POWERSforID: Personalized online weight and exercise response system for individuals with intellectual disability: A randomized controlled trial

Neumeier, William H.; Guerra, Nichole; Hsieh, Kelly; Thirumalai, Mohanraj; Ervin, David A.; Rimmer, James H.

doi:10.1016/j.dhjo.2021.101111

Cited by 7 publications

(19 citation statements)

References 37 publications

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“…In total, 80 studies were identified as eligible for inclusion in the systematic review, of which 67 were from databases and clinical registries and 13 from additional searches. Three fully published versions of study protocols that had been identified in the initial search were retrieved after the updated search in February 2022 (Neumeier et al 2021;Niemeier et al 2021;Lally et al 2022). The process is summarised in a flow diagram using PRISMA guidelines (Figure 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…Participants were nearly equally represented in terms of gender, but some studies focused on a single gender (Jackson & Thorbecke 1982;Fisher 1986;Rosety-Rodriguez et al 2013;Ordonez et al 2014;Boer et al 2016;Bossink et al 2017;Boer 2018;Niemeier et al 2021). Few studies reported on socioeconomic backgrounds -participants either came from similar socioeconomic backgrounds (Niemeier et al 2021), belonged to well-educated (Pett et al 2013) and employed (Neumeier et al 2021) middle-class families (Martínez-Zaragoza et al 2016), or from low-income backgrounds with little formal education (Jackson & Thorbecke 1982;Harris et al 2017). Participants resided at home with family and carers, in community centres, in dispersed housing provided by public or private providers, medium secure services or lived independently.…”

Section: Participant Characteristicsmentioning

confidence: 99%

“…as core components (Rotatori et al 1980;Rotatori et al 1986;Mann et al 2006;Melville et al 2011;Saunders et al 2011;McDermott et al 2012;Bergström et al 2013;San Mauro-Martín et al 2016;Harris et al 2017;Ptomey et al 2018a,b;Ptomey et al 2020;Niemeier et al 2021;Lally et al 2022). Other core components combinations included diet advice (Jackson & Thorbecke 1982;Fisher 1986;Norvell & Ahern 1987;Chapman et al 2005;Chapman et al 2008;Bazzano et al 2009;Curtin et al 2013;Marks et al 2013;Neumeier et al 2021;Lally et al 2022) and resistance exercise (Marks et al 2013;Pett et al 2013;Martínez-Zaragoza et al 2016;Kovačič et al 2020). Interventions were also based on single core-components (Yilmaz et al 2014;Croot et al 2018;House A et al 2018a;Marks et al 2019).…”

Section: Multiple Behaviours (Low Physical Activity Sedentary Behavio...mentioning

confidence: 99%

“…Comparator groups included active comparators (Harris et al 2017;Kovačič et al 2020), waitlist control (Rotatori et al 1986;Norvell & Ahern 1987;McCarran & Andrasik 1990;Marks et al 2013;Pett et al 2013;Neumeier et al 2021), treatment/activities control (Rotatori et al 1980;Jackson & Thorbecke 1982) or usual care (Fisher 1986;McDermott et al 2012;Bergström et al 2013;Curtin et al 2013;House A et al 2018a;Ptomey et al 2018a, b;Niemeier et al 2021;Lally et al 2022). For example, active comparators included Special Olympics training (Kovačič et al 2020) or an adapted mainstream weight management programme (Harris et al 2017).…”

Section: Multiple Behaviours (Low Physical Activity Sedentary Behavio...mentioning

confidence: 99%

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Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta‐analysis at intervention and component levels

Rana,

Westrop,

Jaiswal

et al. 2024

J intellect Disabil Res

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BackgroundAdults with intellectual disabilities (IDs) are susceptible to multiple health risk behaviours such as alcohol consumption, smoking, low physical activity, sedentary behaviour and poor diet. Lifestyle modification interventions can prevent or reduce negative health consequences caused by these behaviours. We aim to determine the effectiveness of lifestyle modification interventions and their components in targeting health risk behaviours in adults with IDs.MethodsA systematic review and meta‐analysis were conducted. Electronic databases, clinical trial registries, grey literature and citations of systematic reviews and included studies were searched in January 2021 (updated February 2022). Randomised controlled trials and non‐randomised controlled trials targeting alcohol consumption, smoking, low physical activity, sedentary behaviours and poor diet in adults (aged ≥ 18 years) with ID were included. Meta‐analysis was conducted at the intervention level (pairwise and network meta‐analysis) and the component‐level (component network meta‐analysis). Studies were coded using Michie's 19‐item theory coding scheme and 94‐item behaviour change taxonomies. Risk of bias was assessed using the Cochrane Risk of Bias (ROB) Version 2 and Risk of Bias in Non‐randomised Studies of Interventions (ROBINS‐I). The study involved a patient and public involvement (PPI) group, including people with lived experience, who contributed extensively by shaping the methodology, providing valuable insights in interpreting results and organising of dissemination events.ResultsOur literature search identified 12 180 articles, of which 80 studies with 4805 participants were included in the review. The complexity of lifestyle modification intervention was dismantled by identifying six core components that influenced outcomes. Interventions targeting single or multiple health risk behaviours could have a single or combination of multiple core‐components. Interventions (2 RCTS; 4 non‐RCTs; 228 participants) targeting alcohol consumption and smoking behaviour were effective but based on limited evidence. Similarly, interventions targeting low physical activity only (16 RCTs; 17 non‐RCTs; 1413 participants) or multiple behaviours (low physical activity only, sedentary behaviours and poor diet) (17 RCTs; 24 non‐RCTs; 3164 participants) yielded mixed effectiveness in outcomes. Most interventions targeting low physical activity only or multiple behaviours generated positive effects on various outcomes while some interventions led to no change or worsened outcomes, which could be attributed to the presence of a single core‐component or a combination of similar core components in interventions. The intervention‐level meta‐analysis for weight management outcomes showed that none of the interventions were associated with a statistically significant change in outcomes when compared with treatment‐as‐usual and each other. Interventions with core‐components combination of energy deficit diet, aerobic exercise and behaviour change techniques showed the highest weight loss [mean difference (MD) = −3.61, 95% credible interval (CrI) −9.68 to 1.95] and those with core‐components combination dietary advice and aerobic exercise showed a weight gain (MD 0.94, 95% CrI −3.93 to 4.91). Similar findings were found with the component network meta‐analysis for which additional components were identified. Most studies had a high and moderate risk of bias. Various theories and behaviour change techniques were used in intervention development and adaptation.ConclusionOur systematic review is the first to comprehensively explore lifestyle modification interventions targeting a range of single and multiple health risk behaviours in adults with ID, co‐produced with people with lived experience. It has practical implications for future research as it highlights the importance of mixed‐methods research in understanding lifestyle modification interventions and the need for population‐specific improvements in the field (e.g., tailored interventions, development of evaluation instruments or tools, use of rigorous research methodologies and comprehensive reporting frameworks). Wide dissemination of related knowledge and the involvement of PPI groups, including people with lived experience, will help future researchers design interventions that consider the unique needs, desires and abilities of people with ID.

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Section: Literature Searchmentioning

confidence: 99%

Section: Participant Characteristicsmentioning

confidence: 99%

Section: Multiple Behaviours (Low Physical Activity Sedentary Behavio...mentioning

confidence: 99%

Section: Multiple Behaviours (Low Physical Activity Sedentary Behavio...mentioning

confidence: 99%

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Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta‐analysis at intervention and component levels

Rana,

Westrop,

Jaiswal

et al. 2024

J intellect Disabil Res

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“…Recent studies have shown measurable benefits from the use of mobile technologies in health care and the use of technology in everyday life has been explored and deemed promising for individuals with ID [18][19][20][21]. Although some studies have explored the possibility of using mobile technologies for promoting PA for individuals with ID, there has been only one preliminary report of a randomized controlled trial (RCT) using smartphone support to increase motivation for PA in youths and adults with ID [22][23][24][25]. In Norway, many individuals with ID have a smartphone or a tablet device they can use for tailored PA interventions and this use has not been tested.…”

Section: Use Of Technology For Individuals With Idmentioning

confidence: 99%

mHealth Support to Stimulate Physical Activity in Individuals With Intellectual Disability: Protocol for a Mixed Methods Pilot Study

Michalsen¹,

Wangberg²,

Hartvigsen³

et al. 2022

JMIR Res Protoc

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Background: Several studies have shown that individuals with intellectual disabilities (IDs) have low levels of physical activity (PA), and intervention studies on PA suggest inconsistent evidence. The use of technology as a means of motivation for PA has yet to be extensively explored and needs to be further investigated. Objective:We aim to assess the feasibility and acceptability of procedures for an intervention arm in a future trial on mobile health (mHealth) to support PA for individuals with IDs. In addition, we aim to examine how the use of technology can influence motivation for PA among participants, their caregivers, and staff members. Methods:A mixed methods pilot study of an intervention arm will be carried out in a planned randomized controlled trial (RCT). Ten participants with ID and their caregivers or a staff member will be included. Information will always be provided by a caregiver or a staff member, or participants with ID if possible. Assessments will be carried out at baseline, follow-up after 4 weeks, and 12 weeks, and include questionnaires on PA, social support, self-efficacy, and challenging behavior. PA will be measured with 2 different activity trackers (Fitbit and Axivity) for 1 week at all assessments. Feasibility will be assessed as recruitment and adherence rate, missing data, usability of the motivational mHealth tool, and estimates of effectiveness. Acceptability of study procedures, activity measures, and motivation for participation in PA will be additionally assessed with qualitative methods at the end of the intervention. Results: Enrollment commenced in May 2021. Data collection was completed in March 2022.Conclusions: This pilot study will evaluate the feasibility and acceptability of study procedures of the intervention arm of a planned RCT to address feasibility issues, improve study procedures, and estimate effectiveness of the study measures. How the use of technology can influence motivation for PA will also be examined, which can help guide and improve future PA interventions involving the use of technology.

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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

Westrop,

Rana,

Jaiswal

et al. 2024

J intellect Disabil Res

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BackgroundLifestyle 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.MethodsA 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).ResultsThe 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.ConclusionsFuture 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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POWERSforID: Personalized online weight and exercise response system for individuals with intellectual disability: A randomized controlled trial

Cited by 7 publications

References 37 publications

Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta‐analysis at intervention and component levels

Lifestyle modification interventions for adults with intellectual disabilities: systematic review and meta‐analysis at intervention and component levels

mHealth Support to Stimulate Physical Activity in Individuals With Intellectual Disability: Protocol for a Mixed Methods Pilot Study

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

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