Sedentary behaviours and physical activity in UK and Thai adults with intellectual disabilities

Background. Adults with intellectual disabilities face numerous health inequalities. Lifestyles, such as high sedentary behaviours and low physical activity levels may contribute to the inequalities. Hence, reducing sedentary behaviour and increasing physical activity could have a role. The research on these behaviours in adults with intellectual disabilities that is conducted in Western countries is limited and requires further research. However, no studies were identified that investigated sedentary behaviours and physical activity in Thai adults with intellectual disabilities. Therefore, this thesis is aimed to add to the knowledge-base on sedentary behaviour and physical activity of adults with intellectual disabilities in UK and Thailand. Study 1. A secondary analysis of data from The UK Household Longitudinal Study was conducted to explore Individual, interpersonal, and environmental correlates of sedentary behaviours (TV hours) in adults with intellectual disabilities. Analysis showed that adults with intellectual disabilities living in good and poor neighbourhoods had different correlates. In good neighbourhoods, having children and being employed had significant effects to lower the odds of high TV time. In poor neighbourhoods, it was better quality leisure services that lower odds of high TV time. Study 2. The aim of this study was to evaluate the feasibility of using accelerometers in measuring sedentary behaviours in Thai adults with intellectual disabilities. The protocol was tested on 10 Thai adults with intellectual disabilities. Most of the participants (90%) were able to adhere to the protocol. It is feasible to apply accelerometer as method of measurement to Thai adults with intellectual disabilities. Study 3. This study was to evaluate levels and patterns of sedentary behaviours in Thai adults with intellectual disabilities (N = 38). The average daily sedentary time was 403 min/day. The sedentary time was accumulated in bouts lasting less than 10 minutes. Women were more sedentary than men. Evening was the most sedentary time. Gender, level of intellectual disabilities, BMI, and BMI Asian cut points were predictors of sedentary behaviour. Study 4. This study was to examine levels and patterns of physical activity in Thai adults with intellectual disabilities (N = 38). Thai adults with intellectual disabilities had an average of 119 minutes per week of MVPA, 229 minutes per day of LPA and 4,899 steps per day. Thirty-two percent of participants met the goal of 150 minutes of MVPA per week. The most active and least active time were early morning and late evening, respectively. MVPA levels were significantly higher during weekdays compared to weekend days. Women were less active than men. Age, level of intellectual disabilities, and BMI Asian cut points were predictors of physical activity. Conclusion. Thai adults with intellectual disabilities had high levels of sedentary behaviours and low levels of physical activity. Thai women with intellectual disabilities were more sedentary and less active than men. There was evidence of importance of environmental factors on sedentary behaviour proxy (TV time), however more research is required. Exploration into in sedentary behaviours and physical activity provides an understanding of the lifestyles of adults with intellectual disabilities and opens opportunities to reduce health inequalities in the future

Individual, interpersonal, and environmental correlates of sedentary behaviours in adults with intellectual disabilities

Background: Sedentary behaviours have adverse health outcomes and adults with intellectual disabilities are at a higher risk of unhealthy lifestyle behaviours. The lack of knowledge relating to sedentary behaviours in adults with intellectual disabilities has impeded the development of effective interventions. This study aimed to investigate individual, interpersonal and environmental correlates that are associated with sedentary behaviours in adults with intellectual disabilities. Method: A secondary analysis of data from The UK Household Longitudinal Study (Understanding Society; collected 2011–2013) was conducted. Twenty-two predictor variables were included in a stepwise logistic regression, with TV hours during weekdays (≤3 and >3 h/day) used as a proxy for sedentary behaviours. A sample of 266 adults, with mean age of 37.9 and range from 18 to 49 years old, with intellectual disabilities were identified. Because 63.9% were female, 62.4% had children and 28.2% were employed, the sample is likely to be most representative of more able adults with intellectual disabilities. Results: A significant interaction term between having children and neighbourhood status was found in the initial model so separate models for good and poor-quality neighbourhoods are reported. Having children only had a significant effect to lower the odds of high TV time among participants living in good quality neighbourhoods (OR 0.10, 95% CI 0.03, 0.25). However, for people living in poor quality neighbourhoods it was better quality leisure services that was associated with lower odds of high TV time (OR 0.48, 95% CI 0.23, 0.90). Being employed only significantly reduced the odds of high TV time in the good quality neighbourhood model (OR 0.35, 95% CI 0.12, 0.78). These effects highlight the importance of environmental effects on lifestyle behaviours of adults with intellectual disabilities. Conclusions: Future research should aim to expand our understanding of environmental effects on the sedentary behaviours and other lifestyle behaviours of adults with intellectual disabilities