Using a theoretically driven approach with adults with mild-moderate intellectual disabilities and carers to understand and improve uptake of healthy eating and physical activity

Conducting theory‐based qualitative interviews with adults with intellectual disabilities and their carers: Adaptations to facilitate participation

“…The qualitative findings were analysed using thematic analysis using a critical realist approach (Braun & Clarke, 2006). Twenty percent of the interview data was secondary coded for methodological rigour in applying theoretical constructs to the findings (Bains & Turnbull, 2020).…”

“…However, the research team designed the interview protocol and collected, transcribed, coded and analysed the data for two reasons. First, we were familiar with behaviour change theories and had chosen a model that past research and evidence suggested would provide an appropriate framework to guide the interview protocol (Bains & Turnbull, 2020).…”

“…Adults with intellectual disabilities also face wider social and environmental barriers to healthier eating and physical activity. These barriers include difficulties accessing appropriate knowledge and skills training (e.g., cooking or exercise classes) and lack of availability and consistency of social support to implement healthful behaviours due to resource constraints (Bains & Turnbull, 2020;Cartwright et al, 2015Cartwright et al, , 2017Matthews et al, 2016;O'Leary et al, 2018;Spanos et al, 2013;Stancliffe & Anderson, 2017). Staff and carers also may not have high levels of health literacy (Melville et al, 2009), skills and mastery in cooking, promoting participation in physical activity amongst adults with intellectual disabilities and competing support demands to fulfil which may take precedence (Bains & Turnbull, 2020;O'Leary et al, 2018).…”

“…The interviews with staff and carers enabled inductive exploration of ways to increase self-efficacy and improve outcome expectancies, goal setting and positive social support amongst adults with intellectual disabilities in practice. The ideas generated could then be explored with adults with intellectual disabilities to gather their perspectives on these issues using an iterative process of transcription, coding and preliminary analysis between interview waves with each sub group (staff and carers and adults with intellectual disabilities respectively).Kate: Some people, you know, have got that ability for a bit of experimentation … Erm I know the first time I ever tried tamarind, er I thought I go into the shop, I bought it I had a little taste … Interviewer: What about little, taste tests, do you think that could work with some people?T A B L E 3 Participant characteristics of adults with intellectual disabilities (cf:Bains & Turnbull, 2020)…”

How to Write a “Prescription” for Physical Exercise

“…Therefore, it is important for all health professionals who treat AIDD to be able to determine their baseline "physical activity level" (i.e., minutes/week of both Sedentary behavior and Moderate/Vigorous physical activity) and prescribe effective patient-preferred endurance (aerobic) and/or resistance (strength-building) exercise programs [5][6][7][8][9][10][11]. While AIDDs will willingly wear activity watches [12], there has been difficulty "recording" their minutes of exercise due to lack of abilities of AIDDs and/or cooperation of their caregivers [13,14]. These measures are important because extensive research has shown that they are associated with increased risk for mental illness, cardiovascular disease, cancer, and many other diseases, as well as an overall increased mortality risk.…”