Frances Owen

Health self-advocacy training for persons with intellectual disabilities

BACKGROUND People with intellectual disabilities (ID) have unequal access to health care. While systemic efforts are addressing health inequalities, there remains a need to demonstrate that persons with ID can increase their health self-advocacy skills. METHOD A randomised control design with up to 6-month follow-up was used to evaluate the 3Rs (Rights, Respect and Responsibility) health self-advocacy training program for persons with ID (n = 31). Training involved teaching participants to recognise and redress health rights violations in the context of respect and responsibility. Training materials included PowerPoint slides and interactive video scenarios illustrating health rights, respect and responsibility problem and non-problems. Two-hour training sessions were conducted twice a week in a group format where participants played a game and answered questions. RESULTS The health rights training group made significantly more correct responses on post training and follow-up tests than the control group. Training effects generalised to untrained scenarios and in situ health interviews. CONCLUSIONS The results of this study suggest that persons with ID can learn complex skills related to health self-advocacy. More research is needed to improve in situ generalisation.

Meta-analysis of deinstitutionalisation adaptive behaviour outcomes: Research and clinical implications

Abstract Background A meta-analysis examined the effects of deinstitutionalisation on adaptive behaviour outcomes in persons with intellectual disability. The need for an updated review in this area is reflected by recent policy shifts in community care practices and the international status of deinstitutionalisation efforts. Method Twenty-three studies were compared using standardised mean effect sizes across 5 demographic, 4 methodological, and 1 outcome variable. Results Moderate habilitative gains were found in 75% of adaptive behaviour domains. A weighted linear multiple regression revealed that larger effect sizes were significantly predicted by sample size and research design. Disability level also moderated the extent to which sample size affected the magnitude of effect sizes. Conclusions These results are discussed in relation to the implications they have for community services for persons with intellectual disability. The difficulties in accurately comparing studies with dissimilar procedures and contexts are also outlined.