Individual and family based approaches to increase physical activity in adolescents with IDD

摘要 患有智力和发育障碍(IDD)的青少年体力活动较少， 与正常发育的同龄人相比，心血管健康状况更好。患有IDD的青少年也面临 参加中等到剧烈的体力活动(MVPA)的其他障碍，包括对 家长接送锻炼设施，缺乏适当的锻炼设施，缺乏PA专业人员 缺乏对患有IDD的青少年的具体需求的专门知识，缺乏同伴支持。上一首 增加青少年IDD患者MVPA的干预措施收效甚微，至少部分原因是 要求父母将他们的孩子送到锻炼设施，这对 已经在处理为有特殊需要的青少年提供常规护理的家庭。我们最近 开发了一个远程系统，在训练有素的健康教练的带领下，向患有IDD的青少年群体提供MVPA 在家里通过平板电脑进行视频会议。这种方法不再需要 交通，提供社会互动和来自健康教练和其他参与者的支持，并且是 在家长参与最少的情况下是可行的。我们建议18个月。试验(6个月)活动，6个月。维护，6 莫斯。非接触性随访)比较114名IDD青少年客观评估MVPA的变化 随机分为仅提供给青少年(AO)的单级干预或多级干预 分发给青少年和家长(A、P)。接受干预的青少年将被要求 参加由训练有素的健康教练使用视频会议进行的家庭MVPA小组会议 并完成每周一次的活动家庭作业。A P组青少年的父母 将被要求参加MVPA小组视频会议和家庭作业活动，参加 与青少年举行关于MVPA在健康和功能方面的作用的教育/支持会议 在青少年和青少年中增加MVPA的战略，并将提供获得 Facebook页面，与A P手臂上其他青少年的父母互动。我们的主要目标是比较 两组间平均MVPA(min./d)增加0~6个月。其次，我们会 比较MVPA、久坐时间、心血管适能、肌力、运动能力素质的变化 寿命和青少年达到美国建议的60分钟的百分比。18个月的MVPA/d。 我们还将探索过程变量/参与者特征的影响，包括小组出席率 视频(AO-青少年；A P-青少年/家长)和教育/支持会议(仅限A P)，自我监测 MVPA(AO-青少年；A P-青少年/父母)，父母使用Facebook页面(仅限A P)，同伴 小组PA会议期间的互动/支持、青少年自我效能感、社会支持和PA障碍 父母MVPA、对PA的信念和态度、父母的时间限制、年龄、性别和IDD诊断。

Abstract Adolescents with intellectual and developmental disabilities (IDD) are less physically active and have lower cardiovascular fitness compared with their typically developing peers. Adolescents with IDD also face additional barriers to participation in moderate-to-vigorous physical activity (MVPA) including dependence on parents for transportation to exercise facilities, lack of appropriate exercise facilities, lack of PA professionals with expertise regarding the specific needs of adolescents with IDD, and lack peer support. Previous interventions to increase MVPA in adolescents with IDD have met with limited success, at least in part due to requiring parents to transport their adolescent to an exercise facility, which represents significant barrier to families already dealing with the burden of providing routine care for a special needs adolescent. We recently developed a remote system to deliver MVPA, led by a trained health coach, to groups of adolescents with IDD in their homes via video conferencing on a tablet computer. This approach eliminates the need for transportation, provides social interaction and support from both the health coach and other participants, and is feasible with minimal parent involvement. We propose an 18 mo. trial (6 mos. active, 6 mos. maintenance, 6 mos. no-contact follow-up) to compare changes in objectively assessed MVPA in 114 adolescents with IDD randomized to a single level intervention delivered only to the adolescent (AO) or a multi-level intervention delivered to both the adolescent and a parent (A+P). Adolescents in both intervention arms will be asked to attend home-based, group MVPA sessions conducted by a trained health coach using video conferencing software and to complete a weekly activity homework assignment. Parents of adolescents in the A+P group will be asked to participate in the group video MVPA sessions and homework activity, attend educational/support sessions with their adolescents regarding the role of MVPA in health and function and strategies for increasing MVPA in both their adolescent and themselves, and will be provided access to a Facebook page to interact with parents of other adolescents in the A+P arm. Our primary aim is to compare mean increases in MVPA (min./d) between the AO and A+P groups from 0 to 6 mos. Secondarily we will compare changes in MVPA, sedentary time, cardiovascular fitness, muscular strength, motor ability quality of life and the percentage of adolescents achieving the US recommendation of 60 min. MVPA/d across 18 mos. We will also explore the influence of process variables/participant characteristics including attendance at group video (AO-adolescent; A+P-adolescent/parent) and education/support sessions (A+P only), self-monitoring of MVPA (AO-adolescent; A+P-adolescent/parent), parental use of Facebook page (A+P only), peer interactions/support during group PA sessions, adolescent self-efficacy, social support and barriers for PA, parental MVPA, beliefs and attitudes toward PA and parental time constraints, age sex and IDD diagnosis.