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

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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.