Promoting a healthy diet and physical activity in adults with intellectual disabilities living in community residences: design and evaluation of a cluster-randomized intervention.
Promoting a healthy diet and physical activity in adults with intellectual disabilities living in community residences: design and evaluation of a cluster-randomized intervention.
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DOI：
10.1186/1471-2458-10-761
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发表时间：
2010-12-13
影响因子：
4.5
通讯作者：
Hagströmer M
中科院分区：
文献类型：
--
作者：
Elinder LS;Bergström H;Hagberg J;Wihlman U;Hagströmer M
许多智力残疾的成年人饮食习惯不良，体力活动少，体重不稳。本研究方案描述了旨在改善该目标人群饮食和体力活动的健康干预措施的设计和评价。在瑞典，智力残疾的成年人往往居住在社区住所，那里的工作人员对居民的特殊健康需求缺乏足够的教育。没有出版的生活方式干预措施同时针对居民和工作人员。干预措施旨在适应社区居民的日常工作。它基于社会认知理论，需要12-15个月才能完成。干预包括三个组成部分：1）在居民家中为居民举办10次健康教育会议; 2）在每个住所的工作人员中任命一名健康大使并形成一个网络; 3）为每个住所的工作人员建立一个学习圈。通过与管理人员协商、培训卫生教育工作者和指导卫生大使来实施干预措施。忠诚度是根据居民和工作人员参与干预活动的情况进行评估的。研究设计是一项随机分组试验，以体力活动作为主要结局，通过计步器进行客观评估。次要结果是通过数码摄影评估的饮食质量，测量的体重，身高和腰围，以及通过生活质量量表评估的生活质量。中间结果是通过向管理人员发出的调查问卷评估的住宅区工作程序的变化。居住在斯德哥尔摩县社区住宅的轻度至中度智力残疾成年人有资格被纳入。多水平分析用于评价对主要和次要结局的影响。有序回归分析的干预对社区居民的日常工作的影响。通过观察和半结构化访谈，在探索性定性研究中确定了实施的障碍和促进因素。尽管存在一些挑战，但我们希望，这项干预措施的结果将导致新的和改进的健康促进方案，使目标群体受益。ISRCTN33749876
Many adults with intellectual disabilities have poor dietary habits, low physical activity and weight disturbances. This study protocol describes the design and evaluation of a health intervention aiming to improve diet and physical activity in this target group. In Sweden, adults with intellectual disabilities often live in community residences where the staff has insufficient education regarding the special health needs of residents. No published lifestyle interventions have simultaneously targeted both residents and staff. The intervention is designed to suit the ordinary work routines of community residences. It is based on social cognitive theory and takes 12-15 months to complete. The intervention includes three components: 1) Ten health education sessions for residents in their homes; 2) the appointment of a health ambassador among the staff in each residence and formation of a network; and 3) a study circle for staff in each residence. The intervention is implemented by consultation with managers, training of health educators, and coaching of health ambassadors. Fidelity is assessed based on the participation of residents and staff in the intervention activities. The study design is a cluster-randomised trial with physical activity as primary outcome objectively assessed by pedometry. Secondary outcomes are dietary quality assessed by digital photography, measured weight, height and waist circumference, and quality of life assessed by a quality of life scale. Intermediate outcomes are changes in work routines in the residences assessed by a questionnaire to managers. Adults with mild to moderate intellectual disabilities living in community residences in Stockholm County are eligible for inclusion. Multilevel analysis is used to evaluate effects on primary and secondary outcomes. The impact of the intervention on work routines in community residences is analysed by ordinal regression analysis. Barriers and facilitators of implementation are identified in an explorative qualitative study through observations and semi-structured interviews. Despite several challenges it is our hope that the results from this intervention will lead to new and improved health promotion programs to the benefit of the target group. ISRCTN33749876
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