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

描述（由申请人提供）：该项目的总体目标是确定健康促进计划Steps to Your Health（STYH）在患有精神发育迟滞、自闭症或创伤性脑损伤的成年人中的疗效。STYH是一个八次会议的参与性和教学性干预，已在南卡罗来纳州的这些人群中使用了十多年。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。正在进行的项目评估表明，STYH参与者除了减肥外，还在知识、体育活动和饮食方面有了显着改善。以前的评估虽然有希望，但没有提供计划影响的明确证据，因为它们没有利用实验研究设计。考虑到对认知障碍者进行有效的健康促进干预的必要性，有希望的评估结果要求对计划的有效性进行良好的控制研究。这项研究是一项随机试验，对象是南卡罗来纳州的STYH项目社区居民，他们患有轻度至中度的认知障碍，这些障碍是由于智力迟钝、自闭症或创伤性脑损伤造成的。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进行，但也鼓励与干预参与者生活在同一家庭的所有成年人参加该计划，尽管他们不会被纳入分析。参与者和对照组将在基线和项目完成后一周、六个月和十二个月进行评估。主要研究结果是通过自我报告和加速计测量的身体活动水平，通过自我报告和直接观察测量的饮食组成以及体重减轻。还将评估有关饮食、运动和减压的知识。我们假设STYH参与者与对照组相比将表现出增加的体力活动，更健康的饮食和更大的体重减轻。我们进一步假设，根据以前的分析，增加知识将是主要的中间变量，占在这些领域的计划的影响。这项研究将为认知障碍成年人的现有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.