Health‐promoting physical activity of adults with mental retardation

Stanish, Heidi I.; Temple, Viviene A.; Frey, Georgia C.

doi:10.1002/mrdd.20090

Cited by 95 publications

(78 citation statements)

References 50 publications

(102 reference statements)

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“…Our qualitative findings largely support the literature [47][48][49][50] in finding that people with ID had limited knowledge about healthy lifestyle messages and experienced barriers in undertaking physical activity. However, we acknowledge that findings from the qualitative exploratory interviews with service users may be limited because of the short interview length (average 9-10 minutes), although this length does not include the additional time taken to explain the study, assess capacity, obtain consent and allow for breaks.…”

Section: Key Behavioural Goals Of the Education Programmesupporting

confidence: 80%

“…4 Severity levels for ID are typically categorised by broad intelligence quotient (IQ), alongside the required deficits in independent living skills, into mild (IQ [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69], moderate (IQ [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49], severe and profound (IQ < 20) ID. 5 Acknowledging the wide variation that exists between individuals with ID, typical abilities suggested for each category are outlined in Table 1 [based on World Health Organization (WHO) International Classification of Diseases, Tenth Edition (ICD-10)].…”

Section: Definition Of Intellectual Disability and Case Identificationmentioning

confidence: 99%

“…Prader-Willi syndrome). 46 Physical inactivity and sedentary behaviour are both common among people with ID, with only a minority (18-33%) achieving the recommended 30 minutes of moderate to vigorous physical activity (MVPA) daily, 47,48 and < 15% of people with ID complete the recommended 10,000 steps per day. 49 Furthermore, < 10% of adults with ID who live in supported accommodation have an intake of fruit and vegetables that is sufficient for a balanced diet.…”

Section: Type 2 Diabetes and Impaired Glucose Regulationmentioning

confidence: 99%

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Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.

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Section: Key Behavioural Goals Of the Education Programmesupporting

confidence: 80%

Section: Definition Of Intellectual Disability and Case Identificationmentioning

confidence: 99%

Section: Type 2 Diabetes and Impaired Glucose Regulationmentioning

confidence: 99%

See 1 more Smart Citation

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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“…This could provide a model for prevention of obesity in this population. 350,351 Ethnic Minority and Low-Income Populations Several factors are thought to contribute to the ethnic disparities in obesity in ways that potentially influence the nature of preventive interventions that will be effective. [352][353][354] Historical and current exposure to social inequities may lead to adverse eating and physical activity patterns through various mechanisms, 355 including the possibility that overeating is used as a mechanism to cope with stress or that children are overfed as "insurance" against hunger.…”

Section: Children and Adolescents With Mental And Physical Disabilitiesmentioning

confidence: 99%

Population-Based Prevention of Obesity

Kumanyika¹,

Obarzanek²,

Stettler³

et al. 2008

Circulation

535

263

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Abstract-Obesity is a major influence on the development and course of cardiovascular diseases and affects physical and social functioning and quality of life. The importance of effective interventions to reduce obesity and related health risks has increased in recent decades because the number of adults and children who are obese has reached epidemic proportions. To prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population-based approaches to obesity prevention are complementary to clinical preventive strategies and also to treatment programs for those who are already obese. This American Heart Association scientific statement aims: 1) to raise awareness of the importance of undertaking population-based initiatives specifically geared to the prevention of excess weight gain in adults and children; 2) to describe considerations for undertaking obesity prevention overall and in key risk subgroups; 3) to differentiate environmental and policy approaches to obesity prevention from those used in clinical prevention and obesity treatment; 4) to identify potential targets of environmental and policy change using an ecological model that includes multiple layers of influences on eating and physical activity across multiple societal sectors; and 5) to highlight the spectrum of potentially relevant interventions and the nature of evidence needed to inform population-based approaches. The evidence-based experience for population-wide approaches to obesity prevention is highlighted. (Circulation. 2008;118:428-464.)

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“…Individuals with intellectual disabilities are physically less active than the general community (Temple and Walkley 2003;Emerson 2005;Stanish, Temple and Frey 2006) due to their low level of motor abilities (Horvat and Franklin, 2001;Seagraves et al, 2004). Insufficient physical activity further limits the person's autonomy in activities of daily living (Piek, Dawson, Smith and Gasson, 2008) which negatively affects their health (Carbo-Carrete, Guardia-Olmos and Gine 2016).…”

Section: Introductionmentioning

confidence: 99%