Understanding physical activity in the group home setting: a qualitative inquiry.

PURPOSE: Persons with intellectual disabilities have low physical activity levels and high rates of chronic disease. One predictor limitedly explored is the home environment, which could influence the type and amount of physical activity in this population. The purpose of this study is to qualitatively explore physical activity in the group home setting and determine what key stakeholders want from a physical activity programme. METHOD: This study adopted a qualitative descriptive design, using semistructured focus groups. Twenty stakeholders (i.e., residents with intellectual disability, support staff and programme coordinators) participated in one of three focus groups, separated by stakeholder status. RESULTS: A number of factors emerged that would assist rehabilitation professionals in understanding physical activity within the group home setting. The following six meta-themes were identified: nature of residents' physical activity, facilitators to physical activity, barriers to physical activity, personal factors, organizational factors and solutions to increase physical activity. CONCLUSIONS: Findings suggest that residents with intellectual disabilities have low physical activity and opportunities for participation. Key attributes of the group home setting were identified between barriers and facilitators to activity. Consideration for the development of physical activity programmes should focus on the unique needs of the group home setting as expressed by stakeholders. Implications for rehabilitation Physical activity can improve physical fitness, function, and community participation yet physical activity remains low among adults with intellectual disabilities. Understanding physical activity within the group home setting is essential to develop targeted interventions to increase activity within that environment. Key barriers for physical activity within the group home setting include; operational priorities, limited staff, staff turnover, busy schedules, and staff attitudes towards physical activity.

Formative evaluation on a physical activity health promotion program for the group home setting.

Physical inactivity and high rates of chronic conditions is a public health concern for adults with intellectual disability. Few health promotion programs target the group home setting which is the pre-dominant form of residential accommodation for persons with intellectual disability. A process evaluation of a physical activity health promotion program, Menu-Choice, was conducted with five group home sites for adults with intellectual and developmental disabilities. Menu-Choice assists group home staff in including physical activity goals within resident schedules. The physical activity program was designed based on theoretical frameworks, community-based participatory approaches, and established health promotion guidelines for adults with disabilities. Fourteen program coordinators (age M 39; 77% females), 22 staff (age M 39; 82% females), and 18 residents (age M 59; 72% females; 56% ambulatory) participated. Results from the fidelity survey and program completion highlight potential challenges with implementation. Findings will assist with the refinement of the program for continued implementation trials in the group home community.

Obesity in children with developmental and/or physical disabilities.

Children with developmental or physical disabilities, many of whom face serious health-related conditions, also are affected by the current obesity crisis. Although evidence indicates that children with disabilities have a higher prevalence of obesity than do children without disabilities, little is known of the actual magnitude of the problem in this population. To address this concern, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) held a conference on obesity in children with intellectual, developmental, or physical disabilities, bringing together scientists and practitioners in the fields of obesity and disability to foster collaboration, identify barriers to healthy weight status in populations with disabilities, propose avenues to solutions through research and practice, and develop a research agenda to address the problem. This article describes current knowledge about prevalence of obesity in this population, discusses factors influencing obesity risk, and summarizes recommendations for research presented at the conference.

Nutrition and adults with intellectual or developmental disabilities: systematic literature review results.

Approximately 4.5 million Americans have an intellectual or developmental disability. Concern is increasing about these individuals' nutrition-related behavior and its implications for their health. This article reports on a systematic search of the current literature listed in the PsycINFO and PubMed databases related to nutritional status of adults with intellectual or developmental disabilities. The authors used key terms for nutrition, secondary conditions, and intellectual and developmental disability and categorized literature pertaining to nutrition-related studies of adults with intellectual or developmental disabilities as follows: dietary intake studies, anthropometric assessments of nutritional risks, biochemical indexes, and clinical evaluations.

Nutritional intervention improves menu adequacy in group homes for adults with intellectual or developmental disabilities.

BACKGROUND: Research documents that adults with intellectual or developmental disabilities (IDD) living in the community experience nutritional deficits, inadequate diets, and poor nutritional status. OBJECTIVE: We developed a nutrition intervention that was targeted at improving the food systems in group homes for adults with intellectual or developmental disabilities, called MENU-AIDDs (Materials Supporting Education and Nutrition for Adults with Intellectual or Developmental Disabilities). METHODS: MENU-AIDDs was implemented for 8 and 16 weeks in four community-based group homes for adults with IDD. Improved nutritional adequacy of planned menus was tested as a marker of improved dietary intake in the residents of the homes. RESULTS: Results showed significant statistical and clinical improvements in the planned menus whereby there were significant increases in the appearance on menus of whole grains, vegetables overall and green/yellow/orange vegetables in particular, and low-fat proteins, and significant decreases in the higher-fat proteins, potatoes, and "junk foods." The positive practice of specifying portion sizes on the menus increased significantly. CONCLUSIONS: MENU-AIDDs is a community-based health promotion intervention that can improve menu planning and dietary adequacy while being responsive to the needs of group home residents, direct care staff, and administrators.

Nutrition education and support program for community-dwelling adults with intellectual disabilities.

To test the efficacy, acceptability, and appropriateness of a nutrition education and support program, 4 community-based group homes for adults with intellectual or developmental disabilities participated in a pilot intervention with extended baseline period and pre-post-test design. Adults (N = 32) with intellectual or developmental disabilities, 20 direct service staff, 4 managers of group homes, and 2 health specialists at private service providers participated in the intervention, consisting of a system of nutrition supports in nutrition education and guidelines, menu and meal planning, grocery shopping, and cooking designed for the special needs of this population. Positive impacts were found using the program, including fidelity measures, food systems changes and acceptability to users, planned and served foods, and cost changes associated with implementation.