While this population is a difficult one to reach for research, attempts to do so should not be abandoned, because the potential health benefits for this underserved group far outweigh the recruitment barriers experienced.
Background People with intellectual disability who live in the community often have poor health and healthcare, partly as a consequence of poor communication, recall difficulties and incomplete patient health information.
Materials and Methods A cluster randomized‐controlled trial with 2 × 2 factorial design was conducted with adults with intellectual disability to investigate two interventions to enhance interactions among adults with intellectual disability, their care providers and general practitioners (GPs). The interventions were the Comprehensive Health Assessment Program (CHAP), a one‐off health review tool, and the Ask health diary, designed for ongoing use. Follow‐up was for 12 months post‐intervention. Evidence of health promotion, disease prevention and case‐finding activities were extracted from GPs clinical records.
Results Increased health promotion, disease prevention and case‐finding activity were found in the intervention groups using the CHAP. It had a positive impact on Pneumococcus vaccination (OR 7.4; 95% CI: 1.5–37.1), hearing testing (4.5; 1.9–10.7), Hepatitis A vaccinations (5.4; 1.8–16.3), vision testing (3.4; 1.4–8.3), and weight measurement (3.1; 1.5–6.4). There were no strong changes in the measured outcomes in the group who used the Ask health diary alone.
Conclusions The use of the CHAP increased health promotion, disease prevention and case‐finding activity in adults with intellectual disability living in the community and confirms the previously demonstrated benefits of the CHAP can be extended to less formal residential settings. The use of the Ask health diary did not improve the measured healthcare activity, at least in the short term, although it may contribute in other ways towards better health.
Two per cent of people in Australia have intellectual disability and the adults in this population often have poor health status. This poor health can be partly attributed to communication difficulties encountered by people with intellectual disability and also health professionals in consultation settings. The design and development processes of an educational intervention to improve communication between patients, general practitioners (GPs) and also advocates in a population of adults with intellectual disability are described. The design process was collaborative and involved adults with intellectual disability, GPs, parents, support workers and other professionals. It was a nine-step development process and led to the final communication tool package, the ask (advocacy skills kit) 5-year health diary and educational session. As a result of the collaborative design and development processes, this diary included qualities not found in most other medical record keeping systems: visual appeal, advice on how to be a health advocate, utility for a range of users, privacy, portability and sufficient capacity to record personal patient information which enhanced communication between doctor, patient and advocate. It is proving to be very popular. Clear implications were found for applying established criteria and incorporating the needs of users in the design of educational interventions in the intellectually disabled population. Health promotion tools aiming to improve the current poor health status of adults with intellectual disability should be developed further.
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