Walk well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

BMC Public Health

Nanette Mutrie²  Andrew Walker¹  Heather Murray⁶  Alex McConnachie⁶  Lynsay Matthews⁴  Kirsten Stalker³  Craig Melville⁵  Fiona Mitchell⁵ 

[1] Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, UK;Institute for Sport, Physical Education and Health Sciences, Moray House School of Education, University of Edinburgh, Edinburgh, Scotland, UK;Glasgow School of Social Work, University of Strathclyde, Glasgow, Scotland, UK;Physical Activity for Health Research Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland, UK;Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK;Institute of Health and Wellbeing, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland, UK

关键词: Walking intervention;    Physical activity;    Intellectual disability;   

Others  :  1162062
DOI  :  10.1186/1471-2458-13-620

 received in 2013-06-10, accepted in 2013-06-24,  发布年份 2013

【 摘 要 】

Background

Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. 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, designed for adults with intellectual disabilities, and a randomised 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 researcher 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

ISRCTN: ISRCTN50494254

【 授权许可】

   
2013 Mitchell et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]NHS Health Scotland: Health needs assessment report: People with learning disabilities in Scotland. Glasgow: NHS Health Scotland; 2004.
• [2]Krahn GL, Hammond L, Turner A: A cascade of disparities: health and health care access for people with intellectual disabilities. Ment Retard Dev Disabil Res Rev 2006, 12:70-82.
• [3]Emerson E, Baines S: Health inequalities & people with learning disabilities in the UK: 2010, Improving Health and Lives. UK: Learning Disabilities Observatory; 2010.
• [4]Beange H, McElduff A, Baker W: Medical disorders of adults with mental retardation: a population study. Am J Ment Retard 1995, 99:595-604.
• [5]Cooper S-A, Smiley E, Finlayson J, Jackson A, Allan L, Williamson A, Mantry D, Morrison J: The prevalence, incidence and factors predictive of mental ill-health in adults with profound intellectual disabilities. J Appl Res Intellect Disabil 2007, 20:493-501.
• [6]Michael J: Healthcare for all: Report of the independent inquiry into access to healthcare for people with learning disabilities. London: Department of Health; 2008.
• [7]Scheepers M, Kerr M, O'Hara D, Bainbridge D, Cooper SA, Davis R, Fujiura G, Heller T, Holland A, Krahn G, Lennox N, Meaney J, Wehmeyer M: Reducing health disparity in people with intellectual disabilities: a report from health issues special interest research group of the international association for the scientific study of intellectual disabilities. Journal of Policy and Practice in Intellectual Disabilities 2005, 2:249-255.
• [8]Robertson J, Emerson E, Gregory N, Hatton C, Turner S, Kessissoglou S, Hallam A: Lifestyle related risk factors for poor health in residential settings for people with intellectual disabilities. Res Dev Disabil 2000, 21:469-486.
• [9]Draheim CC, McCubbin JA, Williams DP: Differences in cardiovascular disease risk between nondiabetic adults with mental retardation with and without Down syndrome. Am J Ment Retard 2002, 107:201-211.
• [10]Emerson E: Underweight, obesity and physical activity in adults with intellectual disability in supported accommodation in Northern England. J Intellect Disabil Res 2005, 49:134-143.
• [11]McGuire BE, Daly P, Smyth F: Lifestyle and health behaviours of adults with an intellectual disability. J Intellect Disabil Res 2007, 51:497-510.
• [12]Temple VA, Walkley JW: Perspectives of constraining and enabling factors for health-promoting physical activity by adults with intellectual disability. J Intellect Dev Disabil 2007, 32:28-38.
• [13]Finlayson J, Jackson A, Cooper SA, Morrison J, Melville CA, Smiley E, Allan L, Mantry D: Understanding predictors of low physical activity in adults with intellectual disabilities. J Appl Res Intellect Disabil 2009, 22:236-247.
• [14]Hilgenkamp TI, Van Wijck R, Evenhuis HM: Low physical fitness levels in older adults with ID: results of the HA-ID study. Res Dev Disabil 2012, 33:1048-1058.
• [15]Ogilvie D, Foster CE, Rothnie H, Cavill N, Hamilton V, Fitzsimons CF, Mutrie N: Interventions to promote walking: systematic review. Br Med J 2007, 334:1204.
• [16]Peterson JJ, Janz KF, Lowe JB: Physical activity among adults with intellectual disabilities living in community settings. Prev Med 2008, 47:101-106.
• [17]Stanish HI, Temple VA, Frey GC: Health-promoting physical activity of adults with mental retardation. Ment Retard Dev Disabil Res Rev 2006, 12:13-21.
• [18]Stanish HI, Draheim CC: Walking habits of adults with mental retardation. Ment Retard 2005, 43:421-427.
• [19]Stanish HI, Draheim CC: Assessment of walking activity using a pedometer and survey in adults with mental retardation. Adapt Phys Activ Q 2005, 22:136-145.
• [20]Temple VA: Barriers, enjoyment, and preference for physical activity among adults with intellectual disability. Int J Rehabil Res 2007, 30:281-287.
• [21]Temple VA, Stanish HI: Pedometer-measured physical activity of adults with intellectual disability: predicting weekly step counts. Am J Intellect Dev Disabil 2009, 114:15-22.
• [22]Finalyson J, Turner A, Granat MH: Measuring the actual levels and patterns of physical activity/inactivity of adults with intellectual disabilities. J Appl Res Intellect Disabil 2011, 24:508-517.
• [23]Sidman CL: Count your steps to health and fitness. ACSM's Health and Fitness Journal 2002, 6:13-17.
• [24]Martinson BC, Crain L, Sherwood N, Hayes M, Pronk NP, O’Connor PJ: Population reach and recruitment bias in a maintenance RCT in physically active older adults. J Phys Act Health 2010, 7:127-135.
• [25]Tudor-Locke C, Johnson WD, Katzmarzyk PT: Accelerometer-determined steps per day in US adults. Medicine & Science in Sports & Exercise 2009, 41:1384-1391.
• [26]Fitzsimons C, Baker G, Gray S, Nimmo M, Mutrie N, The Scottish Physical Activity Research Collaboration: Does physical activity counselling enhance the effects of a pedometer-based intervention over the long-term: 12-month findings from the Walking for Wellbeing in the west study. BMC Publ Health 2012, 12:206. BioMed Central Full Text
• [27]Le-Masurier G, Sidman C, Corbin C: Accumulating 10,000 Steps: Does this Meet Current Physical Activity Guidelines? Res Q Exerc Sport 2003, 4:74.
• [28]Tudor -Locke C, Craig CL, Aoyagi Y, Bell RC, Croteau KA, De Bourdeaudhuij I, Ewald B, Gardner AW, Hatano Y, Lutes LD, Matsudo SM, Ramirez-Marrero FA, Rogers LQ, Rowe DA, Schmidt MD, Tully MA, Blair SN: How many steps/day are enough? For older adults and special populations. The International Journal of Behavioural Nutrition and Physical Activity 2011, 8:80. BioMed Central Full Text
• [29]McDermott S, Whitner W, Thomas-Koger M, Mann JR, Clarkson J, Barnes TL, Bao H, Meriwether RA: An efficacy trial of 'Steps to Your Health', a health promotion programme for adults with intellectual disability. Health Educ J 2012, 71:278-290.
• [30]Ewing G, McDermott S, Thomas-Koger M, Whitner W, Pierce K: Evaluation of a cardiovascular health program for participants with mental retardation and normal learners. Health Educ Behav 2004, 31:77-87.
• [31]Bodde AE, Seo DC, Frey GC, Lohrmann DK, Van Puymbroeck M: Developing a physical activity education curriculum for adults with intellectual disabilities. Health Promot Pract 2012, 13:116-123.
• [32]Mann J, Zhou H, McDermott S, Poston MB: Healthy behaviour change of adults with mental retardation: Attendance in a health promotion program. Am J Ment Retard 2006, 111:62-73.
• [33]Carmeli E, Zinger-Vaknin T, Morad M, Merrick J: Can physical training have an effect on well-being in adults with mild intellectual disability? Mech Ageing Dev 2005, 126:299-304.
• [34]Carmeli E, Barak S, Morad M, Kodesh E: Physical exercises can reduce anxiety and improve quality of life among adults with intellectual disability. International SportMed Journal 2009, 10:77-85.
• [35]Riggen K, Ulrich D: The effects of sport participation on individuals with intellectual disability. Adapt Phys Activ Q 2003, 1:42-51.
• [36]Heller T, Hsieh K, Rimmer JH: Attitudinal and psychosocial outcomes of a fitness and health education program on adults with down syndrome. American Journal On Mental Retardation 2004, 109:175-185.
• [37]Moss SJ: Changes in coronary heart disease risk profile of adults with intellectual disabilities following a physical activity intervention. J Intellect Disabil Res 2009, 53:735-744.
• [38]Foster CE, Brennan G, Matthews A, McAdam C, Fitzsimons C, Mutrie N: Recruiting participants to walking intervention studies: a systematic review. Int J Behav Nutr Phys Act 2011, 8:137. BioMed Central Full Text
• [39]Treweek S, Mitchell E, Pitkethly M, Cook J, Kjeldstrøm M, Taskila T, Johansen M, Sullivan F, Wilson S, Jackson C, Jones R: Strategies to improve recruitment to randomised controlled trials. Cochrane Database Systematic Review 2010, 1:1-106.
• [40]Baker G, Gray SR, Wright A, Fitzsimons C, Nimmo M, Lowry E, Mutrie N, Scottish Physical Activity Research Collaboration: The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial. Int J Behav Nutr Phys Act 2010, 7:51. BioMed Central Full Text
• [41]MacMillan F, Fitzsimons C, Black K, Granat MH, Grant MP, Grealy M, Macdonald H, McConnachie A, Rowe DA, Shaw R, Skelton DA, Mutrie1 N: West End Walkers 65+: A randomised controlled trial of a primary care-based walking intervention for older adults: study rationale and design. BMC Publ Health 2011, 11:120. BioMed Central Full Text
• [42]Bandura A: Social foundations of thought and action: A social cognitive theory. New Jersey: Prentice-Hall; 1986.
• [43]Bird EL, Baker G, Mutrie N, Ogilvie D, Sahlqvist S, Powell J: Behavior Change Techniques Used to. Health Psychol: Promote Walking and Cycling. A Systematic Review; 2013.
• [44]Kirk AF, Barnett J, Mutrie N: Physical activity consultation for people with type 2 diabetes. Evidence and guidelines. Diabet Med 2007, 8:809-816.
• [45]Melville CA, Boyle S, Miller S, Macmillan S, Penpraze V, Pert C, Spanos D, Matthews L, Robinson N, Murray H, Hankey CR: An open study of the effectiveness of a multi-component weight loss intervention for adults with intellectual disabilities and obesity. Br J Nutr 2011, 105:1553-1562.
• [46]MRC: Developing and evaluating complex interventions: new guidance. London: Medical Research Council; 2008. http://www.mrc.ac.uk/Utilities/Documentrecord/index.htm?d=MRC004871 webcite
• [47]Schulz KF, Altman DG, Moher D: CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Br Med J 2010, 340:697-702.
• [48]Lubans DR, Morgan PJ, Tudor-Locke C: A systematic review of studies using pedometers to promote physical activity among youth. Preventative Medicine 2009, 48:307-315.
• [49]Gleeson-Kreig JM: Self-monitoring of physical activity: Effects on self-efficacy and behavior in people with type 2 diabetes. Diabetes Educ 2006, 32:69-77.
• [50]Ashford S, Edmunds J, French DP: What is the best way to change self-efficacy to promote lifestyle and recreational physical activity? A systematic review with meta-analysis. Br J Health Psychol 2010, 15:265-288.
• [51]Sniehotta FF, Scholz U, Schwarzer R: Bridging the intention-behaviour gap: Planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol Health 2005, 20:143-160.
• [52]Sniehotta FF, Scholz U, Schwarzer R: Action plans and coping plans for physical exercise: a longitudinal intervention study in cardiac rehabilitation. Br J Health Psychol 2006, 11:23-37.
• [53]Thomas S, Reading J, Shephard R: Revision of the physical activity readiness questionnaire (PAR-Q). Can J Sport Sci 1992, 17:338-345.
• [54]Hart TL, Swartz AM, Cashin SE, Strath SJ: How many days of monitoring predict physical activity and sedentary behaviour in older adults? Int J Behav Nutr Phys Act 2011, 8:62. BioMed Central Full Text
• [55]Tudor-Locke C, Burkett L, Reiss JP, Ainsworth BE, Macere CA, Wilson DK: How many days of pedometer monitoring predict weekly physical activity in adults? Preventative Medicine 2005, 40:293-298.
• [56]Mattews L, Hankey C, Penpraze V, Boyle S, Macmillan S, Miller S, Murray H, Pert C, Spanos D, Robinson N, Melville CA: Agreement of accelerometer and a physical activity questionnaire in adults with intellectual disabilities. Prev Med 2011, 52:361-364.
• [57]Schalock RL, Brown I, Brown R, Cummins RA, Felce D, Matikka L, Keith KD, Parmenter T: Conceptualization, measurement, and application of quality of life for persons with intellectual disabilities: report of an international panel of experts. Ment Retard 2002, 40:457-470.
• [58]Wolfs CAG, Dirksen CD, Kessels A, Willems DCM, Verhey FRJ, Severens JL: Performance of the EQ-5D and the EQ-5D + C in elderly patients with cognitive impairments. Health Qual Life Outcomes 2007, 5:33. BioMed Central Full Text
• [59]Perry J, Felce D: Subjective and objective quality of life assessment: Responsiveness, response bias, and resident: proxy concordance. Ment Retard 2002, 40:445-456.
• [60]Perry J, Felce D: Factors associated with outcome in community group homes. Am J Ment Retard 2005, 110:121-135.
• [61]Ryan RM, Frederick C: On energy, personality, and health: subjective vitality as a dynamic reflection of well-being. J Pers 1997, 65:529-565.
• [62]Peterson JJ, Lowe JB, Peterson NA, Nothwehr FK, Janz KF, Lobas JG: Paths to leisure physical activity among adults with intellectual disabilities: self-efficacy and social support. Am J Health Promot 2008, 23(1):35-42.
• [63]Resnick B, Jenkins LS: Testing the reliability and validity of the self-efficacy for exercise scale. Nurs Res 2000, 49:154-159.
• [64]Nind M: Conducting qualitative research with people with learning, communication and other disabilities: methodological challenges. University of Southampton: National Centre for Research Methods, ESRC National Centre for Research Methods Review Paper, (NCRM/012); 2009.
• [65]WHO Commission on Social Detriments of Health: Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva: World Health Organisation; 2008.
• [66]Glasgow R, Boles S, Vogt T: Reach Effectiveness Adoption Implementation Maintenance (RE-AIM). [19-Feb-2012]. 2012. http://www.re-aim.org webcite
• [67]Kohl HW, Craig CL, Lambert EV, Lioue S, Alkandari JR, Leetongin G, Kahlmeier S: The pandemic of physical inactivity: Global action for public health. Lancet 2012, 380:294-305.
• [68]Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW: Correlates of physical activity: Why are some people physically active and others not? Lancet 2012, 380:258-271.
• [69]Temple VA, Frey GC, Stanish HI: Physical activity of adults with mental retardation: review and research needs. Am J Health Promot 2006, 21:2-12.
• [70]Hawkins A, Look R: Levels of engagement and barriers to physical activity in a population of adults with learning disabilities. Br J Learn Disabil 2006, 34:220-226.
• [71]Messent PR, Cooke CB, Long J: Primary and secondary barriers to physically active health lifestyles for adults with learning disabilities. Disabil Rehabil 1999, 21:409-419.
• [72]Wullink M, Widdershoven G, Van Schrojenstein Lantman-de Valk H, Dinant GJ, Metsemakers J: Autonomy in relation to health among people with intellectual disability: a literature review. J Intellect Disabil Res 2009, 53:816-826.
• [73]Spanos D, Hankey CR, Boyle S, Koshy P, Macmillan S, Matthews L, Miller S, Penpraze V, Pert C, Robinson N, Melville CA: Carers' perspectives of a weight loss intervention for adults with intellectual disabilities and obesity: a qualitative study. J Intellect Disabil Res 2012, 57:90-102.
• [74]Melville CA, Hamilton S, Miller S, Boyle S, Robinson N, Pert C, Hankey CR: Carer knowledge and perceptions of healthy lifestyles for adults with intellectual disabilities. J Appl Res Intellect Disabil 2009, 22:298-306.