Health Promotion Intervention For Adults Research Articles

Pay Attention to Hypertension (PAtH): Findings from a cardiovascular health promotion intervention for adults with intellectual disabilities participating in Special Olympics programming.

Cardiovascular disease (CVD) affects adults globally. People with intellectual disabilities (PWID) may be at higher risk of CVD and associated risk factors (e.g. obesity, hypertension, and diabetes). We developed Pay Attention to Hypertension (PAtH), a cardiovascular health promotion intervention, and tested its impact on changes in blood pressure (BP), lifestyle behaviours and health-related empowerment among PWID. PAtH was developed with a Special Olympics community organisation that supports PWID in developing self-confidence and social skills through participation in sports. The 6-month intervention consisted of 1-h individualised virtual sessions delivered monthly by nursing students/novice nurses. Sessions covered specific themes, including monitoring BP, adopting healthy lifestyles and managing stress, and were individually tailored to the capacities and needs of participants. A single group pre-post-intervention design was used to assess the intervention's effects among participants who completed the intervention and data collection. Data included baseline and follow-up BP measurements from 7-day logbooks and questionnaires assessing lifestyle behaviours [physical activity (PA), screen time and diet], and health-related empowerment. Seventy-four participants were included in the analyses. Between baseline and follow-up, there were no changes in systolic and diastolic BP, PA or leisure screen time. The proportion of participants who reported adding salt when cooking decreased from baseline to follow-up (19.7% vs. 12.7%, P=0.034), and we found improvements for several items measuring health-related empowerment (P≤0.003). Improvements in health-related empowerment were found following PAtH. More intensive interventions may be needed to result in changes in lifestyle behaviours and BP. The integration of adapted cardiovascular health promotion initiatives within well-established community organisations such as Special Olympics is a promising avenue to contribute to cardiovascular health promotion among PWID.

Understanding the Implementation Process of a Multi-Component Health Promotion Intervention for Adults with Intellectual Disabilities in Sweden.

There is a need to better understand implementation processes of health interventions. This study describes the implementation of a multicomponent intervention to improve diet and physical activity amongadults with intellectual disabilities, viewed from the perspectives of staff and managers. All health ambassadors (n=12), appointed among staff and managers (n=5) taking part of a health intervention in community residences in Sweden, were interviewed with a focus on barriers and facilitators regarding implementation of the intervention. Data were analysed using content analysis. The overarching theme describes the importance of supporting motivation for change among managers, caregivers and residents. The experiences of the implementation process are described in four main categories: intervention characteristics, individual commitment, organizational capacity and societal factors. The implementation can be facilitated by a programme meeting perceived needs, a flexible and participatory approach, external input and an extensive preparation phase.

An efficacy trial of 'Steps to Your Health', a health promotion programme for adults with intellectual disability.

Although there are evaluation and effectiveness studies of health promotion interventions for adults with intellectual disabilities (ID), randomized efficacy trials of such interventions are lacking. A randomized active control intervention trial. The participants attended the health promotion classes in local disability agency service facilities. Method: We enrolled 443 individuals and randomly assigned them to one of two eight-week participatory classes. The 'Steps to Your Health' (STYH) classes emphasized moderate to vigorous physical activity (MVPA), healthy eating and body mass index (BMI) reduction. The control intervention focused on hygiene and safety. We did not find a statistically significant difference in mean MVPA or BMI change between completers of the STYH group compared to the control group one year after the intervention was completed. We did find that participation in STYH classes had a non-significant association with odds of reduction in BMI (odds ratio [OR] 2.87, 95% confidence interval [CI] 0.91-9.11) and completers who lived in group homes were more likely than their counterparts who lived with families or in apartments to decrease their BMI (OR 4.61; 95% CI 1.14-18.64). This trial did not demonstrate a significant effect of STYH participation on change in mean minutes of MVPA or mean BMI 12 months after classes ended, although there was a non-significant association with odds of reduction of BMI (p = 0.07). This study has implications for design of intervention studies in people with intellectual disability (ID).

A randomized trial of a health promotion intervention for adults with disabilities

Background People with disabilities face a range of health disparities, including increased risk for preventable health problems. Thus, health promotion efforts addressing the reduction of risk factors are especially important for this population. Objective This study examined changes in health behaviors among adults with disabilities following participation in the Healthy Lifestyles for People with Disabilities health promotion program. It was hypothesized that intervention participants would demonstrate significant increases in healthy behaviors in areas such as health responsibility, physical activity, nutrition, stress management, interpersonal relationships, and spiritual growth while controls would not show significant change. Methods Participants (n = 95) were randomly assigned to the intervention or to a wait-list. After initially serving as controls, wait-list members later received the intervention as well. A measure of health behaviors was completed at baseline, 4 months, 7 months, and 10 months. Results Health behavior scores of immediate intervention participants increased significantly (p <.001) while the scores of wait-list members showed no significant change. After subsequently attending a Healthy Lifestyles workshop, scores of wait-list participants also increased significantly (p = .001). Conclusions The Healthy Lifestyles intervention appears to be successful in helping adults with disabilities increase healthy behaviors.

A Pilot Evaluation of the In SHAPE Individualized Health Promotion Intervention for Adults with Mental Illness

This pilot study examined whether participation in the individualized, community-integrated In SHAPE health promotion program would result in improved physical activity and dietary behaviors, health indicators, and psychological functioning or symptoms in 76 adults with schizophrenia, bipolar disorder, major depression, or other mental disorders. Over a 9-month period, participation was associated with increased exercise, vigorous activity, and leisurely walking (P < .01), and a trend toward improved readiness to reduce caloric intake (P = .053). Participants demonstrated a reduction in waist circumference (P < .05), but no change in BMI. Satisfaction with fitness (P < .001) and mental health functioning (P < .05) improved, and severity of negative symptoms decreased (P < .01). This study demonstrated the feasibility and potential effectiveness of the In SHAPE program, which consisted of exercise and dietary modification. Based on these promising results, randomized controlled trials of the In SHAPE program are necessary to establish its effectiveness compared with usual care and alternative approaches to enhancing fitness.

The Healthy Lifestyle Change Program: A Pilot of a Community-Based Health Promotion Intervention for Adults with Developmental Disabilities

Although adults with developmental disabilities are at high risk for obesity and its sequelae, few community-based lifestyle interventions targeting those with developmental disabilities exist. The study was a single group, community-based demonstration project with pre-post test evaluation conducted from December 2005 to June 2006. Eligible participants were 431 community-dwelling adults with developmental disabilities, aged 18-65 years, who were overweight/obese (BMI > or =25) with another risk factor for diabetes or metabolic syndrome or who had a diagnosis of diabetes, and received services from a community agency. Eighty-five signed up (20% of those eligible), 68 participated in an initial class, and 44 completed the program (35% attrition rate). The Healthy Lifestyle Change Program (HLCP) is a community-based health intervention developed and implemented using community-based participatory research methods by members of the developmental disabilities community, in collaboration with academic researchers. The HLCP was a 7-month, twice-weekly education and exercise program to increase knowledge, skills, and self-efficacy regarding health, nutrition, and fitness among adults with developmental disabilities. Peer mentors served as participant leaders and primary motivators. Changes in weight, BMI, abdominal girth, access to care, and self-reported nutrition, physical activity, and life satisfaction were each measured. Two thirds of participants maintained or lost weight, with a mean weight loss of 2.6 pounds and a median weight loss of 7 lbs (range: 2-24 lbs). Average BMI decreased by 0.5 kg/m(2) (p=0.04). Abdominal girth decreased in 74% of participants (mean= -1.9 inches). Sixty-one percent of participants reported increased physical activity. Mean exercise frequency increased from 3.2 times to 3.9 times per week (p=0.01). Mean exercise duration increased from 133 minutes to 206.4 minutes per week (p=0.02). Significant improvements in nutritional habits and self-efficacy were reported. Over half (59%) of participants showed improvements in life satisfaction. Participants received 206 referrals for needed medical care. The HLCP and its dissemination increased participants' and peer mentors' ability to act as community advocates and partners in research. The HLCP resulted in improved lifestyles, weight loss success, and increased community capacity, indicating that a community-based program with significant participation of those with developmental disabilities is feasible. This program should be expanded and evaluated with larger populations with developmental disabilities.

The Need for Health Promotion for Adults who are Visually Impaired

Health promotion interventions for adults who are visually impaired have received little attention. This article reports what is currently known about the health, overweight and obesity, and levels of physical activity reported by these adults. Conclusions about the need for health promotion activities based on this information are provided, and suggestions for implementing these activities or interventions are offered.

Living Well With a Disability Health Promotion Intervention: Improved Health Status for Consumers and Lower Costs for Health Care Policymakers.

Objective: Investigate effectiveness of a health promotion intervention for adults with mobility impairments. Study Design: Interrupted time series, staggered baseline quasi-experimental with random assignment to treatment start date. Setting: 9 Centers for Independent Living in 8 states. Participants: Adults with mobility impairments living independently (N 188). Intervention: Living Well With a Disability: Facilitated group health promotion (16 hr over 8 weeks). Main Outcomes Measures: Secondary conditions, symptom days, health care utilization. Results: Reductions in limitation from secondary conditions, symptom days, and health care utilization over the intervention period. Effects on secondary conditions maintained for 12 months. Overall cost savings of $807 per person (total for sample $151,716) projected from reductions in health care utilization of study sample. Conclusions: Health promotion interventions can increase quality of life while helping to control health care costs.