Health disparities between individuals with intellectual disabilities, including Down Syndrome, and the general population are well documented. These disparities include issues related to obesity and heart disease. Causal factors have been noted in the literature such as lower activity levels, poor diets and issues related to accessing health care services. Efforts to address these issues have met with moderate success but are not widely implemented due to costs and their staff intensive nature in regards to inherent support needs. New approaches need to be explored that have potential to alleviate these health disparities in ways that also encourage cost effectiveness, self direction and independence. This project proposes development and evaluation of a novel approach designed to provide motivation, increased physical activity and monitoring supports for individuals with intellectual disabilities who experience weight and cardiovascular problems. It involves development of a portable, integrated GPS hardware/software system designed to promote increased walking exercise in the user's local environment. The system will also record/report activity and integrate with basic health monitoring measures such as blood pressure, heart rate and weight. To accomplish this, the system would include a configuration module that would be used by care givers to create GPS based navigation prompts, landmarks, and optional "treasure hunts" for local outdoor environments. Once created, these routes would be used by one or more individuals with intellectual disabilities to navigate the route via foot travel while using a simplified interface to indicate success in locating "treasure hunt" items. The system would record time, distance and other parameters of route travel for verification and provide optional game-like rewards such as printable achievement certificates or point accumulation that could later be exchanged for other tangible reinforcements. Finally, the system will integrate with existing, wireless health monitoring systems such as easy to use blood pressure, heart rate and weight scale monitors designed to be used upon route completion. Measures from the monitors will be retained by the system to help evaluate intervention efficacy, for reporting to caregivers and health care professionals, and for progress analysis over time.
Five Specific Aims are proposed to accomplish this activity: 1) complete development of initial functional and technical system requirements, 2) complete prototype design and development, 3) conduct a field evaluation involving the use of the prototype by individuals with intellectual disabilities and other stakeholders, 4) completion of final system design and development activities, and 5) complete system documentation and project reporting. The long term objective is provision of a technology intervention designed with significant stakeholder involvement that provides research based evidence of usability and effectiveness in reducing exercise related health disparities for individuals with intellectual disabilities.
This project will result in a portable system designed to support increased exercise and monitor/report selected health measures for individuals with intellectual disabilities who are obese or overweight. The benefit to public health may include reduced health disparities, improved cardiovascular and mental health and a reduction in related health care costs.