A cluster randomised control trial of a multi-component weight management programme for adults with intellectual disabilities and obesity

Abstract

There have been few published controlled studies of multi-component weight management programmes that include an energy deficit diet (EDD), for adults with intellectual disabilities and obesity. The objective of this study was to conduct a single-blind, cluster randomised controlled trial comparing a multi-component weight management programme to a health education programme. Participants were randomised to either TAKE 5, which included an EDD or Waist Winners Too (WWToo), based on health education principles. Outcomes measured at baseline, 6 months (after a weight loss phase) and 12 months (after a 6-month weight maintenance phase), by a researcher blinded to treatment allocation, included: weight; BMI; waist circumference; physical activity; sedentary behaviour and health-related quality of life. The recruitment strategy was effective with fifty participants successfully recruited. Both programmes were acceptable to adults with intellectual disabilities, evidenced by high retention rates (90 %). Exploratory efficacy analysis revealed that at 12 months there was a trend for more participants in TAKE 5 (50·0 %) to achieve a clinically important weight loss of 5-10 %, in comparison to WWToo (20·8 %) (OR 3·76; 95 % CI 0·92, 15·30; 0·064). This study found that a multi-component weight management programme that included an EDD, is feasible and an acceptable approach to weight loss when tailored to meet the needs of adults with intellectual disabilities and obesity.

Correlates of objectively measured sedentary time in adults with intellectual disabilities

“…A limitation of this study was the multiple correlates included in the analysis were restricted to those collected during baseline data collection of two multi-component behaviour change interventions ( Harris et al, 2015 , Melville et al, 2015 ). As a result, a wider investigation into additional interpersonal, social, and organizational factors was not possible.…”

“…A secondary analysis of pooled baseline data from two randomised controlled trials (RCTs) of lifestyle behaviour change programmes was conducted. One RCT was focused on weight management (n = 50; Harris et al, 2015 , Harris et al, 2015 ) and the second one on increasing physical activity (n = 102; Mitchell et al, 2013 , Melville et al, 2015 ).…”

The feasibility of using the EQ-5D-3L with adults with mild to moderate learning disabilities within a randomized control trial: a qualitative evaluation

“…The EQ-VAS was not included on the advice of the service user involvement group who felt completing this element of the measure would be too difficult for participants, a view supported by the findings of previous studies [ 11 , 20 ]. Instead, participants were asked to rate their own health (“In general, would you say your health is?”) on a five-point scale of excellent, very good, good, fair or poor, also printed on a card using a large font.…”

“…Proxy measures of health status are always problematic to a degree, especially in relation to subjective experiences of pain and mood; however, they may be useful in conjunction with self-report measures in this population [ 16 , 17 ]. Third, a version of the measure for children the EQ-5D-Y [ 18 , 19 ] has also been used with adults with a learning disability although the activity examples are not appropriate for adults [ 20 ] and the EQ-5D-Y has not been validated in a population of children or adults with a learning disability. In summary, there are a number of issues with measuring the health status and health-related quality of life in adults with a learning disability and several authors have called for further research [ 4 , 20 – 22 ].…”

Energy expenditure measured with accelerometers and self‐report questionnaire in people with intellectual disabilities

“…One of the most used methods is the International Physical Activity Questionnaire Short Version (IPAQ‐S), which has been used to measure physical activity in people with intellectual disability in previous studies (Harris et al . ; Matthews et al . ; Moss & Czyz ; Pérez‐Cruzado & Cuesta‐Vargas ) due to its ease of use, application time (less than 15 min) and excellent reliability for general population based on activity intensity classification (ICC = 0.81) (Craig et al .…”