An Efficacy Trial of Steps to Your Health for Adults with Learning Domain Disabil

描述(由申请人提供)：本项目的总体目标是确定Steps to Your Health(STYH)的效果，这是一个健康促进计划，在患有智力障碍、自闭症或创伤性脑损伤的成年人中。STYH是在南卡罗来纳州的这些人口群体中使用了十多年的八次参与性和教育性干预措施。它强调身体活动、良好的营养和减轻压力是健康生活方式的关键方面。正在进行的计划评估表明，STYH参与者除了减肥外，还在知识、体力活动和饮食方面有了显著改善。之前的评估虽然很有希望，但并没有提供项目影响的确凿证据，因为它们没有利用实验研究设计。考虑到需要为认知障碍者提供明显有效的健康促进干预措施，有希望的评估结果要求对计划有效性进行良好控制的研究。这项拟议的研究是对南卡罗来纳州STYH计划社区居住的成年人进行的随机试验，这些成年人由于智力低下、自闭症或创伤性脑损伤而导致轻度至中度认知障碍。参与者将通过当地残疾服务机构招募，并随机参加STYH计划或作为对照。虽然随机化将在个人层面上进行，但所有与干预参与者生活在同一家庭的成年人也将被鼓励参与该计划，尽管他们不会被包括在分析中。参与者和对照人员将在项目完成后的基线和一周、六个月和十二个月进行评估。关键的研究结果是通过自我报告和加速度计测量的体力活动水平，通过自我报告和直接观察测量的饮食组成，以及体重减轻。此外，还将评估有关饮食、锻炼和减压的知识。我们假设，与对照组相比，STYH参与者将表现出更多的体力活动、更健康的饮食和更大的体重减轻。基于前面的分析，我们进一步假设，增加的知识将是解释这些领域中每个领域的计划影响的主要中间变量。这项研究将为认知障碍成年人现有的健康促进计划提供重要信息，并将为未来为这一人群设计有效干预措施的努力提供信息。

DESCRIPTION (provided by applicant): The overall aim of this project is to determine the efficacy of Steps to Your Health (STYH), a health promotion program, in adults with mental retardation, autism, or traumatic brain injury. STYH is an eight session participatory and didactic intervention that has been utilized for over ten years in these population groups in South Carolina. It emphasizes physical activity, good nutrition, and stress reduction as key aspects of a healthy lifestyle. Ongoing program evaluations indicate that STYH participants significantly improve in their knowledge, physical activity, and diet in addition to losing weight. Previous evaluations, while promising do not provide definitive proof of a program impact, as they did not utilize experimental study designs. Given the need for demonstrably effective health promotion interventions for persons with cognitive disabilities, the promising evaluation results call for a well-controlled study of program efficacy. The proposed study is a randomized trial of the STYH program community-dwelling adults in South Carolina with mild to moderate cognitive impairment due to mental retardation, autism, or traumatic brain injury. Participants will be recruited through local disability service agencies and randomized to participate in the STYH program or serve as controls. While randomization will be at the individual level, all adults living in the same household with an intervention participant will be encouraged to participate in the program as well, though they will not be included in the analyses. Participants and controls will be assessed at baseline and one week, six months, and twelve months following program completion. The key study outcomes are levels of physical activity as measured by self report and accelerometers, dietary composition as measured by self report and direct observation, and weight loss. Knowledge about diet, exercise, and stress reduction will also be assessed. We hypothesize that STYH participants will exhibit increased physical activity, healthier diets, and greater weight loss in comparison with controls. We further hypothesize, based on previous analyses that increased knowledge will be the primary intermediate variable that accounts for the program impact in each of these areas. This research will provide important information on an existing health promotion program for adults with cognitive disabilities and will inform future efforts at designing effective interventions for this population.