Healthy Behavior Change of Adults With Mental Retardation: Attendance in a Health Promotion Program

Abstract

Participation in a health promotion program for 192 overweight and obese adults with mental retardation was associated with behavior change resulting in reduction of body mass index-BMI (weight in kg, divided by height in meters, squared) by the end of the program. We analyzed the mediating and intermediate factors contributing to weight reduction and found knowledge and exercise to be the primary contributing factors. The curriculum emphasized exercise, nutritional choices, and stress reduction. Participation in the program was associated with a reduction of 0.8 BMI or approximately 2.3 kg for 26% of the participants. Increased knowledge about healthy diet and exercise was the most significant mediator of program impact on BMI.

Nutrition and Adults With Intellectual or Developmental Disabilities: Systematic Literature Review Results*

“…As more adults with intellectual or developmental disabilities gain greater independence, we cannot assume they will have the constant supervision necessary to conduct proxy dietary intake analysis. The use of a proxy in conjunction with interviews and self-reporting is a promising and recommended approach but has not been validated for dietary intake data collection with adults who have intellectual or developmental disabilities (e.g., Draheim, Williams, & McCubbin, 2002a;Mann, Zhou, McDermott & Poston, 2006;Seekins, Traci, Bainbridge, & Humphries, 2005). Table 2 summarizes 15 dietary intake studies relevant to adults with intellectual or developmental disabilities and published from 1985 through 2007.…”

“…Three studied institutionalized adults (Cunningham et al, 1990;Litchford & Wakefield, 1985;Molteno et al, 2000), 12 studied adults living in community settings (Bertoli et al, 2006;Braunschweig et al, 2004;Draheim et al, 2002aDraheim et al, , 2007Humphries et al, 2007;Humphries, Traci, & Seekins, 2004;Lindeman, 1991;Mann et al, 2006;McGuire et al, 2007;Robertson et al, 2000;Seekins et al, 2005;Stewart et al, 1994), 1 compared a cross-section of samples from the community and from an intermediate care facility (Mercer & Ekvall, 1992), and 1 study assessed dietary intake longitudinally in a sample of adults as they moved from an institution to a community residence (Bryan et al, 2000). Of the communitybased studies, 3 studied dietary intake via menu review (Humphries et al, 2004;Lindeman, 1991;Mercer & Ekvall, 1992), 1 used 7-day food records (Bertoli et al, 2006), 7 used a food frequency questionnaire (Braunschweig et al, 2004;Draheim, 2007;Draheim et al, 2002a;Humphries et al, 2007;McGuire et al, 2007;Robertson et al, 2000;Seekins et al, 2005), and 2 used diet history (Mann et al, 2006;Stewart et al, 1994). In addition, 2 studies attempted to correlate dietary intake with chronic disease (CVD risk factors; Braunschweig et al, 2004;Draheim et al, 2002a).…”

The State of the Science of Health and Wellness for Adults With Intellectual and Developmental Disabilities

“…Health and wellness interventions have been shown to increase self-efficacy for exercise; lower depression; improve cardiovascular health, muscular strength and endurance; improve weight status; improve GI health; improve nutritional quality and adequacy of available food; result in an overall improvement in knowledge and health-related behavior for at least some of the participants; and decrease maladaptive and increase adaptive behavior (Abdullah et al, 2004; Heller, McCubbin, Drum, & Peterson, 2011; Holburn et al, 2008; Humphries Pepper. Traci, Olson & Seekins, et al, 2009; Mann et al, 2006; McDermott et al, 2012; Marks et al, 2013). As in most programs that target lifestyle change, outcomes for people with IDD are modest and evaluations have rarely measured change longer than one year following program completion.…”

“…Individuals with IDD tend to lead very sedentary lifestyles and are not achieving a level of physical activity that would positively affect health (Mann, Zhou, McDermott, & Poston, 2006: Peterson, Janz, & Lowe, 2008; Seekins, Traci, Bainbridge, & Humphries, 2005). Other risk factors for obesity for people with IDD include age (with higher rates among older adults), gender (with higher rates among women), and mobility status (with lower rates for those not independently mobile) (Bandini, Curtin, Hamad, Tybor, & Must, 2005; Bhaumik et al, 2008; Melville et al, 2007; Rimmer & Yamaki, 2006; Stancliffe et al, 2011).…”

“…A program designed to address weight loss, nutrition, exercise, and stress reduction (Steps to Your Health) was adapted for individuals with ID (Mann et al, 2006). Eight classes were delivered by community services providers and provided concrete examples of each concept and participatory activities.…”