GRAIDs: a framework for closing the gap in the availability of health promotion programs and interventions for people with disabilities

Abstract

BackgroundEvidence-based health promotion programs developed and tested in the general population typically exclude people with disabilities. To address this gap, a set of methods and criteria were created to adapt evidence-based health promotion programs for people with disabilities. In this first study, we describe a framework for adapting evidence-based obesity prevention strategies for people with disabilities. We illustrate how the framework has been used to adapt the U.S. Centers for Disease Control and Prevention’s (CDC) obesity prevention strategies for individuals with physical and developmental disabilities.MethodsThe development of inclusion guidelines, recommendations and adaptations for obesity prevention (referred to as GRAIDs – Guidelines, Recommendations, Adaptations Including Disability) consists of five components: (i) a scoping review of the published and grey literature; (ii) an expert workgroup composed of nationally recognized leaders in disability and health promotion who review, discuss and modify the scoping review materials and develop the content into draft GRAIDs; (iii) focus groups with individuals with disabilities and their family members (conducted separately) who provide input on the potential applicability of the proposed GRAIDs in real world settings; (iv) a national consensus meeting with 21 expert panel members who review and vote on a final set of GRAIDs; and (v) an independent peer review of GRAIDs by national leaders from key disability organizations and professional groups through an online web portal.ResultsThis is an ongoing project, and to date, the process has been used to develop 11 GRAIDs to coincide with 11 of the 24 CDC obesity prevention strategies.ConclusionA set of methods and criteria have been developed to allow researchers, practitioners and government agencies to promote inclusive health promotion guidelines, strategies and practices for people with disabilities. Evidence-based programs developed for people without disabilities can now be adapted for people with disabilities using the GRAIDs framework.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0100-5) contains supplementary material, which is available to authorized users.

Requirements on a community-based intervention for stimulating physical activity in physically disabled people: a focus group study amongst experts

“…The finding that no new intervention should be designed, but that an existing intervention should be adapted is consistent with research of Rimmer et al, which describes a framework for adapting existing evidence-based strategies for people with disabilities [21]. The importance of stimulating both sports and active lifestyle agrees findings of van der Ploeg et al [15].…”

The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study

“…Although these inter-sectoral collaborations might be one of the successful elements of promoting physical activity in people with disabilities, it can be a challenge to establish and maintain these collaborations due to lack of time and/or differences in cultures and interests between sectors [57][58][59]. The counselors in the "Physical Activity Counseling Centers" may play a promising role in overcoming these challenges and therefore creating and maintaining a sustainable network between rehabilitation and community-based physical activity [9,60].…”

The Guide to Community Preventive Services and Disability Inclusion

“…25 The Guidelines, Recommendations, Adaptations, Including Disabilities model employs this technique and has been used to develop recommendations on community-level interventions. 26 …”