| Abstract |
- Background: A particular health inequity that has drawn national attention is obesity in persons with disabilities (CDC, 2011). Estimates suggest that as many as 80% of adults with mild to moderate intellectual disability (ID) are overweight or obese (Stanish & Draheim, 2005). Despite the benefits of being active (e.g. controlling body weight, improving functional and mental health status, and reducing cardiovascular disease) (CDC, 2011), only 30% of adults with ID are meeting recommended guidelines, many of which are also demonstrating preferences for sedentary behaviors (Stanish et al., 2006; Frey et al., 2005; Dixon-Ibarra, et al., 2013). Caregivers play an important role in the activity behaviors of those with ID, especially in the group home setting, where an increasing number of people with ID live. However, there are currently no health promotion programs that focus on changing the way caregivers in the group home setting facilitate physical activity (PA) for residents. Thus, the purpose of this project was to develop a specially designed health promotion program using community engagement and established health promotion guidelines for persons with disabilities (Drum et al., 2010).
Methods: Phase I of program development involved focus group discussions with an 'Advisory Group' of group homes stakeholders (i.e., program coordinators, staff, and residents) to obtain insider knowledge about PA in the group home setting and suggestions for program development. Based on 'Advisory Group' feedback and established guidelines, the Menu-Choice Physical Activity Program was created. Phase II, program implementation, included a 10 week pilot intervention with one month follow-up. Program coordinators, staff, and residents from one group home agency were included in program implementation. Data collection for the pilot intervention included training evaluations, program fidelity surveys, evaluation of program materials, health outcomes (i.e., PA and body weight), and face to face interviews with staff and residents.
Results: Phase I 'Advisory Group' focus groups resulted in the following themes that aided in program design: 1) Nature of residents' PA, 2) Facilitators to PA, 3) Barriers to PA, 4) Personal Factors, 5) Organizational Factors, and 6) Solutions to increase PA. Phase II pilot intervention determined the most and least frequently used program materials and provided insight to the types and amount of activity scheduled during the intervention. The group home sites only used basic program components and discontinued use from post to one month follow up. Physical activity and body weight did not change from baseline to post intervention. Qualitative interviews conducted, as part of the program evaluation, identified the following themes: 1) Program training, 2) Program Implementation, 3) Program Physical Activity, 4) Program Barriers, 5) Program Facilitators, and 6) Program Feedback.
Conclusion: During Phase I, community engagement was critical in understanding how PA is or is not included in the group home setting. The 'Advisory Group' provided needed feedback for the design of the program. For Phase II, the pilot intervention was essential for determining how the program would work in the real world setting. The quantitative and qualitative findings from the pilot will be used to refine the current program materials, program name, training, and implementation in an effort to create a program designed to meet the needs of individuals with ID residing in the group home setting.
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