3 research outputs found
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Physical Activity Promotion for Emerging Adults with Intellectual and Developmental Disabilities Transitioning from High School into the Community: A Virtual Intervention Grounded in Self-Determination Theory
People with intellectual and developmental disabilities (IDD) engage in lesser physical activity (PA) and more time in sedentary activities as compared to those without disabilities. A subset of people with IDD who are most vulnerable to develop habits detrimental to health is the emerging adults who are transitioning from adolescence into adulthood. Therefore, this age is an important time to promote healthy behaviors, including PA.
This dissertation focuses on promoting PA for emerging adults with IDD. Three emerging adults completed this study that was community-engaged and grounded in the self-determination theory (SDT). The study consisted of a baseline, an intervention, and a follow-up phase. The intervention consisted of components to enhance the basic psychological needs of autonomy, competence and relatedness in PA. Participants were expected to wear a Fitbit for the entire duration of the study.
This dissertation has two manuscripts. The objective of Manuscript 1 was to assess the feasibility and effectiveness of the virtual intervention grounded in SDT on three basic psychological needs and six levels of motivations and on PA behavior. Findings indicate that a virtual intervention to promote PA for emerging adults with IDD is feasible. Participants also increased their goal gradually through the course of the intervention. There were no significant differences noted in the participants’ basic psychological needs or six levels of motivation at four different time points during the course of the study.
The second manuscript sought to understand the perspectives of emerging adults with IDD on the components of the virtual PA intervention. Findings indicate that Fitbit could be used effectively to motivate emerging adults with IDD to set goals and engage in regular PA. Participants in this study had a greater sense of autonomy in PA and in setting PA goals while also depending on their caregivers for engaging in PA outdoors.
Overall findings from the study add to the limited literature that focuses on PA promotion for emerging adults with IDD. This dissertation lays a foundation to develop and implement a larger study recruiting more participants, conducting the intervention for a longer period and follow-up with the participants for more months following the withdrawal of the intervention. More mixed methods studies need to move away from conducting questionnaires for people with IDD but focus more on seeking perspectives from them through qualitative methods including using semi-structured interviews, focus groups and photovoice
Telehealth Family Navigation for Early Autism Services Access: The Autism ALERT Project
Background: Delays in access to educational services for autism are common and more likely among children from families of color and/or with low income. In-person family navigation accelerates autism diagnosis; however, the effectiveness of telehealth autism diagnostic navigation is unknown.
Objectives: To test preliminary feasibility and efficacy of a telehealth autism navigation program.
Method: This was a site-randomized pilot trial of autism family navigation for Oregon children in 2021-2022. The intervention used layperson family resource specialists based at Oregon’s Help Me Grow program as navigators for families of children with autism symptoms. Pediatric clinics with \u3e30% Medicaid, located in 5 Oregon counties, were invited to enroll children in the study. 7 clinics (49 primary care providers [PCPs]) participated; 4 were randomized to the family navigation intervention and 3 to usual care. PCPs in both arms received training on autism screening and referral to medical/educational services. PCPs then referred any child age 1-55 months with a positive screen and/or provider autism concern to the study. For children in intervention arm clinics, the navigator called parents, providing information about autism and the autism diagnostic process, assistance with paperwork, social support, and appointment reminders. Control arm clinics/children received no calls. Study enrollment continued until 50 children (30 intervention, 20 control) enrolled. Child Early Intervention/Early Childhood Special Education (EI/ECSE) data were collected from Oregon’s state database 6 months after enrollment. Primary study outcomes compared intervention and control arms on: % of children receiving EI/ECSE referrals within 6 months, % receiving an evaluation in EI/ECSE within 6 months, time from enrollment to EI/ECSE evaluation, and % of evaluated children receiving an autism educational label within 6 months.
Results: All clinics enrolled children; children were 40.8% (n=20) white, 26.5% (n=13) Latino, and 32.7% (n=9) multiracial and/or other race/ethnicity. 16% were female (n=8); median age was 2. Intervention families received a median of 12 navigator telehealth contacts. Overall, 70% (n=21) of intervention arm and 42% (n =8) of control arm families were successfully referred to EI/ECSE (p = 0.05). Of those referred, 86% (n=18) of intervention arm and 100% (n=8) of control arm children were evaluated in EI/ECSE (n.s.). Median time to EI/ECSE evaluation was 103 days in the intervention and 162 days in the control arm (p = 0.68; Figure 1). Overall, 40% of intervention arm (n = 12) and 21% (n = 4) of control arm children had an autism placement, with a trend toward autism as the primary placement type in the intervention arm (p = 0.12).
Conclusion: Telehealth family navigation shows promise for improving access to autism services in EI/ECSE, especially for securing an early EI/ECSE evaluation, and increasing autism educational labels. A full-scale trial can investigate more distal outcomes including receipt of medical diagnosis and therapeutic services use
Functional Genomics Identify Distinct and Overlapping Genes Mediating Resistance to Different Classes of Heterobifunctional Degraders of Oncoproteins
Genome-scale CRISPR gene editing studies by Shirasaki et al. reveal which genes confer myeloma cell resistance to PROTACs that leverage different E3 ligases to degrade various oncoproteins. The study provides a framework for sequential/alternating versus combined use of PROTACs, depending on which E3 ligase and oncoprotein they engage