The move for individuals with ID from institutional to community settings has increased their opportunities for self-determination and provided a less restrictive environment. However, knowledge, motivation, and efficacy to engage in a healthy lifestyle tend to be low in both individuals who have ID and their care providers. Community and residential living arrangements often make choosing a healthy diet and participating in physical activity difficult. In group living situations, it is easy to serve the same foods and portion sizes to all residents. Care providers frequently decide on meal content without input from the majority of the residents. Moreover, studies show that parents of adults who have ID lack information and support in limiting access to unhealthy foods and encouraging healthy activity patterns. Financial and transportation issues also make it difficult for individuals with ID to participate in community-based physical activity programs. As a result, individuals who have ID often have poor energy dense diets and tend to be inactive; they experience rates of obesity greater than the general population which contributes to a high prevalence of health related problems, including cancer, diabetes, hypertension, and cardiovascular diseases. There is a compelling need for healthy lifestyle programs targeted to the specific context and learning needs of this population. The proposed project HELP-ID; (Healthy Eating and Lifestyle Program for Individuals) With ID, will use the best of the behavioral weight loss programs while incorporating an innovative, yet research-based approach specifically designed for the needs of this population. Guided by Social Cognitive Theory (SCT), HELP-ID is an engaging multimedia program that delivers information on nutrition, easy to implement and cost effective meal planning ideas, and a lifestyle physical activity program to individuals with ID and their care providers. In Phase I, we will develop a prototype of Help-ID and successfully established feasibility of the program. The primary aims of the Phase II study will be to fully develop the comprehensive healthy eating and lifestyle program for overweight and obese adults with ID and evaluate its efficacy in a randomized-controlled trial with overweight/obese adults who have ID and who live at home, in foster homes, in group homes, or independently with supports, and their care providers.
The disparity in health status between those with and without ID is a serious public health concern. Due to lack of system supports and education, people who have ID do not engage in health promotion or disease prevention activities to the same extent as the non-ID population. Accordingly, the incidence of obesity in adults who have ID has increased over the last 20 years and at disproportionately higher rates than the general population. There is a pressing need to include this group in healthy eating, nutrition education, and promotion of physical activities. By focusing on individuals with ID, this program brings needed intervention tools to an underserved population. This project has strong public health significance in that it aims to improve the immediate and long-term health of participants who have ID and who are obese or at risk for obesity.
