disabilities. FINDINGS Five studies were identified. All of the studies' MCIs were tailored for adults with intellectual disabilities. Tailoring included measures such as simplified communication tools, individualized sessions, and the presence of carers where appropriate. CONCLUSIONS Emerging evidence suggests ways in which MCIs can be tailored for adults with intellectual disabilities but, given the few studies identified, it is not possible to recommend how they can be routinely tailored. Further studies are justified for adults with intellectual disabilities at risk of obesity-related conditions.
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Affiliation(s)
- Alison J. Doherty
- National Institute for Health Research (NIHR)Collaboration for Leadership in Applied Health Research and Care, North West Coast (CLAHRC, NWC)PrestonUK
- School of NursingFaculty of Health & WellbeingUniversity of Central LancashirePrestonUK
| | - Stephanie P. Jones
- School of NursingFaculty of Health & WellbeingUniversity of Central LancashirePrestonUK
| | - Umesh Chauhan
- School of NursingFaculty of Health & WellbeingUniversity of Central LancashirePrestonUK
- MacKenzie Chair in Primary Care MedicineUniversity of Central Lancashire; GP and CVD LeadEast Lancashire Clinical Commissioning GroupUK
| | - Josephine M. E. Gibson
- National Institute for Health Research (NIHR)Collaboration for Leadership in Applied Health Research and Care, North West Coast (CLAHRC, NWC)PrestonUK
- School of NursingFaculty of Health & WellbeingUniversity of Central LancashirePrestonUK
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17
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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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18
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Temple VA, Frey GC, Stanish HI. Interventions to promote physical activity for adults with intellectual disabilities. ACTA ACUST UNITED AC 2017; 59:446-453. [DOI: 10.21149/8218] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 06/07/2017] [Indexed: 11/06/2022]
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19
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Development of Cooking Skills as Nutrition Intervention for Adults with Autism and Other Developmental Disabilities. J Acad Nutr Diet 2017; 117:671-679. [DOI: 10.1016/j.jand.2016.06.368] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Indexed: 01/08/2023]
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20
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Hakim RM, Ross MD, Runco W, Kane MT. A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability. J Exerc Rehabil 2017; 13:89-94. [PMID: 28349039 PMCID: PMC5332005 DOI: 10.12965/jer.1732838.419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/31/2017] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants’ measures of physical performance prior to and following the 8-week aquatic exercise program, improvements were seen in all measures, but the change in scores for the 6-min walk test, 30-sec chair stand test, and the static plank test achieved statistical significance (P<0.05). An 8-week group aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility.
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Affiliation(s)
- Renée M Hakim
- Department of Physical Therapy, University of Scranton, Scranton, PA, USA
| | - Michael D Ross
- Department of Physical Therapy, Daemen College, Amherst, NY, USA
| | - Wendy Runco
- Department of Physical Therapy, St. Joseph's Center, Scranton, PA, USA
| | - Michael T Kane
- Department of Physical Therapy, St. Joseph's Center, Scranton, PA, USA
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21
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Willems M, Hilgenkamp TIM, Havik E, Waninge A, Melville CA. Use of behaviour change techniques in lifestyle change interventions for people with intellectual disabilities: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 60:256-268. [PMID: 28341236 DOI: 10.1016/j.ridd.2016.10.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 10/03/2016] [Accepted: 10/16/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) experience more health problems and have different lifestyle change needs, compared with the general population. AIMS To improve lifestyle change interventions for people with ID, this review examined how behaviour change techniques (BCTs) were applied in interventions aimed at physical activity, nutrition or physical activity and nutrition, and described their quality. METHODS AND PROCEDURES After a broad search and detailed selection process, 45 studies were included in the review. For coding BCTs, the CALO-RE taxonomy was used. To assess the quality of the interventions, the Physiotherapy Evidence Database (PEDro) scale was used. Extracted data included general study characteristics and intervention characteristics. OUTCOMES AND RESULTS All interventions used BCTs, although theory-driven BCTs were rarely used. The most frequently used BCTs were 'provide information on consequences of behaviour in general' and 'plan social support/social change'. Most studies were of low quality and a theoretical framework was often missing. CONCLUSION AND IMPLICATIONS This review shows that BCTs are frequently applied in lifestyle change interventions. To further improve effectiveness, these lifestyle change interventions could benefit from using a theoretical framework, a detailed intervention description and an appropriate and reliable intervention design which is tailored to people with ID.
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Affiliation(s)
- Mariël Willems
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanzehogeschool Groningen, P.O. Box 3109, 9701 DC Groningen, The Netherlands.
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Else Havik
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanzehogeschool Groningen, P.O. Box 3109, 9701 DC Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanzehogeschool Groningen, P.O. Box 3109, 9701 DC Groningen, The Netherlands
| | - Craig A Melville
- Institute of Health and Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, United Kingdom
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22
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Ruud MP, Raanaas RK, Bjelland M. Caregivers' perception of factors associated with a healthy diet among people with intellectual disability living in community residences: A Concept mapping method. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:202-210. [PMID: 27636155 DOI: 10.1016/j.ridd.2016.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/29/2016] [Accepted: 09/09/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Many people with intellectual disabilities (ID) living in community-based residences have been found to have unhealthy diet and weight disturbances. In Norway, a majority of people with ID live in such residences. AIMS The aim of the study was to examine factors affecting the caregivers' opportunity to promote a healthy diet among the residents. METHODS AND PROCEDURES A concept mapping methodology was adopted, including group-based brainstorming, idea synthesising, sorting, rating and analysis of the results. Informants were caregivers in four different community residences for people with mild to moderate ID in the southeast of Norway. A total of 13 informants were recruited (12 females and 1 male), and 10 informants completed two sessions. RESULTS Eight clusters were identified as affecting the caregivers' ability to promote a healthy diet: "Availability and accessibility", "Guidance and autonomy", "Competence among staff", "Planning and involvement", "Customization", "External conditions affecting staff", "Legislation, rules and structure" and "Everyday challenges", each including both barriers and facilitators. CONCLUSIONS AND IMPLICATIONS Multiple factors affect the caregivers' ability to promote a healthy diet. Caregivers' opportunity to promote a healthy diet is complex. Availability and accessibility of healthy food is crucial, but a healthy diet also requires time and competence among the caregivers.
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Affiliation(s)
- Marte Pilskog Ruud
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Science, P.O. Box 5003 NMBU, N-1432 Ås, Norway
| | - Ruth Kjærsti Raanaas
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Science, P.O. Box 5003 NMBU, N-1432 Ås, Norway.
| | - Mona Bjelland
- Department of Nutrition, University of Oslo, P.O. Box 1046 Blindern, N-0317 Oslo, Norway
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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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Sundblom E, Bergström H, Ellinder LS. Understanding the Implementation Process of a Multi-Component Health Promotion Intervention for Adults with Intellectual Disabilities in Sweden. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 28:296-306. [DOI: 10.1111/jar.12139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Elinor Sundblom
- Centre for Epidemiology and Community Medicine; Solna Sweden
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25
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Bennett AE, Cunningham C. A qualitative evaluation of a healthy cookery course in Ireland designed for adults with mild to moderate intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2014; 18:270-281. [PMID: 25099009 DOI: 10.1177/1744629514544074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Adults with an intellectual disability have poorer diets than the general adult population. The Able 2 Cook 4 Health cookery course aims to improve the diets of adults with mild to moderate intellectual disability. This study aims to evaluate the course by obtaining the views of course participants and the views of managers hosting the course. Thirty course participants took part in focus groups. Five managers hosting the course participated in a semi-structured interview. Positive features of the course included the group cooking, social interaction and course instructors. Collaboration between centres hosting the course and participants' home environment is needed to help transfer the skills learned to all home settings. The Able 2 Cook 4 Health cookery course provided participants with an important social outlet to learn essential occupational skills. These findings could particularly influence the diets of adults with an intellectual disability moving into independent living.
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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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Bergström H, Elinder LS, Wihlman U. Barriers and facilitators in health education for adults with intellectual disabilities--a qualitative study. HEALTH EDUCATION RESEARCH 2014; 29:259-271. [PMID: 24399263 DOI: 10.1093/her/cyt111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this study was to explore barriers and facilitators in the implementation of a health course for adults with mild or moderate intellectual disabilities. An inductive qualitative design was used. Data were collected from a health course conducted in 16 study groups with 83 participants in Stockholm, Sweden by unstructured observations in course sessions, a group discussion with course leaders and evaluation notes from the course leaders. The data were analysed by qualitative content analysis. Four categories were identified: (i) 'individual characteristics', implying various needs, (ii) 'pedagogical strategies' used to meet those needs, (iii) 'interaction within the course', dealing with active and less active participation and (iv) 'structures', including learning climate and organizing. The overarching theme 'creating an individualized supportive context' describes the challenge of educating people with intellectual disabilities towards an empowered and well informed decision making regarding their own health. Therefore, there is a need for support not only within the course but also from the social and physical environment as well.
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Affiliation(s)
- H Bergström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden, Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden and Independent Researcher, Stockholm, Sweden
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Edwards M, Holder M, Baum N, Brown R. Targeting Health Improvement via a Nutritional Intervention Program for Adults With Developmental Disabilities and Challenging Behaviors. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Nehama Baum
- MukiBaum Accessibility Foundation; Toronto ON Canada
| | - Roy Brown
- University of Calgary; Calgary AB Canada
- Flinders University; Adelaide SA Australia
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Pérez-Cruzado D, Cuesta-Vargas AI. Improving Adherence Physical Activity with a Smartphone Application Based on Adults with Intellectual Disabilities (APPCOID). BMC Public Health 2013; 13:1173. [PMID: 24330604 PMCID: PMC3866585 DOI: 10.1186/1471-2458-13-1173] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 11/29/2013] [Indexed: 11/20/2022] Open
Abstract
Background People with intellectual disabilities (ID) have lower levels of physical activity and quality of life and they have a lot of barriers to face when taking part in physical activity. Other problems are the poor adherence to physical activity such people have so this study is designed to improve adherence to physical activity for people with intellectual disabilities with the assistance of an application for smartphones. The aim of the study will be to improve physical activity and physical condition after multimodal intervention and to analyse the promotion of adherence to physical activity through a multimodal intervention and an app intervention (mHealth) in people with ID. Methods A two-stage study will be conducted. In stage 1 a multimodal intervention will take place will be done with physical activity and educational advice over eight weeks, two days a week. Data will be measured after and before the intervention. In stage 2 a randomized controlled trial will be conducted. In the intervention group we will install an application to a smartphone; this application will be a reminder to do a physical activity and they have to select whether they have or haven’t done a physical activity every day. This application will be installed for 18 weeks. Data will be measured after and before the application is installed in two groups. We will measure results 10 weeks later when the two groups don’t have the reminder. The principal outcome used to measure the adherence to physical activity will be the International Physical Activity Questionnaire; secondary outcomes will be a fun-fitness test and self-report survey about quality of life, self-efficacy and social support. Samples will be randomized by sealed envelope in two groups, with approximately 20 subjects in each group. It’s important to know that the therapist will be blinded and won’t know the subjects of each group. Discussion Offering people with ID a multimodal intervention and tool to increase the adherence to a physical activity may increase the levels of physical activity and quality of life. Such a scheme, if beneficial, could be implemented successfully within public health sense. Trial registration ClinicalTrials.gov Identifier: NCT01915381.
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Naaldenberg J, Kuijken N, van Dooren K, van Schrojenstein Lantman de Valk H. Topics, methods and challenges in health promotion for people with intellectual disabilities: a structured review of literature. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4534-4545. [PMID: 24161461 DOI: 10.1016/j.ridd.2013.09.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/17/2013] [Accepted: 09/19/2013] [Indexed: 06/02/2023]
Abstract
People with intellectual disabilities (ID) experience substantial health inequities compared, with the general population. Many secondary conditions and lifestyle related health problems could be, prevented with adequate health promotion. The aim of this structured review is to provide insight into, the main characteristics of published health promotion intervention studies for people with ID and, in, doing so, to identify best practice and knowledge gaps. Relevant studies were identified through a, structured literature search of multiple electronic databases (PubMed, CINHAS, Scopus, PsychINFO), the search strategy covered health promotion and intellectual disabilities for available papers, published between February 2002 and 2012. In total, 25 studies were included and analyzed. Overall, studies were diverse and explored a variety of health issues. Papers included a variety of participants (in relation to level of disability) and intervention approaches. With regard to quality, many studies, failed to report how they recruited their participants, and there were substantial challenges identified, by authors in relation to recruitment, implementation of interventions, and the selection of outcome, measures used as well as the usability of measures themselves. Our findings suggest that this field, experiences methodological weaknesses and inconsistencies that make it difficult to compare and, contrast results. Theoretically driven studies that take into account the views and expectations of, participants themselves are needed, as is research that investigates the reliability and validity of, outcome measures for the ID population. Collaboration with mainstream health promotion research is, critical.
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Affiliation(s)
- Jenneken Naaldenberg
- Radboud University Medical Centre, Department of Primary and Community Health Care, Nijmegen, The Netherlands.
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Ptomey L, Goetz J, Lee J, Donnelly J, Sullivan D. Diet Quality of Overweight and Obese Adults with Intellectual and Developmental Disabilities as Measured by the Healthy Eating Index-2005. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2013; 25:10.1007/s10882-013-9339-z. [PMID: 24319322 PMCID: PMC3848605 DOI: 10.1007/s10882-013-9339-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Little research has been conducted to examine diet quality of overweight and obese adults with intellectual and developmental disabilities (IDD) in the United States. The purpose of this study was to determine diet quality, as measured by the Healthy Eating Index-2005 (HEI-2005), of overweight and obese adults with IDD. METHODS Data were obtained from community-dwelling overweight individuals. 3-day food records were administered and completed with assistance by staff or family members and then reviewed by a dietitian. All records were analyzed and HEI-2005 was calculated using NDSR output. RESULTS 178 records were analyzed from 70 subjects (28 male, 42 female; mean age 33.9 ±11.5 years). The mean energy intake was 1928 ± 891 kcals and the mean total HEI-2005 score was 46.7± 11.5. Participants scored the lowest in total fruits, whole grains, dark green and orange vegetables, non-hydrogenated vegetable oils, and sodium. Both male and females had diets deficient in fiber, vitamin A, vitamin D, vitamin E, folate, and potassium. Additionally men were deficient in vitamin K, and women were deficient in calcium. CONCLUSIONS Overweight and Obese adults with IDD had a lower HEI-2005 score compared to the general population and are at an increased risk of poor diet quality and nutritional deficiencies that could contribute to the development of diabetes, cardiovascular disease, cancer and other health complications.
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Affiliation(s)
- Lauren Ptomey
- Department of Dietetics and Nutrition, Center for Physical Activity and Weight Management, University of Kansas Medical Center, 3901 Rainbow Boulevard; MS 4013; Kansas City, KS 66160, Phone Number: 913-945-8182, Fax Number: 913-588-8946
| | - Jeannine Goetz
- Department of Dietetics and Nutrition, University of Kansas Medical Center, 3901 Rainbow Boulevard; MS 4013; Kansas City, KS 66160
| | - Jaehoon Lee
- , 1425 Jayhawk Boulevard; Lawrence, KS 66045-7547. Center for Research Methods and Data Analysis, University of Kansas, Lawrence, KS 66045, Phone Number: 785-550-7098, Fax Number: 785-864-2009
| | - Joseph Donnelly
- Department of Internal Medicine, Cardiovascular Research Institute, Center for Physical Activity and Weight Management, University of Kansas Medical Center, 1301 Sunnyside Ave; Robinson Room 100; Lawrence, KS 66045
| | - Debra Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, 3901 Rainbow Boulevard; MS 4013; Kansas City, KS 66160
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Bergström H, Hagströmer M, Hagberg J, Elinder LS. A multi-component universal intervention to improve diet and physical activity among adults with intellectual disabilities in community residences: a cluster randomised controlled trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3847-3857. [PMID: 24021393 DOI: 10.1016/j.ridd.2013.07.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/10/2013] [Accepted: 07/10/2013] [Indexed: 06/02/2023]
Abstract
People with ID have an increased risk for unhealthy diets, physical inactivity and weight disturbances. The aim of the current study was to investigate the effectiveness of a novel and complex intervention to improve diet and physical activity, targeting both caregivers and residents, in community residences for people with ID. A three component intervention based on Social Cognitive Theory was developed, including: (1) appointment of a health ambassador in each community residence attending network meetings, (2) a study circle for caregivers, and (3) a health course for the residents. The intervention lasted for 12-16 months and allowed for some local tailoring. A cluster randomised controlled trial, randomised at residence level, was conducted to evaluate the effects of the intervention. Thirty community residences for people with mild or moderate ID in Stockholm County, Sweden, were included. A total of 130 participants, 74 women and 56 men aged 20-66 years, entered, and 129 participants completed the study. The primary outcome was physical activity, measured by pedometry. Secondary outcomes were BMI, waist circumference, dietary quality measured by digital photography, satisfaction with life assessed with a scale, and work routines assessed with a questionnaire. Outcomes were related to intervention fidelity. A positive intervention effect was found on physical activity, with an average increase of 1608 steps/day among participants in the intervention group (P=0.045). The effect size was 0.29 (Cohen's d). The type of residence was found to be an effect moderator. A positive intervention effect was found as well on work routines, with an average increase of 7.1 percentage points on a self-assessment scale among residences in the intervention group (P=0.016). No significant effects were found on BMI, waist circumference, dietary quality, or satisfaction with life. In conclusion, this innovative intervention was effective in improving physical activity and work routines. It is likely that even greater effects could be achieved by improvements in implementation strategies, leading to higher fidelity.
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Affiliation(s)
- Helena Bergström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 3, 141 83 Huddinge, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Box 1497, 171 29 Solna, Sweden.
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Bergström H, Hochwälder J, Kottorp A, Elinder LS. Psychometric evaluation of a scale to assess satisfaction with life among people with intellectual disabilities living in community residences. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:250-256. [PMID: 22369655 DOI: 10.1111/j.1365-2788.2011.01531.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND In the context of a health intervention among people with intellectual disabilities (ID), there was a need to assess satisfaction with some aspects of life, in order to monitor both potential positive and negative effects of the intervention. The aim of the present study was to develop and evaluate an easily administered scale for assessing satisfaction with home environment and leisure time among people with mild or moderate ID, living in community residences. METHODS A number of questions were constructed to measure satisfaction with home environment and leisure time. The questions were answered by 132 adults with mild or moderate ID, living in community residences in Sweden. The dimensionality of the scale was evaluated by factor analysis, and the reliability was estimated using Cronbach's alpha coefficients. RESULTS The analysis supported a four-factor solution with 12 items. The four factors were: (I) Satisfaction with housing environment; (II) Satisfaction with life; (III) Satisfaction with meals; and (IV) Satisfaction with recreational activity. The four factors explained almost 70% of the variance in the data set. Cronbach alpha coefficients for all scales were above 0.70, indicating that the reliabilities of the scales were satisfactory. Correlations between the four sub-scales ranged from 0.06 to 0.52, indicating low to moderate inter-correlations between the four sub-scales. CONCLUSION The scale has fairly good psychometric properties and is easy to administer. The scale, which can be further improved, can be an important resource in health intervention studies.
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Affiliation(s)
- H Bergström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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Bodde AE, Seo DC, Frey GC, Van Puymbroeck M, Lohrmann DK. Correlates of Moderate-to-Vigorous Physical Activity Participation in Adults With Intellectual Disabilities. Health Promot Pract 2012; 14:663-70. [DOI: 10.1177/1524839912462395] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adults with intellectual disabilities (ID) have low levels of physical activity and higher than average rates of related chronic health conditions. Understanding correlates of their physical activity participation may improve health promoting interventions. Forty-two adults with ID participated in a physical activity study. Physical activity knowledge and skills, awareness of recommendations and demographic characteristics were analyzed for their association with moderate-to-vigorous physical activity (MVPA) participation measured by accelerometers. Five variables were significantly correlated with MVPA. Body mass index was inversely correlated with MVPA, and gender, job location, job tasks, and place of residence were all significantly associated with MVPA. Understanding correlates of physical activity in this population will help inform disability service and health promotion professionals in future research and health intervention design.
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Affiliation(s)
| | - Dong-Chul Seo
- Indiana University Bloomington, Bloomington, IN, USA
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Elinder LS, Brunosson A, Bergström H, Hagströmer M, Patterson E. Validation of personal digital photography to assess dietary quality among people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2012; 56:221-226. [PMID: 21801265 DOI: 10.1111/j.1365-2788.2011.01459.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Dietary assessment is a challenge in general, and specifically in individuals with intellectual disabilities (ID). This study aimed to evaluate personal digital photography as a method of assessing different aspects of dietary quality in this target group. METHOD Eighteen adults with ID were recruited from community residences and activity centres in Stockholm County. Participants were instructed to photograph all foods and beverages consumed during 1 day, while observed. Photographs were coded by two raters. Observations and photographs of meal frequency, intake occasions of four specific food and beverage items, meal quality and dietary diversity were compared. Evaluation of inter-rater reliability and validity of the method was performed by intra-class correlation analysis. RESULTS With reminders from staff, 85% of all observed eating or drinking occasions were photographed. The inter-rater reliability was excellent for all assessed variables (ICC ≥ 0.88), except for meal quality where ICC was 0.66. The correlations between items assessed in photos and observations were strong to almost perfect with ICC values ranging from 0.71 to 0.92 and all were statistically significant. CONCLUSION Personal digital photography appears to be a feasible, reliable and valid method for assessing dietary quality in people with mild to moderate ID, who have daily staff support.
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Affiliation(s)
- L S Elinder
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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Carmeli E, Merrick J, Imam B, Levy R. Exercises and sports participation in healthy older adults with intellectual disability—A pilot study. Health (London) 2012. [DOI: 10.4236/health.2012.429119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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