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St John L, Borschneck G, Volpe T, Thakur A, Lake J, Mallet H, Pereira V, Lunsky Y. The impact of a virtual wellness course for adults with intellectual and developmental disabilities in the third year of COVID-19. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241272508. [PMID: 39194174 DOI: 10.1177/17446295241272508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
The current study examines how a virtual wellness intervention may improve health outcomes in adults with intellectual and developmental disabilities. Thirty-six adults with intellectual and developmental disabilities participated in the wellness intervention. Outcome measures related to satisfaction, mental health, wellbeing, health behaviours and overall health were completed at three time points (pre, post and follow-up). Participants reported high levels of satisfaction and had significant improvements in outcomes related to mental health and wellbeing. Changes in sleep, sedentary behaviour and overall health were not reported, though qualitative evidence suggests that some changes were implemented. The study provides evidence to support the use of virtual interventions to address health concerns in individuals with intellectual and developmental disabilities.
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Affiliation(s)
- Laura St John
- Faculty of Kinesiology, University of Calgary, Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
| | - Gregory Borschneck
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
- School of Medicine, Queen's University, Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
| | - Anupam Thakur
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
| | - Johanna Lake
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
| | - Heidi Mallet
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
| | - Victor Pereira
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada
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Westrop SC, Rana D, Jaiswal N, Wu O, McGarty AM, Melville C, Ells L, Lally P, McEwan M, Harris L, Germeni E. Supporting active engagement of adults with intellectual disabilities in lifestyle modification interventions: a realist evidence synthesis of what works, for whom, in what context and why. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:293-316. [PMID: 38379511 DOI: 10.1111/jir.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/10/2023] [Accepted: 12/19/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Lifestyle modification interventions for adults with intellectual disabilities have had, to date, mixed effectiveness. This study aimed to understand how lifestyle modification interventions for adults with intellectual disabilities work, for whom they work and in what circumstances. METHODS A realist evidence synthesis was conducted that incorporated input from adults with intellectual disabilities and expert researchers. Following the development of an initial programme theory based on key literature and input from people with lived experience and academics working in this field, five major databases (MEDLINE, EMBASE, CINAHL, PsycINFO and ASSIA) and clinical trial repositories were systematically searched. Data from 79 studies were synthesised to develop context, mechanism and outcome configurations (CMOCs). RESULTS The contexts and mechanisms identified related to the ability of adults with intellectual disabilities to actively take part in the intervention, which in turn contributes to what works, for whom and in what circumstances. The included CMOCs related to support involvement, negotiating the balance between autonomy and behaviour change, fostering social connectedness and fun, accessibility and suitability of intervention strategies and delivery and broader behavioural pathways to lifestyle change. It is also essential to work with people with lived experiences when developing and evaluating interventions. CONCLUSIONS Future lifestyle interventions research should be participatory in nature, and accessible data collection methods should also be explored as a way of including people with severe and profound intellectual disabilities in research. More emphasis should be given to the broader benefits of lifestyle change, such as opportunities for social interaction and connectedness.
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Affiliation(s)
- S C Westrop
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - D Rana
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jaiswal
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - O Wu
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A M McGarty
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - C Melville
- Mental Health and Wellbeing, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - L Ells
- Obesity Institute, School of Health, Leeds Beckett University, City Campus, Leeds, UK
| | - P Lally
- UCL Institute of Epidemiology and Health Care, University College London, London, UK
- Department of Psychology, University of Surrey, Guildford, UK
| | - M McEwan
- People First (Scotland), Edinburgh, UK
| | - L Harris
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - E Germeni
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Oreskovic NM, Agiovlasitis S, Patsiogiannis V, Santoro SL, Nichols D, Skotko BG. Brief report: Caregiver perceived physical activity preferences of adults with Down syndrome. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:910-915. [PMID: 35106891 DOI: 10.1111/jar.12979] [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: 05/12/2021] [Revised: 11/08/2021] [Accepted: 01/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adults with Down syndrome commonly have low levels of physical activity and face social barriers to engaging in physical activity, including boredom and companionship concerns. Adults with Down syndrome are at increased risk for several co-occurring medial conditions known to benefit from physical activity, including obesity and dementia. METHOD This study surveyed 140 caregivers of adults with Down syndrome to determine the physical activity preferences of their adult with Down syndrome. RESULTS Dancing was the most frequently caregiver-reported physical activity preference for adults with Down syndrome, followed by walking and active video gaming. Rowing, using an elliptical machine, and jogging were the least preferred activities. Most caregivers reported that their adult with Down syndrome has a companion available for physical activity. CONCLUSION Promoting dance in adults with Down syndrome, a caregiver-reported preferred form of physical activity, may help improve physical activity levels and decrease sedentary behaviours in this population.
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Affiliation(s)
- Nicolas M Oreskovic
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Vasiliki Patsiogiannis
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Stephanie L Santoro
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Dominica Nichols
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brian G Skotko
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Neumeier WH, Guerra N, Hsieh K, Thirumalai M, Ervin D, Rimmer JH. POWERSforID: Personalized online weight and exercise response system for individuals with intellectual disability: A randomized controlled trial. Disabil Health J 2021; 14:101111. [PMID: 33965364 PMCID: PMC8448903 DOI: 10.1016/j.dhjo.2021.101111] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Obesity is associated with early mortality and chronic disease among adults with intellectual disability (ID), yet there is a paucity of effective weight management interventions for this population. OBJECTIVE/HYPOTHESIS This pilot study examined a tailored intervention on weight loss, waist circumference, A1c, and lipid profile among adults with ID. METHODS Obese adults (BMI ≥ 30 kg/m2) with mild to moderate ID were randomized to an intervention (n = 17) or comparison group (n = 18) for a 24-week trial. All participants completed health-related questionnaires and clinic visits. Participants in the intervention group received access to an online weight management platform that assisted them in monitoring their diet and physical activity along with weekly coaching calls (weeks 1-12) that were tapered off to calls every other week (weeks 12-24). The comparison group completed questionnaires and clinic visits, but did not receive access to the online platform or calls. Differences in weight, waist circumference, percent body fat, A1c, lipid profile were assessed at baseline and at week 24. RESULTS The intervention group reduced body weight by an average of 2.7% (-2.6 kg; p = 0.02) and waist circumference by 3.4% (-3.89 cm; p = 0.02) versus the comparison. There were no statistically significant group by time interactions observed among other variables. CONCLUSION Adults with ID who received the intervention were able to maintain or slightly reduce their body weight and waist circumference after the 24-week intervention. Despite not achieving the targeted sample size, the pilot study findings serve as a basis for developing accessible weight management interventions for people with ID.
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Affiliation(s)
- William H Neumeier
- University of Alabama at Birmingham | Lakeshore Foundation Research Collaborative, 331 School of Health Professions Bldg, 1705 University Blvd, Birmingham, AL, 35294-1212, USA.
| | - Nichole Guerra
- The Resource Exchange, 6385 Corporate Drive, Suite 301, Colorado Springs, CO, 80919, USA.
| | - Kelly Hsieh
- University of Illinois at Chicago, Department of Disability and Human Development, 1640 W. Roosevelt Rd., Suite 708, Chicago, IL, 60608, USA.
| | - Mohanraj Thirumalai
- University of Alabama at Birmingham | Lakeshore Foundation Research Collaborative, 331 School of Health Professions Bldg, 1705 University Blvd, Birmingham, AL, 35294-1212, USA
| | - David Ervin
- Jewish Foundation for Group Homes, 1500 East Jefferson Street, Rockville, MD, 20852, USA.
| | - James H Rimmer
- University of Alabama at Birmingham | Lakeshore Foundation Research Collaborative, 331 School of Health Professions Bldg, 1705 University Blvd, Birmingham, AL, 35294-1212, USA.
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Selick A, Bobbette N, Lunsky Y, Hamdani Y, Rayner J, Durbin J. Virtual health care for adult patients with intellectual and developmental disabilities: A scoping review. Disabil Health J 2021; 14:101132. [PMID: 34127406 PMCID: PMC9619129 DOI: 10.1016/j.dhjo.2021.101132] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/06/2022]
Abstract
Background The COVID-19 pandemic led to an abrupt shift to virtual health care for many patients, including adults with intellectual and developmental disabilities (IDD). Approaches to virtual care that are successful for people without IDD may need to be adapted for adults with IDD. Objective The aim of this scoping review was to examine what is known about virtual health care for adults with IDD and in particular, the impact of virtual delivery on access to care for this population. Methods A comprehensive search was conducted of the academic and grey literature. A two-stage screening process was conducted by two independent reviewers and a structured data extraction template was populated for each included study. Findings were analyzed thematically using Access to Care Framework domains. Results In total, 22 studies met inclusion criteria. The majority were published in the past three years and focused on specialized IDD services. A subset of 12 studies reported findings on access to care for adults with IDD. Participants generally reported high acceptability of virtual care, though some preferred face-to-face encounters. Initial results on effectiveness were positive, though limited by small sample sizes. Challenges included internet quality and technical skill or comfort. Conclusions This review suggests that it is possible to deliver accessible, high quality virtual care for adults with IDD, however, relatively little research has been conducted on this topic. Due to COVID-19 there is currently a unique opportunity and urgency to learn when and for whom virtual care can be successful and how it can be supported.
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Affiliation(s)
- Avra Selick
- University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3K1, Canada; Centre for Addiction and Mental Health, 1001 Queen St, Toronto, ON, M6J 1H1, Canada.
| | - Nicole Bobbette
- Centre for Addiction and Mental Health, 1001 Queen St, Toronto, ON, M6J 1H1, Canada; Queen's University, 99 University Ave, Kingston, ON, K7L 3N6, Canada
| | - Yona Lunsky
- University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3K1, Canada; Centre for Addiction and Mental Health, 1001 Queen St, Toronto, ON, M6J 1H1, Canada
| | - Yani Hamdani
- University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3K1, Canada; Centre for Addiction and Mental Health, 1001 Queen St, Toronto, ON, M6J 1H1, Canada
| | - Jennifer Rayner
- University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3K1, Canada
| | - Janet Durbin
- University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3K1, Canada; Centre for Addiction and Mental Health, 1001 Queen St, Toronto, ON, M6J 1H1, Canada
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