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Whitelaw S. Fostering resilience in young people with intellectual disabilities using a 'settings' approach. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:549-566. [PMID: 36977495 PMCID: PMC11059839 DOI: 10.1177/17446295231168186] [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] [Indexed: 06/18/2023]
Abstract
The need to foster resilience amongst young people with intellectual disabilities is increasingly recognised within policy. Critically, understanding of the actual means by which this aspiration might be most sensitively and effectively met is considered weak. This paper reports on an exploratory case-study of a social enterprise community café - The Usual Place - that through the promotion of employability, seeks to promote resilience amongst its young 'trainees' with intellectual disabilities. Two research questions were set: "how is 'resilience' conceptualized within the organisation" and "what features within the organisation are significant in fostering resilience"? We identify a range of significant features associated with being able to successfully foster resilience - the need for a foundational 'whole organisation'(settings) approach based on high levels of participation and choice; the negotiation of a constructive dynamic tension between 'support' and 'exposure'; and the embedding of these actions in embodied actions and day-to-day organisational activities.
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Affiliation(s)
- Sandy Whitelaw
- School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK
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2
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Long C, Plenn E, Acri S, Richardson C. The Impact of Living Situation on Healthcare Encounters for Individuals With Intellectual Disability. Cureus 2023; 15:e51156. [PMID: 38283523 PMCID: PMC10811741 DOI: 10.7759/cureus.51156] [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] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction The living situation of individuals with intellectual disabilities (ID) has evolved throughout the years and ranges from living at home with family caregivers to group homes to independent living arrangements. Living situations can affect access to care and thus healthcare utilization seen by healthcare encounters for individuals with ID. Methods The researchers conducted a chart review of 112 patients to assess demographics, living situations, and healthcare encounters between 2019 and 2021. Living situation categories included independent, biological family, group home, home with other support, and others. Statistical analyses were conducted using R version 4.2.1 (The R Foundation for Statistical Computing, Vienna, Austria). Univariable analyses consisted of the Shapiro-Wilk test of normality, Kruskal-Wallis rank sum test, and pairwise Wilcoxon rank sum test with multiple comparisons correction using the Bonferroni method. Statistical testing for multivariable analysis included the Kruskal-Wallis rank sum test, Spearman's rank correlation, and the negative binomial model. Results Results showed a statistically significant difference in median total encounter value between independently living individuals with ID compared to all other living situations, Χ2 = 4.230, df = 1, p-value = 0.040. Additionally, there is a significant association between medication count and total encounter count, rho = 0.341, S = 154322, p-value < 0.001. Conclusion The study showed that individuals with ID who live independently have fewer healthcare encounters compared to all other living situations. This may be due to various factors such as increased autonomy and free choice, increased barriers to healthcare, or better overall health requiring less medical attention in independently living individuals with ID.
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Affiliation(s)
- Calista Long
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Eion Plenn
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Samantha Acri
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Cheryl Richardson
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
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Hamdani Y, Bonder R, McPherson AC. Wellness in children's rehabilitation - what does it mean? Disabil Rehabil 2023; 45:4236-4244. [PMID: 36437808 DOI: 10.1080/09638288.2022.2148295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Rehabilitation research on wellness promotion for children and youth with disabilities is limited and tends to narrowly focus on physical aspects of health. An overarching sense of wellness includes multiple, overlapping dimensions (e.g., physical, social, emotional, occupational). This study's main objectives were to explore what wellness means for young people with disabilities, and what contributes to their sense of wellness. METHODS A qualitative design involving World Café-style focus groups was used to explore the perspectives of youth with disabilities (14-25 years old, n = 3), parents (n = 6) and healthcare providers (n = 10) on how wellness is understood and addressed at a Canadian children's rehabilitation hospital. Themes were identified through an inductive analysis of focus group transcripts and notes written by participants and research team members. RESULTS Having a variety of relationships and social connections, meaningful activity opportunities, becoming as independent as possible, and having stable medical health contributed to wellness for young people with disabilities. CONCLUSIONS Rehabilitation care can promote wellness by co-creating personalized care pathways across multiple wellness dimensions with young people with disabilities and their families, focusing on strengths rather than deficits, and improving access to a variety of activities and communities.IMPLICATIONS FOR REHABILITATIONRehabilitation professionals in children's rehabilitation have unique, ongoing opportunities to promote and support wellness with young people with disabilities and their families.Rehabilitation professionals can embed personalized, strengths-focused wellness pathways across multiple dimensions into the care of children with disabilities.Helping children and families address barriers to meaningful activities and promoting social connections can foster an overarching sense of wellness.
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Affiliation(s)
- Yani Hamdani
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Revi Bonder
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Deierlein AL, Litvak J, Liu C, Stein CR. Diet quality, diet-related factors and disability status among male adults of reproductive age in the USA. Public Health Nutr 2023; 26:1976-1985. [PMID: 37395178 PMCID: PMC10564594 DOI: 10.1017/s1368980023001222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 05/19/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To examine diet quality and diet-related factors among male adults of reproductive age with and without disabilities. DESIGN Cross-sectional data from the National Health and Nutrition Examination Surveys, 2013-2018. SETTING Disability was reported as serious difficulty hearing, seeing, concentrating, walking, dressing and/or running errands due to physical, mental or emotional conditions. Diet quality was assessed by the Healthy Eating Index (HEI)-2015 and diet-related factors included self-rated diet healthfulness, food security and food assistance programmes. Multivariable linear regression estimated differences in HEI-2015 scores. Multivariable Poisson regression estimated adjusted prevalence ratios (aPR) and 95 % CI for diet-related factors. PARTICIPANTS In total, 3249 males, 18-44 years; of whom, 441 (13·4 %) reported having disabilities. RESULTS Compared with males without disabilities, those with disabilities had a 2·69-point (95 % CI: -4·18, -1·20) lower mean total HEI-2015 score and approximately one-third to half of a point lower HEI-2015 component scores for greens and beans, total protein foods, seafood and plant proteins, fatty acids and added sugars. Males with any disabilities were more likely to have low food security (aPR = 1·57; 95 % CI: 1·28, 2·92); household participation in food assistance programmes (aPR = 1·61; 95 % CI: 1·34, 1·93) and consume fast food meals during the previous week (1-3 meals: aPR = 1·11; 95 % CI: 1·01-1·21 and 4 or more meals: aPR = 1·18; 95 % CI: 1·01-1·38) compared with males with no disabilities. CONCLUSIONS Factors affecting diet and other modifiable health behaviours among male adults of reproductive age with disabilities require further investigation. Health promotion strategies that are adaptive to diverse populations within the disability community are needed.
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Affiliation(s)
| | - Jaqueline Litvak
- School of Global Public Health, New York University, New York, NY, USA
| | - Chang Liu
- School of Global Public Health, New York University, New York, NY, USA
| | - Cheryl R Stein
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
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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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Rinaldi R, Duplat J, Haelewyck MC. Is health a priority? Examining health-related support needs in adults with intellectual disability through a self-determination framework. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:657-671. [PMID: 34114510 DOI: 10.1177/17446295211009660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND People with intellectual disabilities experience inequities in healthcare. Those are maintained by individual limitations as well as environmental factors. In this context, health needs are less likely to be expressed, identified and met. METHOD We led a survey in 832 adults with intellectual disabilities to identify if health was set as a priority and if so, what were their major health-related support needs (in terms of physical, social and psychological health). RESULTS 67.1% of participants reported at least one need. Most frequently, two or more types of needs were reported with gender and living facility having an effect on whether participants would report these needs, but these did not affect which type of needs were reported. CONCLUSIONS Health-related support needs are highly prevalent and diversified in people with intellectual disabilities. This study emphasizes the importance to consider health as a global concept as well as the relationships between health and self-determination.
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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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Vlot-van Anrooij K, Naaldenberg J, Hilgenkamp TIM, Vaandrager L, van der Velden K, Leusink GL. Towards healthy settings for people with intellectual disabilities. Health Promot Int 2021; 35:661-670. [PMID: 31243433 PMCID: PMC7414853 DOI: 10.1093/heapro/daz054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
People with intellectual disabilities (ID) depend on their environment for support to live healthily. The characteristics of healthy settings for people with ID are unknown. This study aims to conceptualize healthy settings for people with ID by conducting an international and multidisciplinary concept mapping study. As theoretical framework the settings approach, an ecological model with a whole system focus toward health promotion, was used. The integrative mixed-methods approach of this study involved concept mapping with researchers specialized in healthcare for people with ID and researchers specialized in healthy settings. The 41 participants generated statements that were later sorted and rated. Findings encompass 13 clusters relating to the social environment, the physical environment and societal preconditions. Specific factors of healthy settings for people with ID include: (i) universal design of the physical environment, (ii) the role of care professionals in the social environment to empower people with ID, (iii) possibilities for care providers to contribute to a health-promoting setting and (iv) preconditions that allow people to engage in society. These factors can be used in strategies to apply the approach in practice and give directions to put in place policies on developing enabling environments and decreasing health inequities.
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Affiliation(s)
- Kristel Vlot-van Anrooij
- Department of Primary and Community Care, Research group Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
- Corresponding author. E-mail:
| | - J Naaldenberg
- Department of Primary and Community Care, Research group Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - T I M Hilgenkamp
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000CA Rotterdam, The Netherlands
| | - L Vaandrager
- Department of Social Sciences, Health and Society, Wageningen University, PO Box 8130, 6706 KN Wageningen, The Netherlands
| | - K van der Velden
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - G L Leusink
- Department of Primary and Community Care, Research group Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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Al‐Heizan MO, St. John B, DuBois L, Niemeier B, Ausderau KK. Difference in Healthcare Usage, Pharmacy Prescriptions, and Healthcare Cost for Special Olympic Athletes Compared to Non‐athletes with Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Owens R, Earle S, McNulty C, Tilley E. What works in community health education for adults with learning disabilities: A scoping review of the literature. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1268-1283. [PMID: 32346968 DOI: 10.1111/jar.12746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/05/2020] [Accepted: 04/06/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Research suggests there is insufficient good quality information regarding the effectiveness of health education aimed at adults with intellectual disabilities. By analysing the literature, this review aimed to identify what constituted effectiveness in this context. METHOD Relevant evaluations were extracted from bibliographic databases according to pre-specified criteria. Papers were analysed using QSR NVivo 11 by developing a narrative synthesis and analytic framework that identified and explored text addressing the research question. RESULTS Twenty-two studies were included. The review identified two broad components of effective health education: mechanisms and context. Mechanisms included embedded programme flexibility, appropriate and accessible resources, and motivational delivery. An effective context included an accessible and supportive environment and longer term opportunities for reinforcement of learning. CONCLUSIONS Important gaps in the literature highlighted a need for further research addressing community learning experiences of adults with intellectual disabilities as well as the effectiveness of infection prevention programmes.
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Abstract
Between 1% and 3% of persons in general population are estimated to have some degree of intellectual disability. A diagnosis of intellectual disability is based on clinical history, level of intellectual ability and level of adaptive function. Both, the intellectual and adaptive functioning are measured using individually administered standardized tests. More than 75% of persons who have intellectual disability have mild intellectual disability and an underlying specific etiology is less likely to be identified; whereas, in a small percentage of persons with severe intellectual disability, an underlying specific biologic cause is highly likely to be identified. Genetic abnormalities, inborn errors of metabolism and brain malformations are major categories of causes identified in severe to profound intellectual disability. The initial clinical presentation and recognition depends on the severity and underlying cause of intellectual disability. The etiology, severity, cognitive abilities, and adaptive function, vary among persons with intellectual disability and need consideration in developing a treatment plan. The physician plays an essential role in the evaluation, treatment of associated medical conditions and preventive care, and in facilitating and coordinating consultative services and community based care.
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Affiliation(s)
- Dilip R Patel
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Maria Demma Cabral
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Arlene Ho
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
| | - Joav Merrick
- Hadassah Hebrew University Medical Center, Jarusalem, Israel.,University of Kentucky, Lexington, USA.,School of Public Health, Georgia State University, Atlanta, USA
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Maine A, Brown MJ, Dickson A, Truesdale M. Pilot feasibility study of the Walking Away from Diabetes programme for adults with intellectual disabilities in two further education colleges: Process evaluation findings. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1034-1046. [PMID: 30941841 DOI: 10.1111/jar.12593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 02/11/2019] [Accepted: 02/27/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND People with intellectual disabilities remain at high risk of developing type 2 diabetes (T2D) due to lifestyle-associated risk factors. Educational programmes have been adapted for people with intellectual disabilities targeting ongoing T2D self-management. However, there are no adapted programmes which aim to prevent T2D through reducing risk factors. The present study initiates addressing this gap. METHODS Further education (FE) colleges in Scotland were recruited for feasibility study using the Walking Away (WA) from Diabetes programme. Process evaluation assessed recruitment, retention, baseline physical activity levels, and acceptability and accessibility using focus groups. RESULTS Ninety six percent of invited students agreed to participate. WA was positively received, and some short-term impact was described. Suggestions for further adaptations regarding materials, delivery and content were provided, including delivery embedded within FE college curriculum. CONCLUSIONS Recruitment, retention and acceptability provide rationale for further research on T2D prevention in FE colleges.
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Affiliation(s)
- Andrew Maine
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Michael J Brown
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Adele Dickson
- Glasgow Caledonian University School of Health and Life Sciences, Glasgow, UK
| | - Maria Truesdale
- Edinburgh Napier University School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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A school-based mentoring program developing healthy behaviors of adolescents with intellectual and developmental disabilities: A pilot feasibility study. Disabil Health J 2019; 12:727-731. [PMID: 30987820 DOI: 10.1016/j.dhjo.2019.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 03/22/2019] [Accepted: 03/27/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies have reported that adolescents with intellectual and developmental disabilities (IDD) have a higher prevalence of obesity due to medication intake, poor diet, and physical inactivity. More importantly, they lack awareness and comprehension to prevent weight problems. Thereby, health-promoting practices should be offered in schools for adolescents with IDD. OBJECTIVE/HYPOTHESIS This pilot study examined the feasibility of a school-based intervention using the I Can Do It! (ICDI) national health promotion model to promote healthy behaviors of adolescents with IDD. METHODS A pretest-posttest design was employed. Fourteen adolescents (9 males, 5 females) aged 12-15 years (mean = 13.4, SD = 0.9) from self-contained classrooms completed a 14-week intervention (60-70 min/session) over 4-month period. Healthy behaviors were evaluated by body composition (waist circumference and BMI z-score), physical activity level and nutrition behaviors. RESULTS Body composition did not change as a result of the intervention. The intervention increased the amount of time spent in physical activity, but not the frequency. In contrast, the children's water consumption did significantly increase after the intervention (d = 3.39). The amount of fruit and vegetables also significantly increased after the intervention, where only 7% reported eating these daily before the intervention and afterwards 86% reported eating fruits and vegetables daily (p < .0001). CONCLUSIONS The results demonstrate that it is feasible to conduct a goal-driven, mentor-based intervention in school for adolescents with IDD. While preliminary effectiveness results are promising, future research should focus on rigorously testing the effectiveness of the ICDI model and examining the programs long-term sustainability.
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Health Literacy and People with Intellectual Disabilities: What We Know, What We Do Not Know, and What We Need: A Theoretical Discourse. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030463. [PMID: 30764539 PMCID: PMC6388359 DOI: 10.3390/ijerph16030463] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/25/2019] [Accepted: 01/31/2019] [Indexed: 11/28/2022]
Abstract
Although health literacy is widely discussed and many heterogeneous conceptualizations exist, people with intellectual disabilities have remained largely unconsidered. The purpose of this conceptual paper is to analyze the particularities of this target group and discuss and consider implications that arise when conceptualizing the health literacy of people with intellectual disabilities. Therefore, we explore relevant approaches from multiple disciplines and examine their transferability to a conceptual understanding of health literacy for people with intellectual disabilities. For future directions we identified three main dimensions: (1) disentangle health literacy from empowerment; (2) apply a positive, asset-based focus to health literacy; and (3) focus on health literacy as a distributed resource across individuals and their individual life-world.
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Croot L, Rimmer M, Salway S, Hatton C, Dowse E, Lavin J, Bennett SE, Harris J, O'Cathain A. Adjusting a mainstream weight management intervention for people with intellectual disabilities: a user centred approach. Int J Equity Health 2018; 17:159. [PMID: 30348176 PMCID: PMC6198382 DOI: 10.1186/s12939-018-0871-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
Background People with intellectual disabilities (ID) may not be able to access and respond to uniformly delivered health interventions. Public bodies have a legal duty to make ‘reasonable adjustments’ to policies and practices to provide fair access and treatment for people with ID. This study aimed to identify adjustments to the Slimming World weight management programme to improve accessibility and assess acceptability and feasibility for this population. Methods This user-centred qualitative study was carried out with a steering group of people with ID (n = 4). Barriers and facilitators to using Slimming World were identified through interviews and focus groups with people with ID (n = 54), carers (n = 12) current members with ID (n = 8) and Slimming World group leaders (n = 11). Adjustments were made and their feasibility and acceptability were explored in a before-and-after mixed methods study where people with ID attended Slimming World for eight weeks. Participants (n = 9), carers (n = 7) and Slimming World group leaders (n = 4) were interviewed to explore their experiences of the adjustments. Participants were weighed at baseline then each week. Results Four key adjustments were identified and addressed by Slimming World who developed prototype Easy Read materials and a letter for carers. Six of the nine participants attended Slimming World for eight weeks and lost weight (1.4 kg to 6.6 kg, reduction in BMI between 0.5 and 1.7 kg/m2), indicating that the adjustments were feasible and acceptable. Two participants dropped out because they felt uncomfortable in a mainstream group and another left because they lacked control over food choice in their residential setting. Conclusions This user-centred approach identified reasonable adjustments that were feasible to implement. In a small uncontrolled feasibility study, people with ID were positive about the adjustments and lost weight. However, issues in the wider context of people’s lives, such as obesogenic environments and concerns about joining mainstream groups, limited the acceptability of Slimming World even with these adjustments. These findings have important implications for policy and suggest that environmental and organisational level interventions are needed alongside those targeting individual behaviour to tackle the obesogenic environment in which many people with ID spend their time, in order to reduce inequalities associated with the consequences of obesity.
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Affiliation(s)
- Liz Croot
- School of Health and Related Research, Sheffield University, Sheffield, UK.
| | - Melanie Rimmer
- School of Health and Related Research, Sheffield University, Sheffield, UK
| | - Sarah Salway
- School of Health and Related Research, Sheffield University, Sheffield, UK
| | - Chris Hatton
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Emma Dowse
- Slimming World Health and Research Team, Slimming World, Alfreton, UK
| | - Jacquie Lavin
- Slimming World Health and Research Team, Slimming World, Alfreton, UK
| | - Sarah E Bennett
- Slimming World Health and Research Team, Slimming World, Alfreton, UK
| | - Janet Harris
- School of Health and Related Research, Sheffield University, Sheffield, UK
| | - Alicia O'Cathain
- School of Health and Related Research, Sheffield University, Sheffield, UK
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16
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Sweileh WM, Wickramage K, Pottie K, Hui C, Roberts B, Sawalha AF, Zyoud SH. Bibliometric analysis of global migration health research in peer-reviewed literature (2000-2016). BMC Public Health 2018; 18:777. [PMID: 29925353 PMCID: PMC6011263 DOI: 10.1186/s12889-018-5689-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/11/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The health of migrants has become an important issue in global health and foreign policy. Assessing the current status of research activity and identifying gaps in global migration health (GMH) is an important step in mapping the evidence-base and on advocating health needs of migrants and mobile populations. The aim of this study was to analyze globally published peer-reviewed literature in GMH. METHODS A bibliometric analysis methodology was used. The Scopus database was used to retrieve documents in peer-reviewed journals in GMH for the study period from 2000 to 2016. A group of experts in GMH developed the needed keywords and validated the final search strategy. RESULTS The number of retrieved documents was 21,457. Approximately one third (6878; 32.1%) of the retrieved documents were published in the last three years of the study period. In total, 5451 (25.4%) documents were about refugees and asylum seekers, while 1328 (6.2%) were about migrant workers, 440 (2.1%) were about international students, 679 (3.2%) were about victims of human trafficking/smuggling, 26 (0.1%) were about patients' mobility across international borders, and the remaining documents were about unspecified categories of migrants. The majority of the retrieved documents (10,086; 47.0%) were in psychosocial and mental health domain, while 2945 (13.7%) documents were in infectious diseases, 6819 (31.8%) documents were in health policy and systems, 2759 (12.8%) documents were in maternal and reproductive health, and 1918 (8.9%) were in non-communicable diseases. The contribution of authors and institutions in Asian countries, Latin America, Africa, Middle East, and Eastern European countries was low. Literature in GMH represents the perspectives of high-income migrant destination countries. CONCLUSION Our heat map of research output shows that despite the ever-growing prominence of human mobility across the globe, and Sustainable Development Goals of leaving no one behind, research output on migrants' health is not consistent with the global migration pattern. A stronger evidence base is needed to enable authorities to make evidence-informed decisions on migration health policy and practice. Research collaboration and networks should be encouraged to prioritize research in GMH.
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Affiliation(s)
- Waleed M. Sweileh
- College of Medicine and Health Science, An-Najah National University, Nablus, Palestine
| | - Kolitha Wickramage
- International Organization for Migration, UN Migration Agency, Migration Health Division, Geneva, Switzerland
| | - Kevin Pottie
- Faculty of Medicine, University of Ottawa, Ottawa, CA Canada
| | - Charles Hui
- Faculty of Medicine, University of Ottawa, Ottawa, CA Canada
| | - Bayard Roberts
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ansam F. Sawalha
- College of Medicine and Health Science, An-Najah National University, Nablus, Palestine
| | - Saed H. Zyoud
- College of Medicine and Health Science, An-Najah National University, Nablus, Palestine
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17
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O'Leary L, Cooper S, Hughes‐McCormack L. Early death and causes of death of people with intellectual disabilities: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:325-342. [DOI: 10.1111/jar.12417] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Lisa O'Leary
- Institute of Health and Wellbeing College of Medical Veterinary and Life Sciences Mental Health and Wellbeing University of Glasgow Glasgow UK
| | - Sally‐Ann Cooper
- Institute of Health and Wellbeing College of Medical Veterinary and Life Sciences Mental Health and Wellbeing University of Glasgow Glasgow UK
| | - Laura Hughes‐McCormack
- Institute of Health and Wellbeing College of Medical Veterinary and Life Sciences Mental Health and Wellbeing University of Glasgow Glasgow UK
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18
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Steenbergen HA, Van der Schans CP, Van Wijck R, De Jong J, Waninge A. Lifestyle Approaches for People With Intellectual Disabilities: A Systematic Multiple Case Analysis. J Am Med Dir Assoc 2017; 18:980-987.e3. [PMID: 28757331 DOI: 10.1016/j.jamda.2017.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 06/07/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Health care organizations supporting individuals with intellectual disabilities (IDs) carry out a range of interventions to support and improve a healthy lifestyle. However, it is difficult to implement an active and healthy lifestyle into daily support. The presence of numerous intervention components, multiple levels of influence, and the explicit use of theory are factors that are considered to be essential for implementation in practice. A comprehensive written lifestyle policy provides for sustainability of a lifestyle approach. It is unknown to what extent these crucial factors for successful implementation are taken into consideration by health care organizations supporting this population. AIM To analyze the intervention components, levels of influence, explicit use of theory, and conditions for sustainability of currently used lifestyle interventions within lifestyle approaches aiming at physical activity and nutrition in health care organizations supporting people with ID. METHODS In this descriptive multiple case study of 9 health care organizations, qualitative data of the lifestyle approaches with accompanying interventions and their components were compiled with a newly developed online inventory form. RESULTS From 9 health care organizations, 59 interventions were included, of which 31% aimed to improve physical activity, 10% nutrition, and 59% a combination of both. Most (49%) interventions aimed at the educational component and less at daily (19%) and generic activities (16%) and the evaluation component (16%). Most interventions targeted individuals with ID and the professionals whereas social levels were underrepresented. Although 52% of the interventions were structurally embedded, only 10 of the 59 interventions were theory-driven. CONCLUSION Health care organizations could improve their lifestyle approaches by using an explicit theoretical basis by expanding the current focus of the interventions that primarily concentrate on their clients and professionals toward also targeting the social and external environment as well as the introduction of a written lifestyle policy. This policy should encompass all interventions and should be the responsibility of those in the organization working with individuals with ID. In conclusion, comprehensive, integrated, and theory-driven approaches at multiple levels should be promoted.
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Affiliation(s)
- Henderika Annegien Steenbergen
- Hanze University of Applied Sciences Groningen, Groningen, The Netherlands; Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Cees P Van der Schans
- 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
| | - Ruud Van Wijck
- Center of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johan De Jong
- Hanze University of Applied Sciences Groningen, School of Sport Studies, Groningen, The Netherlands
| | - Aly Waninge
- Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
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19
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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: 29] [Impact Index Per Article: 4.1] [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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