Kelly Hsieh

Attitudinal and Psychosocial Outcomes of a Fitness and Health Education Program on Adults With Down Syndrome

Attitudinal and psychosocial outcomes of a fitness and health education program for adults with Down syndrome were examined. Participants were 53 adults with Down syndrome ages 30 years and older (29 females, 24 males, M age = 39.72 years) who were randomized into a training (n = 32) or control group (n = 21). The training group participated in a 12-week, 3 days per week, exercise and health education program. Outcome measures included attitudes towards exercise (cognitive-emotional barriers, outcomes expectations, and performance self-efficacy) and psychosocial well-being (community integration, depression, and life satisfaction). Compared to controls, the training group showed significant changes in attitudes towards exercise, including increased exercise self-efficacy, more positive expected outcomes, fewer cognitive-emotional barriers, improved life satisfaction, and marginally lower depression.

Obesity and associated factors in adults with intellectual disability

BACKGROUND We examined the prevalence of obesity in adults with intellectual disabilities (ID) compared with the general population, and the factors associated with obesity and weight management status, comparing individuals with ID who were overweight or obese to those who were not. METHODS We analysed baseline data (n = 1450) from the ongoing 4-year Longitudinal Health and Intellectual Disabilities Study (LHIDS) using a multivariate approach. Measures included body mass index (BMI), demographics, level of ID, diagnoses related to ID, health behaviours (i.e. physical activity, dietary habits, smoking, and alcohol consumption), various health parameters (e.g. mobility limitation, medications), and residential type and location. RESULTS Compared with the general population, adults (≥ 18 years) with ID had a higher prevalence of obesity (38.3% vs. 28%) and morbid obesity (7.4% vs. 4.2%). Being female (AOR = 1.40, 95% CI = 1.09-1.81), having Down syndrome (AOR = 2.53, 95% CI = 1.86-3.45), taking medications that cause weight gain (AOR = 1.80, 95% CI = 1.38-2.37), engaging in less moderate physical activity (AOR = 0.89, 95% CI = 0.79-0.99), and drinking greater amounts of soda (AOR = 1.20, 95% CI = 1.02-1.42) were associated with higher rates of obesity. CONCLUSION Adults with ID, in general, have a high risk of developing obesity, and women with ID have a high risk of developing morbid obesity. Health promotion initiatives should target individuals with the greatest risk.

Impact of a consumer-directed family support program on adults with developmental disabilities and their family caregivers

In the current study we examined the impact offamily support programs for adults with developmental disabilities. Results of the study indicated that participants had fewer unmet needs and used more services than the control group. Participant caregivers were more satisfied with the services their relative received, experienced greater self-efficacy, and were less likely to desire an out-of-home placement than the control group. Participants with developmental disabilities experienced increases in community integration and monthly wage.

Later-Life Planning: Promoting Knowledge of Options and Choice-Making.

The effectiveness of a person-centered later-life planning training program designed to teach older adults (N = 60) with mental retardation about later-life planning issues and increase their participation in choice-making was examined. Using quantitative data analyses, we assessed the impact of the program on intervention and control groups. Results indicated that the intervention group gained more knowledge of concepts in the curriculum and made more choices over time than did the control group. The wide variety of goals that participants set were examined through qualitative analyses; 87% of the participants met or partially met their goals. Information on the supports and barriers to meeting goals is provided.

A Conceptual Model for Identifying, Preventing, and Managing Secondary Conditions in People With Disabilities

Secondary conditions are considered a direct consequence of having a disability, and many are presumed to be preventable. Although a few researchers have noted that people with disabilities are exposed to several secondary conditions, including pain, fatigue, depression, and obesity, what is lacking in the literature is a conceptual framework for understanding the antecedents, risk factors, and consequences of secondary conditions. To move the rehabilitation and public health professions toward a more unified approach to understanding and managing secondary conditions as well as distinguishing them from chronic and associated conditions, this article proposes a set of criteria for defining secondary conditions and a conceptual model that considers the potential factors associated with their onset, impact, severity, and management.

Eight-year follow-up of the impact of environmental characteristics on well-being of adults with developmental disabilities.

The impact of environmental features of residences on adaptive behavior, community integration, and health of adults with mental retardation over an 8-year period was examined. Environmental features included residence type, size, choice-making opportunities, physical attractiveness, and family involvement. We assessed 186 residents who initially lived in nursing homes. At the 8-year follow-up, 133 had moved to community-based residential settings. Findings indicated that residents who moved to community settings had higher levels of adaptive behavior and community integration than residents who remained in nursing homes. A more attractive physical environment and greater opportunity for choice-making were associated with higher levels of adaptive behavior at follow-up. Greater opportunity to make choices and family involvement were associated with higher levels of community integration.

Grandparents as Supports to Mothers of Persons with Intellectual Disability

Abstract This study examined the impact of social support from grandparents on the well-being of mothers of persons with intellectual disabilities. Also, it described the social support functions served by the grandparents across the lifespan and the predictors of this support. The subjects included 120 mothers of a child with moderate to profound intellectual disability living in the family homes. Surveys and interviews conducted in home asked about characteristics of the child (age, level of intellectual disability, physical health, maladaptive behavior) and mother (age, minority status, and socio-economic status); support received other than from grandparents (unmet needs, other informal supports) and grandparent support (instrumental and emotional), and maternal depression. The key variables predicting maternal depression were the mothers younger age and poorer physical health and less emotional support from the grandparents. Grandparents of younger children provided more instrumental support than did grandparents of adult children.

Interventions to promote health: Crossing networks of intellectual and developmental disabilities and aging

BACKGROUND People with intellectual and developmental disabilities experience lower levels of healthy behaviors as do older persons, making health promotion a key priority for these populations. OBJECTIVE The aim of this paper is to review the two fields of developmental disability and aging health promotion research in order to understand strategies used by both and to identify emerging and innovative practices that disability researchers can learn from each other. METHODS We conducted scoping reviews of health promotion intervention peer reviewed articles in English from 1991 to 2011 for intellectual and developmental disabilities and from 2007 to 2011 for the more extensive gerontological literature. Two reviewers extracted data. RESULTS The disability review identified 34 studies and three main types of interventions: exercise, multi-component, and health screens. The aging review identified 176 articles which had a wider variety of intervention topics and techniques, with more articles including innovative approaches to bringing interventions to community settings across a wider variety of populations. CONCLUSIONS As people with intellectual and developmental disabilities are living longer, disability health promotion can look to the aging literature for ideas to incorporate in future interventions for people with intellectual and developmental disabilities, while the gerontological research can learn from the research in intellectual and developmental disabilities on ways to adapt health promotion interventions to people with cognitive and physical limitations. Use of universal design principles could enable greater inclusion of people with disabilities in health promotion interventions for the general aging population.

Impact of age and transitions out of nursing homes for adults with developmental disabilities

The impact of moving out of nursing homes into community-based settings was assessed by comparing the health, community functioning, and lifestyle satisfaction of movers and nonmovers at Time 1 and 3 years later at Time 2. We also examined whether age was a significant factor in outcomes of the transfers. The sample included 165 nonmovers and 67 movers age 30 years and older who initially were living in nursing homes. Findings indicated that movers showed benefits of improved health and community functioning. In addition, interviews with residents indicated higher increases in lifestyle satisfaction for the movers versus the nonmovers. Age of the residents did not have a significant impact on the effects of transferring out of nursing homes.

Impact of Adulthood Stage and Social-Environmental Context on Body Mass Index and Physical Activity of Individuals With Intellectual Disability

Individuals with intellectual disability (ID) are at risk for obesity and physical inactivity. We analyzed a subset of 2009-2010 National Core Indicators (NCI) database to examine (1) the impact of three adulthood stages- younger (20-39 years), middle (40-59 years), and older (60 years and older) on Body Mass Index (BMI) and physical activity (PA); and (2) the relationship between social-environmental context (i.e., residence type, everyday choices, and community participation) and BMI and PA, with adjustment for individual characteristics of the adults with ID. Findings highlight the need to pay more attention to obesity by providing health education and emphasizing healthy choices. Results also suggest the importance of community participation as a way of promoting more physical activity.