Use of health and dental care services in adults with intellectual disability in relation to age and intellectual disability levels

Background - This study investigates the use of health and dental care services in adults with intellectual disability in the last 12 months according to Norwegian recommendations and in relation to age and intellectual disability levels. Method - A cross-sectional community-based survey including 214 participants (56% men). POMONA health indicators were used for data collection. Results - Health checks and contact with general practitioners in the last year increased with age but were less frequent in those with more severe intellectual disability. Hospital admissions were age independent. Less than one-fifth of women had undergone cancer screening, with small variations according to intellectual disability severity levels. Few had an individual plan. More than one-third experienced poor dental health despite frequent controls. Conclusions - The use of health checks was lower than recommended, especially in individuals with more severe intellectual disability. Service access and individual plan use need to be enhanced, and dental care services should be improved

Barriers to physical activity participation for adults with intellectual disability: A cross-sectional study

Background - Identifying barriers that can be modified to promote physical activity is important for informing health interventions for adults with intellectual disabilities. Objectives - Exploring participation in physical activity considering age, sex, living conditions, and health conditions. Further, identifying barriers significantly associated with sedentary activity after adjustment for physical activity correlates. Methods - A cross-sectional study including physical activity and barrier questions from the POMONA-15 health indicators. Multivariate logistic regression analysis with sedentary activity level as dependent variable. Results - Among 213 participants with intellectual disabilities, 36% reported predominately sedentary activities, 53% light and 11% moderate/vigorous physical activity. Barriers related to sedentary activity after adjustment were transportation, health conditions, mobility impairment, and lack of activities at the day activity centre. Conclusions - The findings highlight the need to enhance physical activity opportunities at day activity centres, tailor programmes for wheelchair users, and improve access to physical activity facilities for adults with intellectual disabilities

Factors associated with non-completion of and scores on physical capability tests in health surveys: The North Health in Intellectual Disability Study

Background - This study investigated the completion rates, scores and factors associated with non-completion and low scores on physical capability tests in a health survey administered to adults with intellectual disabilities. Method - Assessment comprised body mass index (BMI), the Short Physical Performance Battery (SPPB), the timed up-and-go (TUG) test, the one-legged stance (OLS) test; and gross motor, communication and behavioural functioning tests. Results - The completion rates among 93 participants (aged 17–78) were 46% for the SPPB, 42% for the TUG, and 31% for the OLS. More severe intellectual disability (OR = 3.12, p  Conclusions - Including physical capability tests in health surveys among adults with intellectual disabilities is important to monitor functional status and guide prevention strategies

Livskvalitet hos mennesker med lett utviklingshemming. En kvalitativ studie

Sammendrag Livskvalitet hos mennesker med utviklingshemming har vært lite forsket på i Norge, mens det internasjonalt sett har vært økende interesse for å utvikle måleinstrumenter for dette konstruktet. Formålet med denne studien var å undersøke hvordan mennesker med lett utviklingshemming opplever sin livskvalitet og hvordan de formidler sin opplevelse til sine omgivelser. Individuelle semistrukturerte intervju ble gjennomført fra oktober 2014 til og med januar 2015 med informanter med lett utviklingshemning og deres kontaktpersoner i kommunen. Ti spørsmål ble valgt ut fra spørreskjema WHOQOL-DIS og spørsmålene ble konkretisert ved behov. Til sammen ble 10 intervjuer transkribert og analysert. De fleste informantene opplever at de har god livskvalitet, noe som samsvarte med personalets opplevelse. Spørsmålene fra spørreskjemaet måtte konkretiseres i større eller mindre grad for alle informantene med lett utviklingshemming, da variasjonen i forståelses- og formidlingsevne var stor. Det bør derfor undersøkes nærmere hvordan samfunnet kan sikre seg reell tilbakemelding på hvordan mennesker med utviklingshemning har det, i større skala enn det som ble gjennomført i denne undersøkelsen. Spørreskjema spesielt tilpasset mennesker med lett utviklingshemning kan bidra til økt svarfrekvens og validitet. Keywords: livskvalitet, lett utviklingshemning, WHOQOL-DIS

Physical performance, physical and perceived health, and the use of healthcare services in a population of adults with intellectual disability

Bakgrunn: Voksne med utviklingshemming har dårligere fysisk og selvrapportert helse, og mindre tilgang til helsetjenester sammenlignet med generell befolkning. Dette har vært lite undersøkt i Norge. Formål: Øke kunnskap om helse og fysisk funksjon hos voksne med utviklingshemming. Undersøke faktorer assosiert med gjennomføring av fysiske funksjonstester, samt fysisk og selvopplevd helse. Identifisere udekkede behov for helsetjenester. Metode: Multisenter tverrsnittstudie med bruk av POMONA helseindikatorer. I en delstudie ble det målt kroppsmasseindex (KMI) og fysiske funksjonstester: Short physical performance battery (SPPB), timed up-and-go (TUG) test, one-legged stance test (OLS). Resultat: Delstudie: 93 deltakere, gjennomsnittsalder: 34.2 år, 58% menn. Over halvparten av deltakerne gjennomførte en eller flere målinger eller tester. Gjennomføringsrate for SPPB var 46%. Lav KMI og mer alvorlig grad av utviklingshemming predikerte manglende gjennomføring. Testskårer var betydelig under referanseverdier for generell populasjon. Lavere skårer var assosiert med høyere alder, nedsatt grovmotorisk funksjon og mer alvorlig grad av utviklingshemming. Hovedstudie: 214 deltakere, gjennomsnittsalder: 36.1 år, 56% menn. Fordelingen av fysiske helsetilstander varierte med grad av utviklingshemming, 79% hadde multimorbiditet. Multivariate analyser viste signifikante assosiasjoner mellom dårlig selvrapportert helse og kvinnelig kjønn, dårligere grovmotorisk funksjon og flere fysiske helsetilstander. Et lavt fysisk aktivitetsnivå tenderte til å påvirke selvrapportert helse negativt. Anbefalt årlig helsesjekk ble gjennomført hos 57%. Flere deltakere med lett utviklingshemming enn med alvorlig grad hadde gjennomført helsesjekk og vært i kontakt med fastlege. Få (13%) hadde en fungerende individuell plan. Selv om 94% rapporterte at de hadde mottatt tannlegetjenester siste året, opplevede 39% dårlig tannhelse. Konklusjon: Studien indikerte en lavere bruk av helsesjekk enn anbefalt. Fysiske funksjonstester bør inkluderes i helseundersøkelsene. Kvinner, de med redusert grovmotorisk funksjon, flere fysiske helsetilstander og lavt fysisk aktivitetsnivå har økt risiko for dårlig selvopplevd helse. Tannhelsetjenester bør forbedres. Helsefremmende strategier innen livsstilsfaktorene fysisk aktivitet og kosthold bør prioriteres for alle personer med utviklingshemming

Mental health, challenging behaviour, diagnosis, and access to employment for people with intellectual disabilities in Norway

Background: Studies have found that presence of challenging behaviours and mental health problems limits employment for people with intellectual disabilities. This study investigates the associations between age, gender, living condition, level of intellec tual disability, diagnoses, behaviour, mental health, and employment in adults with intellectual disabilities in Norway. Method: A cross-sectional community-based survey including 214 adult participants (56% men) with intellectual disabilities. Results: In our sample, 25% had no organised day activity, 27% attended non-work day care, 19% attended sheltered employment, or day care with production, without pay and 29% worked in paid sheltered employment. One participant attended main stream employment. Moderate and severe/profound level of intellectual disability, possible organic condition and irritability significantly reduced the odds of employ ment (paid and unpaid). Conclusion: Findings suggest unequal access to the sheltered employment that was meant to be inclusive. More individualised evaluation of prerequisites is suggested to further facilitate employment for this group

How do multimorbidity and lifestyle factors impact the perceived health of adults with intellectual disabilities?

Background: Adults with intellectual disability (ID) have poorer physical and perceived health than the general population. Knowledge of perceived health predictors is both limited and important for guiding the development of preventive actions. The aims of this study were to investigate (1) the associations between perceived health and demographics, degree of ID, physical health conditions, and weight and physical activity level and (2) lifestyle factors and multimorbidity as predictors for perceived health adjusted for age, gender, and level of ID. Method: The North Health in Intellectual Disability study is a community based cross-sectional survey. The POMONA-15 health indicators were used. Univariate and multivariate logistic regression analyses with poor versus good health as the dependent variable were applied. Results: The sample included 214 adults with a mean age 36.1 (SD 13.8) years; 56% were men, and 27% reported perceiving their health as poor. In univariate analyses, there were significant associations between poor health ratings and female gender, lower motor function, number of physical health conditions and several indicators of levels of physical activity. In the final adjusted model, female gender [odds ratio (OR) 2.4, P < 0.05], level of ID (OR 0.65, P < 0.05), numbers of physical health conditions (OR 1.6, P < 0.001) and lower motor function (OR 1.5 P < 0.05) were significant explanatory variables for poor perceived health, with a tendency to independently impact failure to achieve 30 min of physical activity daily (OR 2.0, P = 0.07). Conclusion: Adults with ID with female gender, reduced motor function and more physical health conditions are at increased risk of lower perceived health and should be given attention in health promoting interventions. A lack of physical activity tends to negatively influence perceived health

Physical Activity With Tailored mHealth Support for Individuals With Intellectual Disabilities: Study Protocol for a Randomized Controlled Trial

Background: Individuals with intellectual disabilities (IDs) have lower levels of physical activity (PA) and greater barriers for participation in fitness activities compared with members of the general population. As increased PA has positive effects on cardiovascular and psychosocial health, it is exceedingly important to identify effective interventions for use in everyday settings. Mobile health (mHealth) methods such as motion sensor games (exergames) and smartphone reminders for PA have been explored and found to be promising in individuals with IDs. Objective: The purpose of this study is to examine the effectiveness of an individually tailored PA program with motivational mHealth support on daily levels of PA in youth and adults with IDs. Methods: The trial uses a randomized controlled design comprising 30 intervention participants and 30 control group participants, aged 16 to 60 years, with sedentary lifestyles or low PA levels. While the controls will receive standard care, the intervention aims to increase the level of PA, measured as steps per day, as the primary outcome. Secondary outcome variables are body mass index, blood pressure, physical performance, social support for PA, self-efficacy in a PA setting, behavior problems, and goal attainment. The intervention involves the delivery of tailored mHealth support, using smartphones or tablets to create structure with focus on the communicative abilities of individual participants. Rewards and feedback are provided in order to motivate individuals to increase participation in PA. Participants in the intervention group, their close relatives, and care staff will be invited to participate in a preintervention goal-setting meeting, where goal attainment scaling will be used to select the participants’ PA goals for the intervention period. All participants will be assessed at baseline, at 3 months, and at 6 months. Results: Enrollment was planned to start in April 2020 but will be delayed due to the pandemic situation. The main contribution of this paper is a detailed plan to run our study, which will produce new knowledge about tailored mHealth to support PA in individuals with intellectual disabilities. Conclusions: We expect the new intervention to perform better than standard care in terms of improved PA, improved self-efficacy, and social support for activities. Technology offers new opportunities to promote healthy behaviors. The results of the study will determine the effectiveness and sustainability of a tailored mHealth support intervention to increase PA in youth and adults with IDs

Physical Activity With Tailored mHealth Support for Individuals With Intellectual Disabilities: Study Protocol for a Randomized Controlled Trial

Background: Individuals with intellectual disabilities (IDs) have lower levels of physical activity (PA) and greater barriers for participation in fitness activities compared with members of the general population. As increased PA has positive effects on cardiovascular and psychosocial health, it is exceedingly important to identify effective interventions for use in everyday settings. Mobile health (mHealth) methods such as motion sensor games (exergames) and smartphone reminders for PA have been explored and found to be promising in individuals with IDs. Objective: The purpose of this study is to examine the effectiveness of an individually tailored PA program with motivational mHealth support on daily levels of PA in youth and adults with IDs. Methods: The trial uses a randomized controlled design comprising 30 intervention participants and 30 control group participants, aged 16 to 60 years, with sedentary lifestyles or low PA levels. While the controls will receive standard care, the intervention aims to increase the level of PA, measured as steps per day, as the primary outcome. Secondary outcome variables are body mass index, blood pressure, physical performance, social support for PA, self-efficacy in a PA setting, behavior problems, and goal attainment. The intervention involves the delivery of tailored mHealth support, using smartphones or tablets to create structure with focus on the communicative abilities of individual participants. Rewards and feedback are provided in order to motivate individuals to increase participation in PA. Participants in the intervention group, their close relatives, and care staff will be invited to participate in a preintervention goal-setting meeting, where goal attainment scaling will be used to select the participants’ PA goals for the intervention period. All participants will be assessed at baseline, at 3 months, and at 6 months. Results: Enrollment was planned to start in April 2020 but will be delayed due to the pandemic situation. The main contribution of this paper is a detailed plan to run our study, which will produce new knowledge about tailored mHealth to support PA in individuals with intellectual disabilities. Conclusions: We expect the new intervention to perform better than standard care in terms of improved PA, improved self-efficacy, and social support for activities. Technology offers new opportunities to promote healthy behaviors. The results of the study will determine the effectiveness and sustainability of a tailored mHealth support intervention to increase PA in youth and adults with IDs