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Misaghian K, Lugo JE, Faubert J. Immediate fall prevention: the missing key to a comprehensive solution for falling hazard in older adults. Front Aging Neurosci 2024; 16:1348712. [PMID: 38638191 PMCID: PMC11024377 DOI: 10.3389/fnagi.2024.1348712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
The world is witnessing an unprecedented demographic shift due to increased life expectancy and declining birth rates. By 2050, 20% of the global population will be over 60, presenting significant challenges like a shortage of caregivers, maintaining health and independence, and funding extended retirement. The technology that caters to the needs of older adults and their caregivers is the most promising candidate to tackle these issues. Although multiple companies and startups offer various aging solutions, preventive technology, which could prevent trauma, is not a big part of it. Trauma is the leading cause of morbidity, disability, and mortality in older adults, and statistics constitute traumatic fall accidents as its leading cause. Therefore, an immediate preventive technology that anticipates an accident on time and prevents it must be the first response to this hazard category to decrease the gap between life expectancy and the health/wellness expectancy of older adults. The article outlines the challenges of the upcoming aging crisis and introduces falls as one major challenge. After that, falls and their mechanisms are investigated, highlighting the cognitive functions and their relation to falls. Moreover, since understanding predictive cognitive mechanisms is critical to an effective prediction-interception design, they are discussed in more detail, signifying the role of cognitive decline in balance maintenance. Furthermore, the landscape of available solutions for falling and its shortcomings is inspected. Finally, immediate fall prevention, the missing part of a wholesome solution, and its barriers are introduced, and some promising methodologies are proposed.
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Affiliation(s)
- Khashayar Misaghian
- Sage-Sentinel Smart Solutions, Kunigami-gun, Okinawa, Japan
- OIST Innovation, Okinawa Institute of Science and Technology Graduate University, Onna, Okinawa, Japan
- Faubert Lab, School of Optometry, Université de Montréal, Montreal, QC, Canada
| | - Jesus Eduardo Lugo
- Sage-Sentinel Smart Solutions, Kunigami-gun, Okinawa, Japan
- Faubert Lab, School of Optometry, Université de Montréal, Montreal, QC, Canada
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Jocelyn Faubert
- Sage-Sentinel Smart Solutions, Kunigami-gun, Okinawa, Japan
- Faubert Lab, School of Optometry, Université de Montréal, Montreal, QC, 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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Valentin B, Maes-Festen D, Schoufour J, Oppewal A. Sarcopenia predicts 5-year mortality in older adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1161-1173. [PMID: 37608512 DOI: 10.1111/jir.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/06/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) have a lower life expectancy than their peers without ID. A contributing factor to the lower life expectancy and early mortality could be sarcopenia: low muscle mass and low muscle function. In the general population, sarcopenia strongly predicts early mortality, but this association is unknown in people with ID. Therefore, this study aims to explore the association between sarcopenia and 5-year mortality in older adults with ID. METHODS In the Healthy Ageing and Intellectual Disabilities (HA-ID) study, the prevalence of sarcopenia was measured at baseline among 884 older adults (≥50 years) with ID. All-cause mortality was measured over a 5-year follow-up period. Univariable and multivariable Cox proportional hazard models were applied to determine the association between sarcopenia (no sarcopenia, pre-sarcopenia, sarcopenia, severe sarcopenia) and early mortality, adjusted for age, sex, level of ID, presence of Down syndrome, and co-morbidity (chronic obstructive pulmonary disease, diabetes type 2 and metabolic syndrome). RESULTS The unadjusted hazard ratio (HR) for sarcopenia was 2.28 [95% confidence interval (CI) 1.48-3.42], P < 0.001), and 2.40 (95% CI 1.40-4.10, P = 0.001) for severe sarcopenia. When adjusted for age, sex, level of ID, and Down syndrome, sarcopenia (HR = 1.72, 95% CI 1.08-2.75, P = 0.022) and severe sarcopenia (HR = 1.86, 95% CI 1.07-3.23, P = 0.028) were significantly associated with early mortality. When additionally adjusted for co-morbidity, the adjusted HR decreased to 1.62 (95% CI 1.02-2.59, P = 0.043) and 1.81 (95% CI 1.04-3.15, P = 0.035) for sarcopenia and severe sarcopenia, respectively. CONCLUSION Sarcopenia is an independent risk factor for early mortality in older adults with ID over a 5-year follow-up period. Our results stress the need to delay the incidence and development of sarcopenia in older adults with ID.
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Affiliation(s)
- B Valentin
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Faculty of Sports and Nutrition, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - D Maes-Festen
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J Schoufour
- Faculty of Sports and Nutrition, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - A Oppewal
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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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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Jung J, Park S, Lee CG. How disability severity is associated with changes in physical activity and inactivity from adolescence to young adulthood. Arch Public Health 2023; 81:29. [PMID: 36810126 PMCID: PMC9942288 DOI: 10.1186/s13690-023-01043-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Disabilities may play a different role in determining people's physical activity (PA) and physical inactivity (PI) levels when they go through multiple lifetime transitions (e.g., graduation, marriage) between adolescence and young adulthood. This study investigates how disability severity is associated with changes in PA and PI engagement levels, focusing on adolescence and young adulthood, when the patterns of PA and PI are usually formed. METHODS The study employed data from Waves 1 (adolescence) and 4 (young adulthood) of the National Longitudinal Study of Adolescent Health, which covers a total of 15,701 subjects. We first categorized subjects into 4 disability groups: no, minimal, mild, or moderate/severe disability and/or limitation. We then calculated the differences in PA and PI engagement levels between Waves 1 and 4 at the individual level to measure how much the PA and PI levels of individuals changed between adolescence and young adulthood. Finally, we used two separate multinomial logistic regression models for PA and PI to investigate the relationships between disability severity and the changes in PA and PI engagement levels between the two periods after controlling for multiple demographic (age, race, sex) and socioeconomic (household income level, education level) variables. RESULTS We showed that individuals with minimal disabilities were more likely to decrease their PA levels during transitions from adolescence to young adulthood than those without disabilities. Our findings also revealed that individuals with moderate to severe disabilities tended to have higher PI levels than individuals without disabilities when they were young adults. Furthermore, we found that people above the poverty level were more likely to increase their PA levels to a certain degree compared to people in the group below or near the poverty level. CONCLUSIONS Our study partially indicates that individuals with disabilities are more vulnerable to unhealthy lifestyles due to a lack of PA engagement and increased PI time compared to people without disabilities. We recommend that health agencies at the state and federal levels allocate more resources for individuals with disabilities to mitigate health disparities between those with and without disabilities.
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Affiliation(s)
- Jihoon Jung
- grid.10698.360000000122483208Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Seungyeon Park
- Department of Health, Physical Education & Exercise Science, Norfolk State University, Norfolk, VA, USA.
| | - Chung Gun Lee
- grid.31501.360000 0004 0470 5905Department of Physical Education, Seoul National University, Seoul, South Korea
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Choi P, Motl RW, Agiovlasitis S. Feasibility of social cognitive theory-based fall prevention intervention for people with intellectual disabilities living in group-home. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:159-171. [PMID: 36530049 DOI: 10.1111/jir.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adults with intellectual disability (ID) have a higher rate of fall events than the general population. Consequently, interventions for reducing fall events and improving health are highly required for individuals with ID. One essential step towards effectively delivering fall prevention interventions among adults with ID involves evaluating their feasibility. This study examined the feasibility of a home-based exercise intervention, supplemented with behavioural change strategies, among individuals with ID living in residential settings. METHOD This study provided an 8-week intervention, consisting of a workshop for support workers and sessions for participants with ID, focusing on behavioural reward/s, education regarding fall prevention/exercise and exercise training. One week prior to and 1 week following such an intervention, such participants underwent measurements for (1) physical performance, (2) fall efficacy, (3) self-efficacy for activity and (4) social support. RESULTS Participants having ID (n = 33), support workers (n = 11) and one administrator participated in this study. There were no adverse events during the intervention, and the mean adherence rate was 70.8 ± 19.5%. Two participants with ID dropped out of the programme due to a lack of interest. The participants with ID significantly improved individual physical performance, self-efficacy for activity, fall efficacy and support from friends and support workers. CONCLUSIONS Fall prevention interventions for adults with ID living in group-homes were highly promising for eventual large-scale implementation within such communities.
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Affiliation(s)
- P Choi
- Department of Kinesiology, Sonoma State University, Rohnert Park, CA, USA
| | - R W Motl
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA
| | - S Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
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Accessible Guide for People With Intellectual Disabilities in a Fitness Environment: A Delphi Study. Adapt Phys Activ Q 2023; 40:38-62. [PMID: 36084929 DOI: 10.1123/apaq.2022-0036] [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: 03/09/2022] [Revised: 07/05/2022] [Accepted: 07/18/2022] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study was to draw consensus among an expert panel regarding essential elements of an accessible fitness center guide for people with intellectual disabilities that will enable them to engage in physical activity fully and effectively. The study was situated in the socioecological model of disability. Researchers drew expert consensus regarding the essential features of accessible guides in fitness environments. A three-round Delphi procedure was used, involving repeated circulation of the questionnaire to an expert panel (N = 33). The panel was asked to rate the importance and adequacy of 66 items regarding the accessible fitness guide. A consensus was reached regarding 43 items after three rounds. The items include 7 body-weight exercises, 2 machine exercises, 12 environment-related items, 15 exercise preparations, 4 social etiquettes, and 3 emergencies.
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Ferreira JP, Matos R, Campos MJ, Monteiro D, Antunes R, Jacinto M. Effects of Physical Exercise Program in Adults with Intellectual and Developmental Disabilities-A Study Protocol. J Clin Med 2022; 11:jcm11247485. [PMID: 36556101 PMCID: PMC9786148 DOI: 10.3390/jcm11247485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
We developed a physical exercise (PE) program for people with Intellectual and Developmental Disabilities (IDD), aiming to determine the effects on physical fitness, health, cognitive ability, and quality of life (QoL). Using experimental methodology, this intervention study recruited 21 adults (18 to 65 years old), institutionalized and with no other associated pathology, who will be allocated to one of the different groups: (i) gym/indoor intervention group (using weight machines), (ii) outdoor intervention group (using low-cost materials), or (iii) control group (without specific intervention, who continue with their normal daily activities). Both intervention groups will engage in 45 min of training per session, twice a week, for 24 weeks. Assessments will be conducted at baseline (initial assessment), 3 months (mid-term assessment), and 6 months (final assessment). Variables assessed include anthropometrics, body composition, functional capacity, muscle strength, general health, cognitive ability, and QoL. The results of this study will assist in the development of more effective strategies, recommendations, and interventions to ensure better and greater adherence to PE by institutionalized individuals with IDD, namely, recommendations for assessment, prescription, and implementation of PE for this population. Additionally, we intend to make available two PE programs, if they are adapted and promote positive effects.
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Affiliation(s)
- José Pedro Ferreira
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal
| | - Rui Matos
- ESECS–Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
| | - Maria João Campos
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), 3040-248 Coimbra, Portugal
| | - Diogo Monteiro
- ESECS–Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Correspondence:
| | - Raul Antunes
- ESECS–Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Miguel Jacinto
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-248 Coimbra, Portugal
- ESECS–Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
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Boucher TQ, McIntyre CL, Iarocci G. Facilitators and Barriers to Physical Activity Involvement as Described by Autistic Youth with Mild Intellectual Disability. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:1-13. [PMID: 36532952 PMCID: PMC9742026 DOI: 10.1007/s41252-022-00310-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Objectives Physical activity involvement among autistic youth and youth with an intellectual disability is significantly lower than the general population. Few studies have included youth with comorbid diagnoses of ASD and intellectual disability. Fewer studies collect information from the youth themselves. This study examined barriers and facilitators to physical activity in autistic youth with mild intellectual disability using semi-structured interviews with youth and through caregiver reports. Methods Fourteen caregivers and their children ages 8 to 16 years old participated. Caregivers completed a questionnaire about their thoughts on their child's physical activity while their children completed the semi-structured interview. A descriptive phenomenological approach was followed. Results Four themes were inductively identified: intrapersonal barriers (factors that are within the person which impede physical activity involvement, such as exhibiting challenging behaviors that inhibit engagement), interpersonal barriers (factors external to the person, such as lack of community support), intrapersonal facilitators (factors within the person that enhance physical activity involvement, such as being intrinsically motivated to improve skills), and interpersonal facilitators (external factors such as supports from caregivers). Conclusions Interviewing youth is important to capture a holistic picture of factors influencing physical activity. Future research may focus on implementing and assessing the efficacy of strategies to address the barriers facing youth diagnosed with ASD and intellectual disability. Supplementary Information The online version contains supplementary material available at 10.1007/s41252-022-00310-5.
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Affiliation(s)
- Troy Q. Boucher
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6 Canada
| | - Cassia L. McIntyre
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6 Canada
| | - Grace Iarocci
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6 Canada
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Giummarra MJ, Randjelovic I, O’Brien L. Interventions for social and community participation for adults with intellectual disability, psychosocial disability or on the autism spectrum: An umbrella systematic review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:935473. [PMID: 36189003 PMCID: PMC9397886 DOI: 10.3389/fresc.2022.935473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022]
Abstract
ObjectiveThis umbrella systematic review examined the effectiveness, facilitators, and barriers of interventions for social, community and civic participation for adults on the autism spectrum, or with intellectual or psychosocial disability.Data SourcesEight databases were searched to identify eligible reviews defined by the: Sample (≥50% adults on the autism spectrum or with intellectual or psychosocial disability), Phenomena of Interest (interventions in community settings that aimed to improve social, community or civic participation, or capacity to participate), Design (any), Evaluation (any method that evaluated impacts on participation or capacity to participate), and Research type (reviews as journal articles, dissertations or in grey literature, in English, published 2010-2020).Review MethodsRapid review methods were used. One researcher screened 27,890 records and 788 potentially eligible full texts. A second reviewer independently screened 20% of records, and ambiguous full text publications. Study quality was extracted, and review quality was assessed with the Assessing Methodological Quality of Systematic Reviews (AMSTAR) checklist. Data from 522 studies in 57 eligible systematic reviews were extracted for narrative synthesis. The Corrected Covered Area (CCA) was calculated to indicate overlap between reviews.ResultsThere was a pooled sample of 28,154 study participants, predominantly from studies in North America, the UK and Europe. There was very low overlap between reviews (CCA = 0.3%). Reviews were predominantly low quality: 77.2% of reviews met <50% of AMSTAR criteria. Most studies were low (45.4%) or moderate (38.3%) quality. Three broad intervention categories improved participation, inclusion and belonging outcomes: (1) interventions to help people identify and connect with participation opportunities (e.g., person centred planning); (2) participation opportunities or activities (e.g., joining a community group, sports or outdoor activities, or arts-based activities); and (3) supports to build skills and capacity to participate socially and in the community.ConclusionsThe evidence highlighted that improved social and community participation requires purposeful strategies that identify meaningful participation preferences (e.g., where, when, how, and with whom) and provide support to build capacity or enable ongoing participation. Community capacity building, peer support and advocacy may also be needed to make the community more accessible, and to enable people to exercise genuine choice.
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Affiliation(s)
- Melita J. Giummarra
- Research and Evaluation Branch, Digital Design and Strategy Division, National Disability Insurance Agency, Melbourne Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Correspondence: Melita J. Giummarra
| | - Ivana Randjelovic
- Research and Evaluation Branch, Digital Design and Strategy Division, National Disability Insurance Agency, Melbourne Victoria, Australia
| | - Lisa O’Brien
- Research and Evaluation Branch, Digital Design and Strategy Division, National Disability Insurance Agency, Melbourne Victoria, Australia
- Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Bevilacqua R, Benadduci M, Bonfigli AR, Riccardi GR, Melone G, La Forgia A, Macchiarulo N, Rossetti L, Marzorati M, Rizzo G, Di Bitonto P, Potenza A, Fiorini L, Cortellessa Loizzo FG, La Viola C, Cavallo F, Leone A, Rescio G, Caroppo A, Manni A, Cesta A, Cortellessa G, Fracasso F, Orlandini A, Umbrico A, Rossi L, Maranesi E. Dancing With Parkinson's Disease: The SI-ROBOTICS Study Protocol. Front Public Health 2022; 9:780098. [PMID: 34993171 PMCID: PMC8724049 DOI: 10.3389/fpubh.2021.780098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/15/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction: Parkinson's disease (PD) is one of the most frequent causes of disability among older people, characterized by motor disorders, rigidity, and balance problems. Recently, dance has started to be considered an effective exercise for people with PD. In particular, Irish dancing, along with tango and different forms of modern dance, may be a valid strategy to motivate people with PD to perform physical activity. The present protocol aims to implement and evaluate a rehabilitation program based on a new system called “SI-ROBOTICS,” composed of multiple technological components, such as a social robotic platform embedded with an artificial vision setting, a dance-based game, environmental and wearable sensors, and an advanced AI reasoner module. Methods and Analysis: For this study, 20 patients with PD will be recruited. Sixteen therapy sessions of 50 min will be conducted (two training sessions per week, for 8 weeks), involving two patients at a time. Evaluation will be primarily focused on the acceptability of the SI-ROBOTICS system. Moreover, the analysis of the impact on the patients' functional status, gait, balance, fear of falling, cardio-respiratory performance, motor symptoms related to PD, and quality of life, will be considered as secondary outcomes. The trial will start in November 2021 and is expected to end by April 2022. Discussions: The study aims to propose and evaluate a new approach in PD rehabilitation, focused on the use of Irish dancing, together with a new technological system focused on helping the patient perform the dance steps and on collecting kinematic and performance parameters used both by the physiotherapist (for the evaluation and planning of the subsequent sessions) and by the system (to outline the levels of difficulty of the exercise). Ethics and Dissemination: The study was approved by the Ethics Committee of the IRCCS INRCA. It was recorded in ClinicalTrials.gov on the number NCT05005208. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.
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Affiliation(s)
| | | | | | | | - Giovanni Melone
- Innovation Lab, Innovation, Marketing and Technology, Exprivia S.p.A., Molfetta, Italy
| | - Angela La Forgia
- Innovation Lab, Innovation, Marketing and Technology, Exprivia S.p.A., Molfetta, Italy
| | - Nicola Macchiarulo
- Innovation Lab, Innovation, Marketing and Technology, Exprivia S.p.A., Molfetta, Italy
| | - Luca Rossetti
- Innovation Lab, Innovation, Marketing and Technology, Exprivia S.p.A., Molfetta, Italy
| | - Mauro Marzorati
- Consiglio Nazionale delle Ricerche, Istituto di Tecnologie Biomediche, Milan, Italy
| | - Giovanna Rizzo
- Consiglio Nazionale delle Ricerche, Istituto di Tecnologie Biomediche, Milan, Italy
| | | | | | - Laura Fiorini
- Dipartimento Ingegneria Industriale, Università degli Studi di Firenze, Firenze, Italy
| | | | - Carlo La Viola
- Dipartimento Ingegneria Industriale, Università degli Studi di Firenze, Firenze, Italy.,Istituto di BioRobotica, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Filippo Cavallo
- Dipartimento Ingegneria Industriale, Università degli Studi di Firenze, Firenze, Italy.,Istituto di BioRobotica, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Alessandro Leone
- Consiglio Nazionale delle Ricerche, Istituto per la Microelettronica e i Microsistemi, Lecce, Italy
| | - Gabriele Rescio
- Consiglio Nazionale delle Ricerche, Istituto per la Microelettronica e i Microsistemi, Lecce, Italy
| | - Andrea Caroppo
- Consiglio Nazionale delle Ricerche, Istituto per la Microelettronica e i Microsistemi, Lecce, Italy
| | - Andrea Manni
- Consiglio Nazionale delle Ricerche, Istituto per la Microelettronica e i Microsistemi, Lecce, Italy
| | - Amedeo Cesta
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy
| | - Gabriella Cortellessa
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy
| | - Francesca Fracasso
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy
| | - Andrea Orlandini
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy
| | - Alessandro Umbrico
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie della Cognizione, Rome, Italy
| | - Lorena Rossi
- Scientific Direction, IRCCS INRCA, Ancona, Italy
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12
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Martinez-Millana A, Michalsen H, Berg V, Anke A, Gil Martinez S, Muzny M, Torrado Vidal JC, Gomez J, Traver V, Jaccheri L, Hartvigsen G. Motivating Physical Activity for Individuals with Intellectual Disability through Indoor Bike Cycling and Exergaming. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052914. [PMID: 35270607 PMCID: PMC8909948 DOI: 10.3390/ijerph19052914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023]
Abstract
People with intellectual disabilities have more sedentary lifestyles than the general population. Regular physical activity is of both medical and social importance, reducing the risk of cardiovascular disease and promoting functioning in everyday life. Exergames have been envisioned for promoting physical activity; however, most of them are not user-friendly for individuals with intellectual disabilities. In this paper, we report the design, development, and user acceptance of a mobile health solution connected to sensors to motivate physical activity. The system is mounted on an indoor stationary bicycle and an ergometer bike tailored for people with intellectual disabilities. The development process involved the application of user-centered design principles to customize the system for this group. The system was pilot-tested in an institutional house involving six end-users (intervention group) and demonstrated/self-tested to relatives of persons with ID and staff (supervision group). A System Usability Scale and open-ended interview in the supervision group were used to assess the user acceptance and perceived usefulness. Results indicate that the users with an intellectual disability enjoyed using the system, and that respondents believed it was a useful tool to promote physical activity for the users at the institution. The results of this study provide valuable information on beneficial technological interventions to promote regular physical activity for individuals with intellectual disabilities.
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Affiliation(s)
- Antonio Martinez-Millana
- Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, 46022 Valencia, Spain;
- Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, 9019 Tromsø, Norway; (H.M.); (V.B.); (A.A.); (M.M.); (G.H.)
- Correspondence:
| | - Henriette Michalsen
- Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, 9019 Tromsø, Norway; (H.M.); (V.B.); (A.A.); (M.M.); (G.H.)
- Department of Rehabilitation, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Valter Berg
- Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, 9019 Tromsø, Norway; (H.M.); (V.B.); (A.A.); (M.M.); (G.H.)
| | - Audny Anke
- Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, 9019 Tromsø, Norway; (H.M.); (V.B.); (A.A.); (M.M.); (G.H.)
- Department of Rehabilitation, University Hospital of North Norway, 9038 Tromsø, Norway
| | | | - Miroslav Muzny
- Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, 9019 Tromsø, Norway; (H.M.); (V.B.); (A.A.); (M.M.); (G.H.)
- Department of Rehabilitation, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Juan Carlos Torrado Vidal
- Department of Computer Science, Norwegian University of Science and Technology, 7491 Trondheim, Norway; (J.C.T.V.); (L.J.)
| | - Javier Gomez
- Departamento de Ingeniería Informática, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
| | - Vicente Traver
- Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, 46022 Valencia, Spain;
| | - Letizia Jaccheri
- Department of Computer Science, Norwegian University of Science and Technology, 7491 Trondheim, Norway; (J.C.T.V.); (L.J.)
| | - Gunnar Hartvigsen
- Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, 9019 Tromsø, Norway; (H.M.); (V.B.); (A.A.); (M.M.); (G.H.)
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13
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Pans M, Úbeda-Colomer J, Monforte J, Devís-Devís J. Physical Activity and Accomplishment of Recommendations in University Students with Disabilities: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115540. [PMID: 34067266 PMCID: PMC8196807 DOI: 10.3390/ijerph18115540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 11/20/2022]
Abstract
University settings are socio-environmental contexts that can reduce health disparities in students with disabilities. Therefore, the aim of this study was twofold: (a) to examine the longitudinal physical activity (PA) changes of Spanish university students with disabilities during a three-year period; and (b) to identify the accomplishment of the World Health Organization’s PA recommendations in this period. A three-year follow-up cohort study was conducted on 355 university students with disabilities (172 men, 183 women). The participants completed an electronic survey on PA after which a descriptive analysis, longitudinal (Wilcoxon tests) and cross-sectional pairwise comparisons (Mann–Whitney U and Kruskal–Wallis tests) were performed on non-normal data. The results show no significant PA changes during the three-year period. The cross-sectional comparisons between the waves presented a reduction in vigorous PA according to sex and similar values by age, origin of disability, and socioeconomic status. A global reduction of 0.6% was found in achieving the recommendations between the waves. We also found an increase of 5.3% in the participants classified as overweight–obese during this period. The findings offered in this study have important implications for university disability care services and sports services. University policies should focus on rethinking PA and sports programs for students with disabilities.
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Affiliation(s)
- Miquel Pans
- AFES Research Group, Departament d’Educació Física i Esportiva, FCAFE, Universitat de València, 46010 València, Spain; (M.P.); (J.Ú.-C.); (J.D.-D.)
| | - Joan Úbeda-Colomer
- AFES Research Group, Departament d’Educació Física i Esportiva, FCAFE, Universitat de València, 46010 València, Spain; (M.P.); (J.Ú.-C.); (J.D.-D.)
| | - Javier Monforte
- Department of Sport and Exercise Sciences, Durham University, 42 Old Elvet, Durham DH1 3HN, UK
- Correspondence:
| | - José Devís-Devís
- AFES Research Group, Departament d’Educació Física i Esportiva, FCAFE, Universitat de València, 46010 València, Spain; (M.P.); (J.Ú.-C.); (J.D.-D.)
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14
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Obrusnikova I, Firkin CJ, Cavalier AR, Suminski RR. Effects of resistance training interventions on muscular strength in adults with intellectual disability: a systematic review and meta-analysis. Disabil Rehabil 2021; 44:4549-4562. [PMID: 33870804 DOI: 10.1080/09638288.2021.1910738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Muscular strength is critical for adults with an intellectual disability (ID) to promote their mobility, cardiovascular capacity, and performance of daily living/recreational/vocational activities. This article reports the results of the first systematic review and meta-analysis of peer-reviewed clinical trials that evaluated the effects of resistance training (RT) interventions on muscular strength in adults with ID. METHODS The protocol was registered with PROSPERO (CRD42020184905). The review focuses on clinical trials that recorded quantitative measures of maximum muscular strength. Eleven electronic databases were searched from their earliest available record up to May 2020. After screening 1996 search records, 11 clinical trials were reviewed. RESULTS The RT interventions, while heterogeneous, had an overall significant (p ≤ 0.05) effect on muscular strength in adults with ID, ages 25-58 years. The findings were more significant and less heterogeneous for non-combined RT interventions than for interventions that combined RT exercises with aerobic or balance exercises. The TESTEX overall score was 8.3 ± 3.6. CONCLUSIONS RT interventions (particularly when not combined with other exercises) are effective in promoting muscular strength in adults with ID. The limited number of studies and the low study quality scores indicate a potential risk of bias, which limits the interpretation of the findings and warrants further investigation.IMPLICATIONS FOR REHABILITATIONMuscular strength is critical for adults with an intellectual disability (ID) to promote their mobility, cardiovascular capacity, and performance of daily living/recreational/vocational activities.RT interventions are an effective means of improving muscular strength in adults with ID, especially when not combined with other forms of exercise.Testing and assessment protocols used in RT programs should be individualized for adults with ID to accommodate their characteristics and should be implemented under conditions similar to those experienced during the training regimen.It is important to implement familiarization sessions before carrying out muscular strength testing or initiating an RT program to ensure safety, accuracy, and effectiveness of the program for adults with ID.
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Affiliation(s)
- Iva Obrusnikova
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, USA
| | - Cora J Firkin
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, USA
| | | | - Richard R Suminski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, USA
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15
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Vancampfort D, Van Damme T, Firth J, Stubbs B, Schuch F, Suetani S, Arkesteyn A, Van Biesen D. Physical activity correlates in children and adolescents, adults, and older adults with an intellectual disability: a systematic review. Disabil Rehabil 2021; 44:4189-4200. [PMID: 33861676 DOI: 10.1080/09638288.2021.1909665] [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] [Indexed: 01/22/2023]
Abstract
PURPOSE Understanding enablers of and barriers for physical activity (PA) participation in people with intellectual disability (ID) is an essential first step to develop effective interventions. This systematic review examined correlates of PA across the socio-ecological model (i.e., intra-personal, inter-personal, environmental and policy level) in people with ID across the lifespan. MATERIAL AND METHODS Major electronic databases were searched from inception until 15 February 2021. Keywords included "physical activity" or "exercise" and "intellectual disability" or "mental retardation." A summary coding was used to analyze the data for adolescents (<18 years), adults (18 < 50 years), and older adults (50≤ years). RESULTS Out of 83 PA correlates, retrieved from 39 studies (n = 26,456), only three consistent (i.e., reported in four or more studies) correlates were identified. In adults, older age (7/11, 64%), more severe ID (9/9, 100%) and the presence of physical mobility problems (3/4, 75%) were associated with decreased PA. From 38 correlates identified, no consistent correlates were identified for children and adolescents and older people. CONCLUSIONS Despite the abundance of evidence of the PA benefits for people with ID, we only found consistent evidence for three correlates reliably being related to PA in adults with ID. More research, particularly among young and older people is urgently needed.IMPLICATIONS FOR REHABILITATIONMore severe intellectual disability is an important barrier for being active in adults with intellectual disability.Presence of physical health problems is an important barrier for being active in adults with intellectual disability.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK.,NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, Wacol, Australia.,Queensland Brain Institute, The University of Queensland, St Lucia, Australia.,School of Medicine, Griffith University, Nathan, Australia
| | - Anke Arkesteyn
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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16
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Roldan A, Reina R. Are Self-Efficacy Gains of University Students in Adapted Physical Activity Influenced by Online Teaching Derived From the COVID-19 Pandemic? Front Psychol 2021; 12:654157. [PMID: 33897564 PMCID: PMC8062798 DOI: 10.3389/fpsyg.2021.654157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
Due to the lockdown caused by the COVID-19 pandemic, e-learning suddenly spread to different levels of education, including university. In Spain, students of sports sciences are prepared during a 4-year study program to work in different areas (including physical education) and with different populations (including people with disabilities). The aims of this study were (1) to assess the effect of pandemic-driven online teaching on self-efficacy (SE) for the inclusion of people with disabilities in a group of university students enrolled in a compulsory course on adapted physical activity (APA); (2) compare the gains from SE before and after the APA course with a sample of students who followed the same course before the pandemic; and (3) explore the influence on SE scores according to three demographic variables: gender, previous SE training, and previous experience with people with disabilities. The study involved a sample of 124 university students (22.1 ± 2.6 years), distributed into two groups: prepandemic (n = 86) and pandemic (n = 38). They voluntarily completed the Spanish version of the Scale of Self-Efficacy of Physical Education Teachers of Physical Education toward Children with Disabilities, obtaining pre- and postcourse measurements. Due to the sudden lockdown, two-thirds of the pandemic course was taught online, and changes in the teaching strategies and tasks had to be made. Similar gains were obtained in both groups for the three subscales of the SE scale (p < 0.001, large effect sizes): intellectual, physical, and visual disability. No significant differences were found for comparisons between groups and the interaction effect of the course taught, nor for the three demographic co-variables. This study shows that teaching strategies that encourage student participation and reflections on learning increase student SE, regardless of the teaching format (i.e., face-to-face vs. online teaching). Moreover, the gains in SE are invariable to demographic co-variables.
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Affiliation(s)
- Alba Roldan
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University, Elche, Spain
| | - Raul Reina
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University, Elche, Spain
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17
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Boot FH, Kahonde C, Dinsmore J, MacLachlan M. Perspectives on access and usage of assistive technology by people with intellectual disabilities in the Western Cape province of South Africa: Where to from here? Afr J Disabil 2021; 10:767. [PMID: 33824859 PMCID: PMC8007997 DOI: 10.4102/ajod.v10i0.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 11/26/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Whilst assistive technology (AT) can play an important role to improve quality of life, health inequity regarding access to appropriate AT for people with intellectual disabilities (ID) is still very much present especially in low resource countries. OBJECTIVES This study focused on exploring factors that influence access to and continued use of AT by people with ID in the Western Cape province of South Africa and to suggest potential implications of these findings and actions required to promote access to AT. METHOD A qualitative approach was used to explore the experiences of people with ID and providers of AT. Face-to-face interviews with 20 adults with mild to profound ID, and 17 providers of AT were conducted and the data were analysed thematically. RESULTS People with ID within the study setting faced many challenges when trying to access AT and for those who managed to acquire AT, its continued usage was influenced by both personal characteristics of the user and environmental factors. Important factors that influence AT access and use for people with ID found in this study were (1) attitudes from the community, (2) knowledge and awareness to identify AT need and (3) AT training and instructions to support the user and care network. CONCLUSION With the perspectives of both the providers and users of AT, this study identified priority factors, which could be addressed to improve AT access and use for people with ID in the Western Cape province.
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Affiliation(s)
- Fleur H Boot
- Department of Primary and Community Care, Faculty of Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
- Assisting Living and Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Callista Kahonde
- Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - John Dinsmore
- Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Malcolm MacLachlan
- Assisting Living and Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
- Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Olomouc University Social Health Institute (OUSHI), Palacky University, Olomouc, Czech Republic
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18
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Kamyuka D, Carlin L, McPherson G, Misener L. Access to Physical Activity and Sport and the Effects of Isolation and Cordon Sanitaire During COVID-19 for People With Disabilities in Scotland and Canada. Front Sports Act Living 2021; 2:594501. [PMID: 33426519 PMCID: PMC7786384 DOI: 10.3389/fspor.2020.594501] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/27/2020] [Indexed: 11/13/2022] Open
Abstract
People with a disability are more at risk of experiencing inequalities in relation to sporting and physical activity opportunities, COVID-19 and the resulting restrictions stand to exacerbate these inequalities. This research directly contributes toward the World Health Organization, global research roadmap priority to explore “the impact of restrictive public health measures (e.g., quarantine, isolation, cordon sanitaire).” Social loneliness and social isolation have a significant impact on the health and wellbeing of individuals, therefore, it is imperative to gain an understanding of the effects of self-isolation and shielding during Covid-19 for people with disabilities to help those in policy and agency positions address these issues. This research utilized a qualitative approach, to speak with people with a disability, athletes and non-athletes and those in a position of management and policy making. Six online focus groups, with people participating in sport and physical activity, using live captioning, chat functions, and an online written discussion forum; through Project Echo website as part of a wider study on sport and accessibility were utilized. The study also drew on interviews and one of the focus groups was with senior policy makers and regional managers responsible for disability sport in Scotland.
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Affiliation(s)
- Denise Kamyuka
- School of Kinesiology, Western University, London, ON, Canada
| | - Liz Carlin
- School of Health and Life Sciences, University of West Scotland, Paisley, United Kingdom
| | - Gayle McPherson
- School of Business and Creative Industries, University of West Scotland, Paisley, United Kingdom
| | - Laura Misener
- School of Kinesiology, Western University, London, ON, Canada
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19
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Powers B, Patterson F, Palmiere K, Healy S. "I sit all of the time": Health-related time-use among adults with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103817. [PMID: 33338775 DOI: 10.1016/j.ridd.2020.103817] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adults diagnosed with intellectual disabilities (ID) are more likely to have cardiometabolic risk factors, including low physical activity (PA), high sedentary behavior (SB), and poor sleep. While these behaviors have typically been studied in isolation, emerging frameworks propose a more integrated approach to the study of these behaviors, asserting that the relative proportion of time spent in each of the health-related time-use behaviors (i.e. PA, SB and sleep) across the 24 -h period is a more powerful determinant of the incidence and progression of disease. This approach has yet to be considered for adults with ID. The purpose of this study was to explore how adults with ID and their formal caregivers (i.e. employed caregivers) perceived their health-related time-use, including the factors that influence their time-use. METHOD Five focus groups were conducted with twelve adults with ID and ten formal-caregivers. Consistent with an interpretive paradigm, this study employed an interpretative phenomenological analysis (IPA) methodology. RESULTS Three interrelated themes were identified: (1) Caregivers as gatekeepers to healthy time-use; (2) Places to move; and (3) Daily movement. The themes captured the participants' perspectives of interpersonal and environmental factors that influence health-related time-use, and how these factors were common to engagement in at least on health-related time-use behavior. CONCLUSIONS Interpersonal factors, including caregivers support and modeling-behaviors, and community factors, in the form of local, accessible, affordable spaces to be active, were identified as the most pertinent factors in determining PA, SB and sleep behaviors. Moreover, adults with ID and caregivers perceived health-related time-use behaviors to be interrelated. Further investigation in this area will ultimately inform the development of pilot interventions that support caregivers as gatekeepers and provide access to health-promoting environments to engage adults with ID in healthy levels of PA, SB, and sleep.
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Affiliation(s)
- Brittany Powers
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, United States
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, United States
| | - Katherine Palmiere
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, United States
| | - Sean Healy
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, United States.
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20
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Raymond É, Lantagne Lopez M. Participation of People With Impairments in Seniors' Organizations: Conditions and Limitations on Inclusion. THE GERONTOLOGIST 2020; 60:1126-1136. [PMID: 32333600 DOI: 10.1093/geront/gnaa011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES While older adults' social participation has attracted sustained attention, the realities faced by seniors with impairments in this area are still understudied. Social representations are formed from socially constructed opinions regarding a given object and have four functions (knowledge, identity, orientation, justification). The purpose of this article is to document the social representations that exist within seniors' organizations regarding participation by older people with impairments. RESEARCH DESIGN AND METHODS In this mixed-methods study, an exploratory sequential design was applied. First, a qualitative phase involved meetings with five focus groups to explore how participants would manage difficult situations in which the inclusion of an older person with impairments must be addressed. Second, a quantitative phase consisted of a questionnaire administered to 86 respondents to examine the components of social representations about the participation of older people with impairments. RESULTS Results show that, although research participants acknowledge that all seniors have the right to participate, this right confronts a collective identity infused with aging model that demands a youthful, "un-disabled" appearance and activities. In terms of the orientation function, making participation a reality is seen as relying on the efforts of people with impairments, but when there is a failure of inclusiveness, the reasons offered to justify it concern the resources available, rather than possible prejudices. DISCUSSION AND IMPLICATIONS Interpretation of the results leads to recommendations for both implementing an inclusion philosophy and practices in seniors' organizations and revisiting the view of impairment in old age as otherness.
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Affiliation(s)
- Émilie Raymond
- School of Social Work and Criminology, Université Laval, Quebec City, Quebec, Canada
| | - Mélanie Lantagne Lopez
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Quebec City, Quebec, Canada
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Chow BC, Choi PHN, Huang WY, Pan CY. Promoting Physical Activity in Group Home Settings: Staff Perspectives through a SWOT Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5805. [PMID: 32796588 PMCID: PMC7459724 DOI: 10.3390/ijerph17165805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/04/2020] [Accepted: 08/08/2020] [Indexed: 12/02/2022]
Abstract
PURPOSE The aim of the study was to investigate perceptions of staff about the promotion of physical activity (PA) in selected group residences of Hong Kong (HK), some of which had experienced a multi-component PA program. METHOD Focus group interviews with nineteen staff members from four group homes (two of which received the program) were conducted. FINDINGS A SWOT analysis provided important insights into residential staff views about key influences on the quality of PA programs for residents with intellectual disabilities (ID). Positive (strengths and opportunities) and negative (weaknesses and threats) influences were identified. They were associated with characteristics of residents, staff, and group residence. Increasing age and low motivation are impediments to PA engagement of adults with ID. Staff competence and prior unsuccessful experience in promoting PA are also implicated. CONCLUSION The PA program quality is mediated by the quality of staff interpersonal interactions with their clients and their commitment in encouraging such adults with ID to join and persistent in PA as well as staff seeking external resources and support as well as using initiative to adapt PA promotion activities in their specific group residential context.
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Affiliation(s)
- Bik C. Chow
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong;
| | - Peggy Hiu Nam Choi
- Department of Sports and Recreation, Technological and Higher Education Institute of Hong Kong, Hong Kong;
| | - Wendy Yajun Huang
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong;
| | - Chien-yu Pan
- Department of Physical Education, National Kaohsiung Normal University, Kaohsiung 80201, Taiwan;
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Niemeier BS, Wetzlmair LC, Bock K, Schoenbrodt M, Roach KJ. Improvements in biometric health measures among individuals with intellectual disabilities: A controlled evaluation of the Fit 5 program. Disabil Health J 2020; 14:100979. [PMID: 32900653 DOI: 10.1016/j.dhjo.2020.100979] [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: 02/19/2020] [Revised: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Individuals with intellectual disabilities (ID) have poorer health statuses compared to the general population. Actions are needed to address health disparities and promote healthy lifestyles among individuals with ID. Moreover, studies that consider program settings for this population are needed. OBJECTIVE The Special Olympics health program, Fit 5, was evaluated to assess effectiveness in improving health measures for individuals with ID. The settings of programs' implementation were also considered. METHODS Four Special Olympics basketball teams participated as an intervention group, and three teams as a control group, in a study of the Fit 5 program that was implemented during, and as part of, a regular 8-week basketball season. Resting heart rate (RHR) and blood pressure, and height and weight to calculate Body Mass Index (BMI), were measured before and after the program. Differences in pre- and post-measures were compared between the two groups with paired samples t-tests and ANCOVA. RESULTS Participants in the intervention group had significantly greater improvements in resting systolic and diastolic blood pressures (p = 0.02 and 0.03, respectively) and RHR (p = 0.003). BMI increased for both groups; however, the increase in the intervention group was significantly less (p = 0.006). The Special Olympics setting was considered familiar and supportive and effectively reached individuals with ID. CONCLUSION The Fit 5 program positively impacts RHR and blood pressure, and could help reduce extents of BMI increases, in individuals with ID when implemented in a common setting. Further investigation of the impact of Fit 5 and similar programs in additional settings is warranted.
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Affiliation(s)
- Brandi S Niemeier
- Department of Kinesiology, University of Wisconsin-Whitewater, 800 West Main Street, Whitewater, WI, 53190, USA.
| | - Lisa-Christin Wetzlmair
- Department of Kinesiology, University of Wisconsin-Whitewater, 800 West Main Street, Whitewater, WI, 53190, USA
| | - Karla Bock
- Special Olympics Wisconsin, 2310 Crossroads Dr, Suite 1000, Madison, WI, 53718, USA
| | - Melissa Schoenbrodt
- Special Olympics Wisconsin, 2310 Crossroads Dr, Suite 1000, Madison, WI, 53718, USA
| | - Kathleen J Roach
- Special Olympics Wisconsin, 2310 Crossroads Dr, Suite 1000, Madison, WI, 53718, USA
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Kuijken NMJ, Naaldenberg J, Anrooij KVV, Sanden MWGNVD, van Schrojenstein HMJ, Valk LD, Leusink GL. Integrating Health Promotion in the Everyday Life of People With Intellectual Disability-The Extent to Which Current Initiatives Take Context Into Account. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:170-179. [PMID: 32240052 DOI: 10.1352/1934-9556-58.2.170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Taking the dynamics of everyday life into account is important for health behavior change. Surveys were conducted to gain insight into available health promoting physical activity and nutrition initiatives in the everyday life of people with intellectual disability (ID). Researchers considered characteristics of the initiatives and the attention they give to resources and hindering factors of healthy living for people with ID. The 47 initiatives mostly focused on physical activity and consisted of regularly organized, stand-alone activities. Care professionals, rather than health professionals, were involved. Organizational resources and hindering factors received relatively little attention. Health promotion for people with ID could benefit from incorporating health behavior into routines of daily living, focusing more attention on organizational resources, and improving the collaboration between health professionals and care professionals.
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Affiliation(s)
- Noortje M J Kuijken
- Noortje M. J. Kuijken, Jenneken Naaldenberg, Kristel Vlot-van Anrooij, Maria W. G. Nijhuis-van der Sanden, Henny M. J. van Schrojenstein Lantman-de Valk, and Geraline L. Leusink, Radboud University Medical Center
| | - Jenneken Naaldenberg
- Noortje M. J. Kuijken, Jenneken Naaldenberg, Kristel Vlot-van Anrooij, Maria W. G. Nijhuis-van der Sanden, Henny M. J. van Schrojenstein Lantman-de Valk, and Geraline L. Leusink, Radboud University Medical Center
| | - Kristel Vlot-van Anrooij
- Noortje M. J. Kuijken, Jenneken Naaldenberg, Kristel Vlot-van Anrooij, Maria W. G. Nijhuis-van der Sanden, Henny M. J. van Schrojenstein Lantman-de Valk, and Geraline L. Leusink, Radboud University Medical Center
| | - Maria W G Nijhuis-van der Sanden
- Noortje M. J. Kuijken, Jenneken Naaldenberg, Kristel Vlot-van Anrooij, Maria W. G. Nijhuis-van der Sanden, Henny M. J. van Schrojenstein Lantman-de Valk, and Geraline L. Leusink, Radboud University Medical Center
| | - Henny M J van Schrojenstein
- Noortje M. J. Kuijken, Jenneken Naaldenberg, Kristel Vlot-van Anrooij, Maria W. G. Nijhuis-van der Sanden, Henny M. J. van Schrojenstein Lantman-de Valk, and Geraline L. Leusink, Radboud University Medical Center
| | - Lantman-de Valk
- Noortje M. J. Kuijken, Jenneken Naaldenberg, Kristel Vlot-van Anrooij, Maria W. G. Nijhuis-van der Sanden, Henny M. J. van Schrojenstein Lantman-de Valk, and Geraline L. Leusink, Radboud University Medical Center
| | - Geraline L Leusink
- Noortje M. J. Kuijken, Jenneken Naaldenberg, Kristel Vlot-van Anrooij, Maria W. G. Nijhuis-van der Sanden, Henny M. J. van Schrojenstein Lantman-de Valk, and Geraline L. Leusink, Radboud University Medical Center
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Schepens HR, Van Puyenbroeck J, Maes B. “One does not forget, it all comes back”: elderly people with intellectual disability review adversities and stress-protection in their lives. QUALITY IN AGEING AND OLDER ADULTS 2019. [DOI: 10.1108/qaoa-11-2018-0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
People with intellectual disability are reported to encounter many negative life events during their increasingly long lives. In the absence of protective elements, these may cause toxic stress and trauma. Given the reported negative effects of such adverse events on their quality of life (QoL), the perspective of older people with intellectual disability themselves may be of relevance. The paper aims to discuss these issues.
Design/methodology/approach
The authors questioned nine participants with mild intellectual disability, aged 61–88 years old, in four 90-min focus group sessions and thematically analysed the data.
Findings
Many recent and bygone negative life events still weighed heavily on the participants. Negative interactions, experiences of loss, lack of control and awareness of one’s disability caused stress. Their emotional response contrasted with their contentment, compliance and resilience. Having (had) good relationships, having learnt coping skills, remaining active, talking about past experiences and feeling free of pain, safe, well supported, capable, respected and involved seemed to heighten resilience and protect participants from toxic stress.
Research limitations/implications
Monitoring and preventing adverse (childhood) experiences, supporting active/emotional coping strategies, psychotherapy and life story work may facilitate coping with negative events and enhance QoL of elderly people with intellectual disability.
Originality/value
Elderly people with mild intellectual disability run a higher risk of experiencing (early) adverse events in life. They are very capable of talking about their experiences, QoL, and the support they need. Focus groups were a reliable method to capture their insights.
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Raymond É. The challenge of inclusion for older people with impairments: Insights from a stigma-based analysis. J Aging Stud 2019; 49:9-15. [PMID: 31229222 DOI: 10.1016/j.jaging.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/22/2019] [Accepted: 03/02/2019] [Indexed: 11/15/2022]
Abstract
The intersection of disability and aging often presents obstacles and discomfort for older people with disabilities keen to access mainstream opportunities for social participation. Besides individual situations and preferences - disability-based or not - environmental and social factors may limit full access to participation for older people with disabilities. Although ageist and ableist trends of contemporary ideas of aging have been documented, few studies have examined how those discourses are enacted in the field. In the context of participatory action research carried out since 2014 in a seniors' leisure club, we conducted 14 individual interviews with volunteers and seven focus groups with 45 members in order to explore their personal experiences with impairments and disability within the club, whether members who develop impairments can continue to participate and whether prospective new members with different types of impairments would be welcomed. We used an interactionist framework inspired by Goffman's work and based on the concept of stigma to analyze participants' narratives. Results indicate that participation by members with disabilities is seen as unusual, disconcerting and disjunctive. Evidence exposes the stigmatizing practices, encompassing labeling, stereotyping, setting apart and discrimination against members with impairments. Their participation may be acceptable if it does not affect the normal course of activities; otherwise, stigmatizing discourses relegate them to the margins. Because stigma can have an overwhelming impact on the lives and social participation of older people with impairments, stakeholders' awareness should be raised so they can understand it and intervene more effectively.
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Boot FH, MacLachlan M, Dinsmore J. Are there differences in factors influencing access and continued use of assistive products for people with intellectual disabilities living in group homes? Disabil Rehabil Assist Technol 2019; 15:173-182. [PMID: 30689464 DOI: 10.1080/17483107.2018.1550116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: The World Health Organization has launched a program to promote Global Cooperation on Assistive Technology (GATE) to implement those parts of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) referring to assistive technology and products. A particular vulnerable group deeply affected by health inequity affecting access to assistive products are people with intellectual disabilities.Objective: The objective of this study is to understand the barriers and facilitators to effectively access and continuously use essential assistive products for people with intellectual disabilities.Materials and methods: Face-to-face interviews with 15 adults with a mild to profound intellectual disability and 15 providers of assistive products were conducted to gain insights about current use, needs, knowledge, awareness, access, customization, funding, follow-up, social inclusion, stigma and policies around assistive products and intellectual disability. The technique of constant comparative analysis was used to analyze the data.Results and conclusion: An overview of factors is presented that fit within seven domains for access and eight domains for continuous use of assistive products for people with intellectual disabilities. It illustrates that access and continuous use are influenced by different barriers and facilitators. These different influences should be taken into account in country policies and frameworks that seek to implement the UNCRPD through assistive technology.Implications for rehabilitationProactive assessment for assistive products by health professionals is rare and the vast majority of people with intellectual disabilities depend on carers to signal the need .A lack of education for carers around available assistive products and the benefits of assistive products for people with intellectual disabilities may lead to an underutilization for this group.The paternalistic attitude of care providers towards people with intellectual disabilities limits access and use to certain (high-tech) assistive products.The segmented and disjointed aspect of public funding to support assistive products found in this study is a key issue for policymakers who aspire to adhere to implementing the UNCRPD equally in all areas of their country.
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Affiliation(s)
- Fleur Heleen Boot
- Assisting Living & Learning (ALL) Institute, Maynooth University, Maynooth, Ireland.,Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Malcolm MacLachlan
- Assisting Living & Learning (ALL) Institute, Maynooth University, Maynooth, Ireland.,Centre for Rehabilitation Studies, Stellenbosch University, Tygerberg, South Africa.,Olomouc University Social Health Institute (OUSHI), Palacky University, Olomouc, Czech Republic
| | - John Dinsmore
- Centre for Practice and Healthcare Innovation, Trinity College Dublin, Dublin, Ireland
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Nau T, Nolan G, Smith BJ. Enhancing Engagement With Socially Disadvantaged Older People in Organized Physical Activity Programs. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2019; 39:257-267. [PMID: 30638424 DOI: 10.1177/0272684x18821301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Participation in physical activity (PA) is low among older adults in developed nations and even lower among several socially disadvantaged groups. This study aimed to identify the actions that can be taken in the promotion, design, and implementation of organized PA programs to improve engagement with socially disadvantaged and underrepresented older people. Research design and methods: Semistructured interviews were conducted with 30 community service providers and 5 focus groups with 42 older participants in existing PA programs. Data were analyzed thematically, and the PRECEDE-PROCEED model for program planning was used to broadly categorize themes. Results: Helpful strategies for addressing predisposing factors such as social anxiety and lack of confidence included user-centered program design and sensitive, informative messaging and promotion. Key enabling strategies were transport assistance and minimizing fees. Facilitating gentle entry to groups and fostering inclusion and safety were identified as valuable reinforcing strategies. Providers regarded organizational networks as beneficial for facilitating referral and addressing resource constraints. Discussion and implications: A multifactorial approach addressing a range of predisposing, reinforcing, and enabling factors is likely to be necessary to enhance engagement in organized PA by socially disadvantaged and underrepresented older people. Key factors relate to creating a positive sociocultural environment, identifying activities of interest, and enhancing ease of access.
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Affiliation(s)
- Tracy Nau
- 1 Sydney School of Public Health, University of Sydney, Australia
| | | | - Ben J Smith
- 1 Sydney School of Public Health, University of Sydney, Australia.,3 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Schepens HRMM, Van Puyenbroeck J, Maes B. How to improve the quality of life of elderly people with intellectual disability: A systematic literature review of support strategies. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:483-521. [DOI: 10.1111/jar.12559] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 10/24/2018] [Accepted: 11/22/2018] [Indexed: 12/16/2022]
Affiliation(s)
| | | | - Bea Maes
- Parenting and Special Education Research Unit KU Leuven Leuven Belgium
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Using formative research with older adults to inform a community physical activity programme: Get Healthy, Get Active. Prim Health Care Res Dev 2018; 20:e60. [PMID: 29976266 PMCID: PMC8512642 DOI: 10.1017/s1463423618000373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim The purpose of this formative study was to explore current knowledge and attitudes towards physical activity, as well as perceived barriers, facilitators and opportunities for physical activity participation among older adults living in the community. The findings have subsequently informed the design, delivery and recruitment strategies of a local community physical activity intervention programme which forms part of Sport England’s national Get Healthy, Get Active initiative. Background There is a growing public health concern regarding the amount of time spent in sedentary and physical activity behaviours within the older adult population. Methods Between March and June 2016, 34 participants took part in one of six focus groups as part of a descriptive formative study. A homogenous purposive sample of 28 community dwelling white, British older adults (six male), aged 65–90 years (M=78, SD=7 years) participated in one of five focus group sessions. An additional convenience pragmatic sub-sample of six participants (three male), aged 65–90 years (M=75, SD=4 years), recruited from an assisted living retirement home participated in a sixth focus group. Questions for focus groups were structured around the PRECEDE stage of the PRECEDE–PROCEDE model of health programme design, implementation and evaluation. Questions addressed knowledge, attitudes and beliefs towards physical activity, as well as views on barriers and opportunities for physical activity participation. All data were transcribed verbatim. Thematic analysis was then conducted with outcomes represented as pen profiles. Findings Consistent views regarding both the potential physical and psychosocial benefits of physical activity were noted regardless of living status. The themes of, opportunities and awareness for physical activity participation, cost, transport, location and season/weather varied between participants living in an assisted living retirement home and community dwelling older adults. Further comparative research on the physical activity requirements of older adults living in assisted living versus community settings are warranted.
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Bowen PG, Clay OJ, Lee LT, Browning W, Schoenberger YM, Martin MY. Texting Older Sisters to Step: The TOSS Study. West J Nurs Res 2018; 41:388-408. [PMID: 29726313 PMCID: PMC6212340 DOI: 10.1177/0193945918770784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The purpose of our two-phase study was to develop acceptable text messages to increase physical activity. Four focus groups (two for each phase) were conducted with older African American women who had access to texting-capable mobile phones and were in the contemplation stage for physical activity. The mean age of Phase 1 participants (n = 12) was 71 and ranged from 65 to 86 years. Content analysis was used to identify fundamental themes that were later used to develop text messages. Six categories emerged from the data and 31 text messages were developed based on focus group input and national recommendations. The mean age of Phase 2 participants (n = 9) was 67 and ranged from 65 to 75 years. Descriptive statistics revealed 100% of participants understood all messages. When messages were evaluated individually, a minimum of 78% felt each message motivated activity and 67% said lengths were perfect. Findings identified messages that were relevant and potentially motivational to stimulate physical activity among this population.
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31
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Pitchford EA, Dixon-Ibarra A, Hauck JL. Physical Activity Research in Intellectual Disability: A Scoping Review Using the Behavioral Epidemiological Framework. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:140-163. [PMID: 29480777 DOI: 10.1352/1944-7558-123.2.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Through a scoping review, the current state of physical activity research in people with intellectual disability was examined. A search of publications between 2000 and 2014 retrieved 362 articles that met inclusion criteria. Eligible studies were coded according to the Behavioral Epidemiological Framework. Of the articles identified, 48% examined associations between physical activity and health outcomes, 9% developed or tested methodology to measure physical activity, 34% examined factors that influence physical activity, 8% evaluated interventions to change physical activity, and 1% examined the dissemination of physical activity/health promotion programming. The categories with lower proportions of studies represent the need for greater population-specific research in physical activity measurement, interventional designs, and translational programs.
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Affiliation(s)
| | | | - Janet L Hauck
- Janet L. Hauck, Michigan State University. E. Andrew Pitchford is now at Iowa State University
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Chen TL, Bhattacharjee T, Beer JM, Ting LH, Hackney ME, Rogers WA, Kemp CC. Older adults' acceptance of a robot for partner dance-based exercise. PLoS One 2017; 12:e0182736. [PMID: 29045408 PMCID: PMC5646767 DOI: 10.1371/journal.pone.0182736] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 07/24/2017] [Indexed: 11/30/2022] Open
Abstract
Partner dance has been shown to be beneficial for the health of older adults. Robots could potentially facilitate healthy aging by engaging older adults in partner dance-based exercise. However, partner dance involves physical contact between the dancers, and older adults would need to be accepting of partner dancing with a robot. Using methods from the technology acceptance literature, we conducted a study with 16 healthy older adults to investigate their acceptance of robots for partner dance-based exercise. Participants successfully led a human-scale wheeled robot with arms (i.e., a mobile manipulator) in a simple, which we refer to as the Partnered Stepping Task (PST). Participants led the robot by maintaining physical contact and applying forces to the robot's end effectors. According to questionnaires, participants were generally accepting of the robot for partner dance-based exercise, tending to perceive it as useful, easy to use, and enjoyable. Participants tended to perceive the robot as easier to use after performing the PST with it. Through a qualitative data analysis of structured interview data, we also identified facilitators and barriers to acceptance of robots for partner dance-based exercise. Throughout the study, our robot used admittance control to successfully dance with older adults, demonstrating the feasibility of this method. Overall, our results suggest that robots could successfully engage older adults in partner dance-based exercise.
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Affiliation(s)
- Tiffany L. Chen
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Tapomayukh Bhattacharjee
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Jenay M. Beer
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, United States of America
- College of Social Work, University of South Carolina, Columbia, SC, United States of America
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Lena H. Ting
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
- Department of Biomedical Engineering, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Madeleine E. Hackney
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Medicine, Atlanta VA Geriatric Research Education and Clinical Center, Atlanta, GA, United States of America
| | - Wendy A. Rogers
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, United States of America
- Department of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
| | - Charles C. Kemp
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States of America
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Bossink LWM, van der Putten AA, Vlaskamp C. Understanding low levels of physical activity in people with intellectual disabilities: A systematic review to identify barriers and facilitators. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 68:95-110. [PMID: 28750208 DOI: 10.1016/j.ridd.2017.06.008] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/14/2017] [Accepted: 06/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) undertake extremely low levels of physical activity. AIMS To enhance understanding concerning low levels of physical activity in people with ID, this study has three aims: (1) to identify barriers to and facilitators of physical activity in people with ID; (2) to examine differences in barriers and facilitators between levels of ID (mild, moderate, severe, and profound); (3) to examine differences in barriers and facilitators between various stakeholder groups. METHODS AND PROCEDURES A systematic search was performed using the following databases from the year 1990: MEDLINE, ERIC, and PsycINFO. The studies included were peer reviewed, available as full text, and written in English, addressing barriers to and facilitators of physical activity in people with ID. The quality of the studies was assessed using existing critical review forms. All studies were subjected to qualitative synthesis to identify and compare barriers and facilitators. OUTCOMES AND RESULTS In all, 24 studies were retrieved, describing 14 personal and 23 environmental barriers and/or facilitators. The quality of the studies varied, particularly for qualitative studies. Only two studies included people with severe or profound ID. Stakeholder groups tend to identify barriers outside their own responsibility. CONCLUSIONS AND IMPLICATIONS Results reveal a broad range of barriers and facilitators, but not for people with more severe ID. Further research should also examine these factors among stakeholders responsible for providing support.
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Affiliation(s)
- L W M Bossink
- Department of Special Needs Education and Youth Care, University of Groningen, Groningen, Netherlands.
| | - Annette Aj van der Putten
- Department of Special Needs Education and Youth Care, University of Groningen, Groningen, Netherlands
| | - Carla Vlaskamp
- Department of Special Needs Education and Youth Care, University of Groningen, Groningen, Netherlands
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Oviedo GR, Travier N, Guerra-Balic M. Sedentary and Physical Activity Patterns in Adults with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14091027. [PMID: 28880236 PMCID: PMC5615564 DOI: 10.3390/ijerph14091027] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/02/2017] [Accepted: 09/06/2017] [Indexed: 02/08/2023]
Abstract
Little is known about the patterns of sedentary time (ST) and physical activity (PA) levels throughout the week among adults and older adults with Intellectual Disability (ID). We analyzed ST and PA patterns of adults and older adults with ID. Forty-two adults and 42 older adults with mild to severe ID participated in this study. Height and weight were obtained to calculate Body Mass Index (BMI). Body fat and fat-free mass percentages were also obtained. Patterns of PA levels and ST were assessed with GT3X Actigraph accelerometers. Adults performed higher amounts of total PA and moderate to vigorous PA than older adults during the week, on weekdays and in center time (all p > 0.05). No differences between males and females were found for either PA levels or ST. Only 10.7% of the participants met the global recommendations on PA for health. The participants of the current study showed low PA levels and a high prevalence of ST. Interestingly, when comparing age and/or sex groups, no differences were observed for ST. Our findings provide novel and valuable information to be considered in future interventions aiming to increase PA levels and reduce ST.
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Affiliation(s)
- Guillermo R Oviedo
- FPCEE-Blanquerna, University Ramon Llull, 34 Císter Street, 08022 Barcelona, Spain.
- Physical Activity, Sport and Recreation Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom 2520, South Africa.
| | - Noémie Travier
- Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Myriam Guerra-Balic
- FPCEE-Blanquerna, University Ramon Llull, 34 Císter Street, 08022 Barcelona, Spain.
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Stancliffe RJ, Anderson LL. Factors associated with meeting physical activity guidelines by adults with intellectual and developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 62:1-14. [PMID: 28103494 DOI: 10.1016/j.ridd.2017.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/21/2016] [Accepted: 01/05/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Many individuals with intellectual and developmental disabilities (IDD) have sedentary lifestyles. AIMS (a) compare adults with IDD with the general adult population on adherence to U.S. physical activity (PA) guidelines, and (b) determine what factors predict adherence to PA guidelines by adults with IDD. METHODS We compared adults with IDD from the 2011-2012 National Core Indicators Adult Consumer Survey (NCI-ACS) with the general U.S. population on meeting PA guidelines. We examined the association of demographic, diagnostic, mobility, health and community participation variables with meeting PA guidelines by adults with IDD. RESULTS The rate for adults with IDD meeting PA guidelines (13.5%) was less than half that of the general population (30.8%). Among adults with IDD, at-risk groups included those with more severe disability, Down syndrome, mobility impairments, obesity, poor health, mental illness, no independent access to community exercise, and less frequent participation in community exercise. Going out for exercise was the only form of community participation associated with meeting PA guidelines. People who accessed the community for exercise independently (i.e., alone) were more likely to meet PA guidelines. CONCLUSIONS Interventions aimed at increasing PA for people with IDD should consider these factors in their design.
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Affiliation(s)
- Roger J Stancliffe
- University of Sydney, Centre for Disability Research and Policy, 75 East Street, PO Box 170, Lidcombe, NSW, 1825, Australia.
| | - Lynda L Anderson
- Research and Training Center on Community Living, University of Minnesota, Pattee Hall, 150 Pillsbury Ave SE, Minneapolis, MN, 55455, USA.
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van Schijndel-Speet M, Evenhuis HM, van Wijck R, van Montfort KCAGM, Echteld MA. A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster-randomised clinical trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:16-29. [PMID: 27072928 DOI: 10.1111/jir.12267] [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: 12/19/2014] [Revised: 11/26/2015] [Accepted: 01/27/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The physical activity level of older adults with intellectual disabilities (ID) is extremely low, and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people. A physical activity programme, including an education programme, was developed for older adults with ID using behaviour change techniques. The programme aimed at improving or maintaining adequate levels of physical activity (primary outcome measure) and motor fitness, cardio respiratory fitness, morphologic and metabolic fitness, activities of daily living, cognitive functioning and depressive symptoms (secondary outcome measures). METHOD The programme's efficacy was evaluated in a cluster-randomised clinical trial among people aged 43 years and over with mild-moderate levels of ID. Five day-activity centres were randomised to the participation group. In these centres, 81 older adults participated in groups of 8 to 10 in the programme, three times a week during 8 months. The programme was executed by physical activity instructors and staff of day-activity centres. Five other day-activity centres were randomised to the control group; 70 older adults in these centres received care as usual. The generalised linear model with mixed effects was used to test the programme's effectiveness. RESULTS Significant effects were found on physical activity, muscle strength, systolic and diastolic blood pressure, serum cholesterol level and cognitive functioning, in favour of the programme's participants. No significant improvements were found on balance, serum glucose, weight, waist circumference, walking speed, mobility, depression or instrumental activities of daily living. CONCLUSIONS The physical activity and fitness programme has established small but significant effects in this sample, but generalising the findings to other settings is difficult due to significant participant dropout. Implementation of evidence-based physical activity programmes among older adults with ID is recommended. Further research is needed to investigate the effectiveness of physical activity on daily life functioning and the development on chronic diseases in the long run.
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Affiliation(s)
- M van Schijndel-Speet
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
- Ipse de Bruggen, Zoetermeer, The Netherlands
| | - H M Evenhuis
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - R van Wijck
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | | | - M A Echteld
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
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Renfro M, Bainbridge DB, Smith ML. Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program. Front Public Health 2016; 4:261. [PMID: 27999771 PMCID: PMC5138240 DOI: 10.3389/fpubh.2016.00261] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 11/03/2016] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. BACKGROUND Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. METHODS A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. RESULTS Despite the limited number of participants (n = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. DISCUSSION Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more participants in diverse geographic regions with longer lengths of participation and follow-up.
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Affiliation(s)
- Mindy Renfro
- MonTECH/Rural Institute, University of Montana , Missoula, MT , USA
| | | | - Matthew Lee Smith
- College of Public Health, Institute of Gerontology, The University of Georgia, Athens, GA, USA; Texas A&M School of Public Health, College Station, TX, USA
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Chow BC, Huang WYJ, Choi PHN, Pan CY. Design and methods of a multi-component physical activity program for adults with intellectual disabilities living in group homes. J Exerc Sci Fit 2016. [PMID: 29541116 PMCID: PMC5801709 DOI: 10.1016/j.jesf.2016.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Adults with intellectual disabilities (ID) often live a sedentary lifestyle and have higher rates of overweight and obesity. The purpose of this report is to describe the design and methods of a multi-component physical activity (PA) intervention program that aims to increase PA levels in adults with ID who live in group homes. The study employed a multi-component delayed treatment control group design involving adults with ID who lived in two group homes. Interventions included 30 exercise sessions in groups over a 10-week period and three educational lessons based on social cognitive theory that aimed to improve self-efficacy and social support for PA in the participants. In addition, staff training in exercise and advice on institutional PA policies were provided to the caregivers working in the group homes. Outcome measures on three aspects were collected: (1) physical fitness, (2) PA as assessed by an ActiGraph accelerometer, and (3) self-efficacy and social support for PA. Our major objective was to develop the intervention protocol, and the successful completion of this study will provide valuable evidence on how to promote active lifestyles in adults with ID.
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Affiliation(s)
- Bik C Chow
- Department of Physical Education, Hong Kong Baptist University, Hong Kong
| | - Wendy Y J Huang
- Department of Physical Education, Hong Kong Baptist University, Hong Kong
| | - Peggy H N Choi
- Department of Physical Education, Hong Kong Baptist University, Hong Kong
| | - Chien-Yu Pan
- Department of Physical Education, National Kaohsiung Normal University, Taiwan
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Matthews L, Mitchell F, Stalker K, McConnachie A, Murray H, Melling C, Mutrie N, Melville C. Process evaluation of the Walk Well study: a cluster-randomised controlled trial of a community based walking programme for adults with intellectual disabilities. BMC Public Health 2016; 16:527. [PMID: 27387203 PMCID: PMC4936049 DOI: 10.1186/s12889-016-3179-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 06/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Walking interventions can be effective in encouraging sedentary populations to become more active; however, limited research has explored the effectiveness of walking interventions for adults with intellectual disabilities. This process evaluation explored the delivery of a community based walking intervention for adults with intellectual disabilities. METHODS Walk Well was a single-blind cluster randomised controlled trial of a 12-week physical activity consultation-led walking intervention. 102 participants were randomised to the Walk Well intervention or a waiting list control group. Participants in the intervention group received three physical activity consultations with a walking advisor at baseline, 6 & 12-weeks. They were encouraged to use a pedometer to set goals and monitor their daily step count. Primary outcome was change in daily step count at 12-weeks. Process evaluation measures included qualitative interviews with key stakeholders (n = 6) and quantifiable data collected as part of the intervention. Additional process data were extracted from a sub-set of qualitative interviews with participants and carers (n = 20). Data were analysed for process information related to context, recruitment and retention, reach, implementation, and fidelity. RESULTS Walk Well was not effective in significantly increasing levels of physical activity. The process evaluation did, however, highlight several important areas for consideration in future studies, including: a successful recruitment and retention strategy reaching a representative sample of adults with intellectual disabilities in the community; feasible and (for most) enjoyable methods of engaging adults with intellectual disabilities in activities to support behaviour change; potential need for greater intervention duration and frequency of contact; advantages and disadvantages of using pedometers as a behaviour change tool; the need for strategies which engage carers in supporting participants; and the complex issue of 'freedom of choice' in relation to lifestyle behaviours and study participation. CONCLUSIONS Walking interventions for adults with intellectual disabilities can be feasibly delivered in the community in relation to reach, recruitment, retention and intervention fidelity. More intensive intervention methods need to be explored as well as strategies to engage and motivate carers in their support of participants. TRIAL REGISTRATION Current Controlled Trials ISRCTN50494254 (3(rd) April 2012).
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Affiliation(s)
- Lynsay Matthews
- Institute of Health and Wellbeing, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland.
| | - Fiona Mitchell
- Department of Physical Activity for Health, University of Strathclyde, Glasgow, Scotland
| | - Kirsten Stalker
- Glasgow School of Social Work, University of Strathclyde, Glasgow, Scotland
| | - Alex McConnachie
- Institute of Health and Wellbeing, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland
| | - Heather Murray
- Institute of Health and Wellbeing, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland
| | - Chris Melling
- Social Work Services, Glasgow City Council, Glasgow, Scotland
| | - Nanette Mutrie
- Institute for Sport, Physical Education and Health Sciences, Moray House School of Education, University of Edinburgh, Edinburgh, Scotland
| | - Craig Melville
- Institute of Health and Wellbeing, Academic Unit for Mental Health & Wellbeing, University of Glasgow, Glasgow, Scotland
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Carbó-Carreté M, Guàrdia-Olmos J, Giné C, Schalock RL. A Structural Equation Model of the relationship between physical activity and quality of life. Int J Clin Health Psychol 2016; 16:147-156. [PMID: 30487858 PMCID: PMC6225033 DOI: 10.1016/j.ijchp.2015.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/04/2015] [Indexed: 11/14/2022] Open
Abstract
Background/Objective: Literature shows that practicing physical activity improves the general health and quality of life of people with intellectual disabilities. However, there is little empirical research on the specific benefits physical activity provides and to what extent these benefits occur. The goal of this study was to examine the impact of perceptions of physical activity and the individualized support on each of eight quality of life-related domains and three higher-order quality of life factors. Method: The sample consisted of adults with intellectual disability (n = 529), their assigned professionals (n = 522), and a family member (n = 462). Most participants attended day and residential services, and we applied the Personal Outcomes Scale and the Support Needs and Strategies for Physical Activity Scale to all of them. Results: The structural model parameter estimation showed high values, especially for the factor of well-being. These data allowed us to confirm that perceptions of physical and individualized supports in the field of physical activity act as predictors of quality of life improvement. Conclusions: The results suggest that organizations devoted to enhancing personal outcomes should include physical activity in their programs, and revise both their own services and the use of physical activity resources available in the community.
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Affiliation(s)
| | - Joan Guàrdia-Olmos
- Institute for Brain, Cognition and Behaviour (IR3 C), Faculty of Psychology, University of Barcelona, Spain
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Dixon-Ibarra A, Driver S, Vanderbom K, Humphries K. Understanding physical activity in the group home setting: a qualitative inquiry. Disabil Rehabil 2016; 39:653-662. [DOI: 10.3109/09638288.2016.1160294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Alicia Dixon-Ibarra
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Simon Driver
- Baylor Institute for Rehabilitation, Baylor University Medical Center at Dallas, Dallas, TX, USA
| | - Kerri Vanderbom
- School of Health Professions, University of Alabama Lakeshore Research collaborative, Birmingham, AL, USA
| | - Kathleen Humphries
- Institute on Development and Disability, Oregon Health and Sciences University, Portland, OR, USA
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Carbó-Carreté M, Guàrdia-Olmos J, Giné C. The Physical Activity Support Needs and Strategies Scale: Its Development and Use. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:32-44. [PMID: 26824132 DOI: 10.1352/1934-9556-54.1.32] [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: 06/05/2023]
Abstract
People with intellectual disability (ID) engage in insufficient physical activity which negatively affects their health. In accordance with the present conception of ID and the supports paradigm, the current study aimed to develop and psychometrically assess an instrument examining the support needs and strategies regarding physical activity by using individuals with ID (n = 529), service providers (n = 522), and family members (n = 462) as information sources. The analysis revealed adequate reliability for the proposed instrument, with α values between .70 and .80, and adequate construct validity for the versions of the scale for the 3 information sources, particularly for service providers. The assessment information can be included in Individualized Support Plans and could be used to design and implement the strategies for facilitating a person's physical activity in their community.
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Affiliation(s)
- Maria Carbó-Carreté
- Maria Carbó-Carreté, Ramon Llull University, Blanquerna Faculty of Psychology and Educational and Sports Sciences, Barcelona, Spain
| | - Joan Guàrdia-Olmos
- Joan Guàrdia-Olmos, Institute for Brain, Cognition and Behaviour (IR3 C), Faculty of Psychology, University of Barcelona; and
| | - Climent Giné
- Climent Giné, Ramon Llull University, Blanquerna Faculty of Psychology and Educational and Sports Sciences, Barcelona, Spain
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Melville CA, Mitchell F, Stalker K, Matthews L, McConnachie A, Murray HM, Melling C, Mutrie N. Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial. Int J Behav Nutr Phys Act 2015; 12:125. [PMID: 26416606 PMCID: PMC4587575 DOI: 10.1186/s12966-015-0290-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 09/22/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities. METHODS We used a cluster randomised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations. Assessments were carried out blind to allocation. Clusters of participants were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for participants and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. RESULTS One hundred two participants in 50 clusters were randomised. 82 (80.4%) participants completed the primary outcome. 66.7% of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, participants walked 4780 (standard deviation 2432) steps per day, spent 65.5% (standard deviation 10.9) of time sedentary and 59% percent had a body mass in the obesity range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95% confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6% (95% CI -2.984 to 6.102), percentage time in MVPA 0.3% (95% CI -0.7 to 1.3), BMI -0.2 kg/m(2) (95% CI -0.8 to 0.4) or subjective well-being 0.3 (95% CI -0.9 to 1.5). CONCLUSIONS This is the first published trial of a walking program for adults with intellectual disabilities. Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities. Since participants spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach. TRIAL REGISTRATION Current Controlled Trials ISRCTN50494254.
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Affiliation(s)
- Craig A Melville
- University of Glasgow, Institute of Health and Wellbeing, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, UK.
| | - Fiona Mitchell
- University of Glasgow, Institute of Health and Wellbeing, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, UK.
| | - Kirsten Stalker
- Social Work and Social Policy, Lord Hope Building, University of Strathclyde, Glasgow, G4 OLT, UK.
| | - Lynsay Matthews
- MRC Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield St, Glasgow, G2 3QB, UK.
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Boyd Orr Building, University Avenue Glasgow, Glasgow, G12 8QQ, UK.
| | - Heather M Murray
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Boyd Orr Building, University Avenue Glasgow, Glasgow, G12 8QQ, UK.
| | - Chris Melling
- Social Work Services, Glasgow City Council, 40 John Street, Glasgow, G1 1JL, UK.
| | - Nanette Mutrie
- University of Edinburgh, Physical Activity for Health Research Centre, St Leonard's Land, Holyrood Road, Edinburgh, EH8 8AQ, UK.
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Cuesta-Vargas AI, Pérez-Cruzado D. Relationship between Barthel index with physical tests in adults with intellectual disabilities. SPRINGERPLUS 2014; 3:543. [PMID: 25332853 PMCID: PMC4183757 DOI: 10.1186/2193-1801-3-543] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 09/18/2014] [Indexed: 11/10/2022]
Abstract
We usually find low levels of fitness condition affect other aspects of living for people with ID like dependency in carrying out activivities of daily living. Therefore we find high levels of dependency in activities of daily living due to poor fitness condition. The aim of the study is to explore the criterion validity of the Barthel index with a physical fitness test. An observational cross-sectional study was conducted. Data from the Barthel index and a physical fitness test were measured in 122 adults with intellectual disability. The data were analysed to find out the relationship between four categories of the physical fitness test and the Barthel index. It needs to be stressed that the correlations between the Barthel index and leg, abdominal and arm strength can confirm that these physical test are predictive of the Barthel index. The correlations between the balance variables as functional reach and single-leg stance with eyes open shown relationships with Barthel Index. We found important correlations between the physical fitness test and the Barthel index, so we can affirm that some physical fitness features are predictor variables of the Barthel index.
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Affiliation(s)
- Antonio I Cuesta-Vargas
- Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Malaga, Spain ; School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, Australia
| | - David Pérez-Cruzado
- Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Malaga, Spain
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van Schijndel-Speet M, Evenhuis HM, van Wijck R, Echteld MA. Implementation of a group-based physical activity programme for ageing adults with ID: a process evaluation. J Eval Clin Pract 2014; 20:401-7. [PMID: 24798030 DOI: 10.1111/jep.12145] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2014] [Indexed: 01/08/2023]
Abstract
RATIONALE, AIM AND OBJECTIVES This paper describes the results of the process evaluation of a physical activity programme for people with intellectual disabilities (ID), including information about the concepts 'fidelity', 'dose delivered', 'satisfaction' and 'context'. METHODS Qualitative and quantitative methods among participants and programme leaders were used. RESULTS The programme was well accepted, feasible and applicable to ageing people with ID. It was successfully implemented in terms of fidelity and dose delivered, although differences between day-activity centres were observed. CONCLUSIONS The hampering factors that are revealed in this study and the facilitating activities that were part of the implementation plan may be used by care provider services for (ageing) people with ID and other groups of people with cognitive and/or physical deficits, such as frail elderly people or people with dementia when developing and or preparing implementation of health promotion programmes.
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Affiliation(s)
- Marieke van Schijndel-Speet
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands; Ipse de Bruggen, Zoetermeer, The Netherlands
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