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，且智力水平较低 与正常发育的同龄人相比，他们的心血管健康状况。患有 IDD 的青少年也面临 参与中度至剧烈体力活动 (MVPA) 的额外障碍，包括依赖 父母前往运动设施的交通费、缺乏适当的运动设施、缺乏 PA 专业人员 缺乏关于 IDD 青少年具体需求的专业知识，但缺乏同伴支持。上一页 增加 IDD 青少年 MVPA 的干预措施取得的成功有限，至少部分原因是 要求父母将孩子送到锻炼设施，这对他们来说是一个重大障碍 家庭已经面临着为有特殊需要的青少年提供日常护理的负担。我们最近 开发了一个远程系统，在训练有素的健康教练的指导下，向患有 IDD 的青少年群体提供 MVPA 在家中通过平板电脑进行视频会议。这种方法消除了需要 交通，提供健康教练和其他参与者的社交互动和支持，并且 在家长参与最少的情况下可行。我们建议 18 个月。试用（6 个月活跃，6 个月维持，6 个月 莫。非接触式随访）比较 114 名 IDD 青少年客观评估的 MVPA 的变化 随机分配至仅针对青少年 (AO) 的单级干预或多级干预 交付给青少年和家长（AP）。两个干预组中的青少年都将被要求 参加由训练有素的健康教练通过视频会议进行的家庭团体 MVPA 课程 软件并完成每周的活动作业。 A P 组青少年的家长 将被要求参加小组视频 MVPA 会议和家庭作业活动，参加 与青少年一起进行有关 MVPA 在健康和功能方面的作用的教育/支持课程，以及 增加青少年和他们自己的 MVPA 的策略，并将获得 与 A P 臂其他青少年的家长互动的 Facebook 页面。我们的主要目的是比较 AO 组和 A P 组之间 MVPA 平均增加（分钟/天）从 0 个月到 6 个月。其次我们会 比较 MVPA、久坐时间、心血管健康、肌肉力量、运动能力质量的变化 寿命和达到美国建议的 60 分钟的青少年百分比。 18 个月内的 MVPA/d。 我们还将探讨过程变量/参与者特征（包括参加小组活动）的影响 视频（AO-青少年；A P-青少年/家长）和教育/支持课程（仅限 A P）、自我监控 MVPA（AO-青少年；A P-青少年/家长）、家长使用 Facebook 页面（仅限 A P）、同伴 团体 PA 会议期间的互动/支持、青少年自我效能、社会支持和 PA 障碍、 父母 MVPA、对 PA 的信念和态度以及父母的时间限制、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.