Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol Walk well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol Development of a multi-component lifestyle intervention for preventing type 2 diabetes and cardiovascular risk factors in adults with intellectual disabilities A single-blind, pilot randomised trial of a weight management intervention for adults with intellectual disabilities and obesity: study protocol Embedding sustainable physical activities into the everyday lives of adults with intellectual disabilities: a randomised controlled trial Research priorities for child and adolescent physical activity and sedentary behaviours: an international perspective using a twin-panel Delphi procedure
Background Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups . The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities . Methods We used a cluster r and omised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations . Assessment s were carried out blind to allocation . Clusters of participants were r and omly allocated to the Walk Well program or a 12-week waiting list control . Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques , written re sources for participants and carers , and an individualised , structured walking programme . The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks . Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity ( MVPA ) , body mass index ( BMI ) , and subjective well being . Results One hundred two participants in 50 clusters were r and omised . 82 ( 80.4 % ) participants completed the primary outcome . 66.7 % of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation . At baseline , participants walked 4780 ( st and ard deviation 2432 ) steps per day , spent 65.5 % ( st and ard deviation 10.9 ) of time sedentary and 59 % percent had a body mass in the obesity range . After the walking programme , the difference between mean counts of the Walk Well and control group was 69.5 steps per day [ 95 % confidence interval ( CI ) -1054 to 1193.3 ] . There were no significant between group differences in percentage time sedentary 1.6 % ( 95 % CI −2.984 to 6.102 ) , percentage time in MVPA 0.3 % ( 95 % CI −0.7 to 1.3 ) , BMI −0.2 kg/m2 ( 95 % CI −0.8 to 0.4 ) or subjective well-being 0.3 ( 95 % CI −0.9 to 1.5 ) . Conclusions This is the first published trial of a walking program for adults with intellectual disabilities . Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities . Since participants spent the majority of their time sedentary , home-based programmes to reduce sitting time may be a viable health improvement approach . Trial registration Current Controlled Trials IS RCT Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) Background Walking interventions have been shown to have a positive impact on physical activity ( PA ) levels , health and wellbeing for adult and older adult population s. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities . This paper will provide details of the Walk Well intervention , design ed for adults with intellectual disabilities , and a r and omised controlled trial ( RCT ) to test its effectiveness . Methods / design This study will adopt a RCT design , with participants allocated to the walking intervention group or a waiting list control group . The intervention consists of three PA consultations ( baseline , six weeks and 12 weeks ) and an individualised 12 week walking programme . A range of measures will be completed by participants at baseline , post intervention ( three months from baseline ) and at follow up ( three months post intervention and six months from baseline ) . All outcome measures will be collected by a research er who will be blinded to the study groups . The primary outcome will be steps walked per day , measured using accelerometers . Secondary outcome measures will include time spent in PA per day ( across various intensity levels ) , time spent in sedentary behaviour per day , quality of life , self-efficacy and anthropometric measures to monitor weight change . Discussion Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities , this RCT will examine if a walking intervention can successfully increase PA , health and wellbeing of adults with intellectual disabilities . Trial registration IS RCT N : IS RCT Background We report on the development of the ' STOP Diabetes ' education programme , a multi-component lifestyle behaviour change intervention for the prevention of type 2 diabetes and cardiovascular risk factors in adults with intellectual disabilities ( ID ) . Methods We combined qualitative stakeholder interviews with evidence review s to develop the intervention , guided by the MRC Framework and informed by intervention mapping and two existing diabetes prevention programmes . We conducted two pilot cycles drawing on additional stakeholder interviews to inform and refine the intervention . Results The STOP Diabetes education programme employed a theoretical framework , using sound learning and behavioural principles and concrete kinaesthetic methods , to provide the grounding for innovative games and activities to promote health behaviour change in adults with ID . Qualitative data also suggested that two educators and one support person delivering a programme of one carer session followed by seven 2.5-h sessions over 7 weeks was acceptable to service users , carers and educators and appeared to benefit the participants . Conclusions The STOP Diabetes education programme was successfully developed and is suitable for a definitive r and omized controlled trial Background The prevalence of obesity in adults with intellectual disabilities has consistently been reported to be higher than the general population . Despite the negative impact of obesity on health , there is little evidence of the effectiveness of weight management interventions for adults with intellectual disabilities and obesity . Preliminary results from a single-str and ed feasibility study of a multi-component weight management intervention specifically design ed for adults with intellectual disabilities and obesity ( TAKE 5 ) and that satisfied clinical recommendations reported that it was acceptable to adults with intellectual disabilities and their carers . This study aims to determine the feasibility of a full-scale clinical trial of TAKE 5 . Methods This study will follow a pilot r and omised trial design . Sixty-six obese participants ( body mass index ( BMI ) ≥30 kg/m2 ) will be r and omly allocated to the TAKE 5 multi-component weight management intervention or a health education ‘ active ’ control intervention ( Waist Winners Too ( WWToo ) ) . Both interventions will be delivered over a 12-month period . Participants ’ anthropometric measures ( body weight , BMI , waist circumference , percentage body fat ) ; indicators of activity ( levels of physical activity and sedentary behaviour ) and well-being will be measured at three time points : baseline , 6 and 12 months . The research er collecting outcome measures will be blind to study group allocation . Conclusions The data from this study will generate pilot data on the acceptability of r and omisation , attrition rates and the estimates of patient-centred outcomes of TAKE 5 , which will help inform future research and the development of a full-scale r and omised clinical trial . Trial registration IS RCT N52903778 Background Adults with intellectual disability ( ID ) are physically very inactive . This study will compare two approaches to increasing physical activity in adults with ID : a lifestyle physical activity ( light-moderate intensity ) approach and a structured exercise ( moderate-vigorous intensity ) approach . The trial will compare the short-term ( 3-month ) and long-term ( 9-month ) outcomes and sustainability of each approach with a usual-care control group . Methods / Design A three-arm r and omised controlled trial ( RCT ) will be conducted . Ninety adults with ID aged 18 - 55 will be r and omly assigned to one of three groups : 1 ) a lifestyle physical activity group ( n = 30 ) , 2 ) a structured exercise group ( n = 30 ) , or 3 ) a usual care control group ( n = 30 ) . Participants in both groups will receive a 12-week intervention delivered by exercise specialists in the community with disability service staff , after which intervention will continue for 6 months , delivered by disability service staff only . Primary outcomes are aerobic fitness , 12-hour energy expenditure , and proxy-reported everyday physical activity . Secondary outcomes include objective ly assessed physical activity and sedentary behaviour , intervention compliance , functional walking capacity , participation in domestic activities , muscle strength , body composition , psychosocial outcomes , quality of life and health care costs . Discussion The trial results will determine the effectiveness and sustainability of two approaches to increasing physical activity and exercise among adults with ID.Trial registration IS RCT N77889248 ( 18 April 2012 ) Background The quantity and quality of studies in child and adolescent physical activity and sedentary behaviour have rapidly increased , but research directions are often pursued in a reactive and uncoordinated manner . Aim To arrive at an international consensus on research priorities in the area of child and adolescent physical activity and sedentary behaviour . Methods Two independent panels , each consisting of 12 experts , undertook three rounds of a Delphi methodology . The Delphi methodology required experts to anonymously answer questions put forward by the research ers with feedback provided between each round . Results The primary outcome of the study was a ranked set of 29 research priorities that aim ed to be applicable for the next 10 years . The top three ranked priorities were : developing effective and sustainable interventions to increase children ’s physical activity long-term ; policy and /or environmental change and their influence on children ’s physical activity and sedentary behaviour ; and prospect i ve , longitudinal studies of the independent effects of physical activity and sedentary behaviour on health . Conclusions These research priorities can help to guide decisions on future research directions
None of the studies reported the reliability and validity of the methods used to measure sedentary behaviour .
Supporting positive change in lifestyle behaviours is a priority in tackling the health inequalities experienced by adults with intellectual disabilities .
In this systematic review , we examine the evidence on the definition , measurement and epidemiology of sedentary behaviour of adults with intellectual disabilities .
Many research ers do not distinguish between insufficient physical activity and sedentary behaviour .