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Background: There is a paucity of theory-informed physical activity research with adults with intellectual disabilities. This study aimed to address this by synthesising existing literature and applying the COM-B model to understand capabilities, opportunities and motivations., Methods: A qualitative evidence synthesis was conducted and reported in accordance with PRISMA guidelines and the ENTREQ. Three databases were systematically searched up to and including February 2022. Qualitative research relating to the physical activity of adults with intellectual disabilities were included. Thematic synthesis was conducted with themes mapped onto the COM-B model., Results: Twenty-five studies were included. Influences of physical activity were identified and mapped onto the COM-B model, which also included COM-B influences of social support provided by caregivers., Conclusions: There are many complex influences of physical activity for adults with intellectual disabilities. Researchers should consider the influences contributing to caregivers' capacity to support physical activity., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Health professionals were trained to deliver adapted psychological interventions for depression to people with learning disabilities and depression alongside a supporter. Exploring the delivery of psychological interventions can help increase access to therapy., Method: Twenty-seven participants took part in six focus groups, and the data were subject to a Framework Analysis., Results: The structure and focus of the manualised therapies, and the use of specific techniques were perceived as key to service-user engagement. Supporters' involvement was valued by therapists if they had a good relationship and regular contact with the individual they supported. Regular clinical supervision was regarded as vital in understanding their role, assessing progress and delivering the interventions., Conclusions: The findings highlight that health professionals can embrace a focussed therapeutic role and increase access to psychological therapies for people with intellectual disabilities., (© 2021 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Quality of primary healthcare impacts on health outcomes. This study aimed to quantify trends in good practice and the healthcare inequalities gap., Method: Indicators of best-practice management of long-term conditions and health promotion were extracted from primary healthcare records on 721 adults with intellectual disabilities in 2007-2010, and 3638 in 2014. They were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression., Results: Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69-10.55), but not for the general population (OR = 0.74; CI = 0.34-1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20-0.73 in 2014, and OR = 0.05; CI = 0.02-0.12 in 2007-2010). In 2014, health care was comparable to the general population on 49/78 (62.8%) indicators., Conclusions: The extent of the healthcare inequality gap reduced over this period, but remaining inequalities highlight that further action is still necessary., (© 2020 John Wiley & Sons Ltd.)

Introduction: Children and adolescents with intellectual disabilities participate in low levels of physical activity and have a greater reliance on their parents to provide activity opportunities. This study explored parents' experiences of promoting physical activity for their child with intellectual disabilities., Methods: Semi-structured interviews were conducted with eight parents of children and adolescents with intellectual disabilities. Interviews were independently coded and analysed by two researchers using thematic analysis., Results: Four themes and nine subthemes were identified. Overall, parents had positive views of physical activity. However, parents face numerous barriers that limit their ability to promote physical activity for their child with intellectual disabilities., Conclusions: Parents experience high levels of exclusion and stigma that negatively affect their promotion of physical activity for their child with intellectual disabilities. Overcoming the barriers faced by parents could therefore be an indirect method to increase physical activity in children and adolescents with intellectual disabilities., (© 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Intellectual disabilities and autism are lifelong and often co-occur. Little is known on their extent of independent association with sensory impairments and physical disability., Methods: For Scotland's population, logistic regressions investigated age-gender-adjusted odds ratios (OR) of associations, independently, of intellectual disabilities and autism with sensory impairments and physical disability., Results: 1,548,819 children/youth, and 3,746,584 adults. In children/youth, the effect size of intellectual disabilities and autism, respectively, was as follows: blindness (OR = 30.12; OR = 2.63), deafness (OR = 13.98; OR = 2.31), and physical disability (OR = 43.72; OR = 5.62). For adults, the effect size of intellectual disabilities and autism, respectively, was as follows: blindness (OR = 16.89; OR = 3.29), deafness (OR = 7.47; OR = 2.36), and physical disability (OR = 6.04; OR = 3.16)., Conclusions: Intellectual disabilities have greater association with the population burden of sensory impairments/physical disability, but autism is also associated regardless of overlap with intellectual disabilities. These may impact further on communication limitations due to autism and intellectual disabilities, increasing complexity of assessments/management of other health conditions. Clinicians need to be aware of these important issues., (© 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Adults with intellectual disabilities are reported to be highly inactive, with research required to understand contributory factors. This systematic review aimed to investigate gender differences in physical activity (PA) and sedentary behaviour (SB) in adults with intellectual disabilities., Methods: This systematic review was reported in accordance with PRISMA guidelines. Seven databases were searched up to, and including, January 2018. Screening identified papers that assessed gender-specific PA and/or SB outcomes in adults with intellectual disabilities. Data were synthesized using a narrative synthesis and random effects model meta-analyses., Results: Twenty-six papers were included; 25 measured PA, and eight assessed SB. Women with intellectual disabilities were least active with a significant overall effect of gender identified. For SB, no consistent gender differences were found., Conclusions: Reflecting the general population, men with intellectual disabilities were most active. Intellectual disability research should consider the role of gender to inform future interventions targeting inactivity., (© 2019 John Wiley & Sons Ltd.)

Background: The purpose of this study was to investigate the patterns of objectively measured sedentary behaviour in adults with intellectual disabilities., Methods: Baseline accelerometer data were pooled from two randomized controlled trials of lifestyle behaviour change programmes for adults with intellectual disabilities. Patterns of sedentary behaviours were computed including total volume, number, and duration of bouts and breaks., Results: Participants spent >70% of the day sedentary (8 hr), which was generally accumulated in short sedentary bouts (<10 min). Participants were engaged in significantly more sedentary time during the morning, although differences between time of day were small (mean bout duration range: 19.8-22.3 min)., Conclusions: The findings add valuable insight into the patterns of sedentary behaviours among adults with intellectual disabilities. Further research investigating the patterns and context of sedentary behaviour is required to develop targeted interventions to reduce total sedentary time in adults with intellectual disabilities., (© 2019 John Wiley & Sons Ltd.)

Background: No studies have explored the acceptability of Behavioural Activation and Guided Self-Help interventions for depression with people who have intellectual disabilities., Method: Twenty-five participants were purposively sampled from participants taking part in a trial comparing Behavioural Activation with a Guided Self-Help intervention. A framework analysis was used to analyse interviews covering participants' expectations and views of therapy., Results: Participants were largely positive about both interventions. However, they identified specific aspects of each intervention which they had found helpful. All participants valued the therapeutic relationship. The participants also had a number of criticisms and suggestions for improving the therapies. A common concern was the time-limited nature of the interventions and a wish for longer-term help. Overall, both sets of participants felt the interventions had relevance for their wider lives., Conclusions: The participants reported having positive engagement with the therapies but expressed a wish for longer-term supportive relationships., (© 2019 John Wiley & Sons Ltd.)

Aim: Very little attention has been paid to the views and experiences of young people with mild intellectual disabilities on the broad topics of adulthood and adult identity. The following study was undertaken to explore how young adults with mild intellectual disabilities conceptualize, relate to, and experience the process of transition., Method: Eight young adults with mild to borderline intellectual disabilities participated in semi-structured interviews. Results were analysed using interpretive thematic analysis., Results: Two umbrella themes were identified: "On a developmental pathway" and "Negotiations in the environment"., Conclusions: The participants concerns were surprisingly similar to those commonly expressed by young adults without disabilities. Self-perceived adult identity appeared to be affected by the participants' personal definitions of adulthood, as well as by social comparisons with both peers and adults. Finally, while concerns were expressed about their capacity to cope with responsibility, most felt optimistic about adopting full adult status in the future., (© 2019 John Wiley & Sons Ltd.)

Background: Clinicians recommend including carers or others in a supporting role in the therapy as an important adaptation of psychological therapies for people with intellectual disabilities. This nested qualitative study from a larger trial explored supporters' experiences of supporting people with intellectual disabilities receiving behavioural activation or guided self-help therapies for depression., Method: Twenty-one purposively sampled supporters were interviewed. The semi-structured interviews were subject to framework analysis, covering expectations of therapy, views of therapy sessions, relationships with therapist and participant, and perceived changes., Results: Supporters were positive about both therapies and reported both therapy-specific and nonspecific therapeutic factors that had significant positive impacts on people's lives. Most supporters reported their involvement contributed to the interventions' effectiveness, and helped establish closer relationships to the people they were supporting., Conclusions: The presence of supporters within psychological therapies for people with intellectual disabilities can be an effective adaptation to therapies for this population., (© 2018 John Wiley & Sons Ltd.)

Background: Promotion of a healthy lifestyle for people with intellectual disabilities is important; however, the effectiveness of lifestyle change interventions is unclear., Aims: This research will examine the effectiveness of lifestyle change interventions for people with intellectual disabilities., Methods and Procedures: Randomized controlled trials (RCTs) of lifestyle change interventions for people with intellectual disabilities were included in a systematic review and meta-analysis. Data on study and intervention characteristics were extracted, as well as data on outcome measures and results. Internal validity of the selected papers was assessed using the Cochrane Collaboration's risk bias tool., Outcomes and Results: Eight RCTs were included. Multiple outcome measures were used, whereby outcome measures targeting environmental factors and participation were lacking and personal outcome measures were mostly used by a single study. Risks of bias were found for all studies. Meta-analysis showed some effectiveness for lifestyle change interventions, and a statistically significant decrease was found for waist circumference., Conclusion and Implications: Some effectiveness was found for lifestyle change interventions for people with intellectual disabilities. However, the effects were only statistically significant for waist circumference, so current lifestyle change interventions may not be optimally tailored to meet the needs of people with intellectual disabilities., (© 2018 John Wiley & Sons Ltd.)

Background: In the general population, the transition from adolescence to adulthood has been identified as a "high-risk" period for weight gain. There has been no research examining health behaviours over this transition in adults with intellectual disabilities., Methods/design: The feasibility of recruitment, retention and relevant health behaviours were measured in 31 adolescents with mild-moderate intellectual disabilities. Anthropometric, objective physical activity, dietary and self-determination measures were collected over a 12-month transitional period from school to adulthood., Results: Key results suggest weight and BMI increased significantly from month 6 to month 12 (p = 0.044 and p = 0.043). Waist circumference increased significantly from baseline to month 12 (p = 0.049), and from month 6 to month 12 (p = 0.03)., Discussion: Recruiting and retaining young adults with intellectual disabilities over a 12-month health behaviour study is feasible. The data indicate the transition from school to adulthood may be the start of a high-risk period for weight gain., (© 2018 John Wiley & Sons Ltd.)

Background: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators., Method: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses., Results: Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%-100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation., Conclusions: Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care., (© 2017 John Wiley & Sons Ltd.)

Background: Adults with intellectual disabilities (ID) experience significant inequalities and tend to be more sedentary and less physically active than the wider population. Walking programmes are an effective way to increase physical activity (PA) but have not been used in studies involving adults with intellectual disabilities., Method: Nineteen adults with intellectual disabilities participated in semistructured interviews or focus groups exploring their experiences of taking part in a walking programme (Walk Well). Data were coded using thematic analysis., Results: Four overarching themes emerged: perceived benefits of taking part in the programme, perceived drawbacks/ barriers, walking choices and using the Walk Well resources. While there was not a significant increase in walking for all, the participants reported positive experiences of taking part in the programme. Self-monitoring proved difficult for some, particularly reading the daily step count recorded on the pedometer and writing it in the diary. Carers also played an important role in facilitating and preventing behaviour change in adults with intellectual disabilities., Conclusion: Additional barriers prevent many adults with intellectual disabilities from participating in PA. Capturing participant experiences provides important information for designing effective and equitable health improvement programmes., (© 2016 John Wiley & Sons Ltd.)

Background: The prevalence of obesity is higher in those with intellectual disabilities than the general population. The aim of the study was to understand the determinants of physical activity and dietary patterns in this population during their final year of school., Method: Qualitative data were generated from 10 interviews with adolescents with mild-moderate intellectual disabilities. Data were analysed using deductive thematic analysis, employing Self-Determination Theory as a theoretical framework., Results: Adolescents' environment and social interactions play a pivotal role in influencing physical activity and dietary patterns. Three themes emerged from the analysis: situatedness, motivation and wider environmental influences., Conclusions: School structure, high self-efficacy and social connectedness facilitate increased physical activity and healthier diet in adolescents with intellectual disabilities. Home life, low self-efficacy and a lack of social connectedness can serve as a barrier to PA and a healthy diet., (© 2017 John Wiley & Sons Ltd.)

Background: The evidence base for weight management programmes incorporating a weight loss and a weight maintenance phase for adults with intellectual disabilities (ID) is limited. This study describes the weight maintenance phase of a multicomponent weight management programme for adults with intellectual disability and obesity (TAKE 5)., Materials and Methods: Thirty-one participants who had completed the 16 week TAKE five weight loss intervention (Phase I) were invited to participate in a 12 month weight maintenance intervention (Phase II). Content included recommendations of the National Weight Control Registry., Results: Twenty-eight participants completed Phase II with 50.4% maintaining their weight (mean weight change -0.5 kg, SD 2.2), 28.7% gaining weight (mean weight gain 5.4 kg, SD 2.2) and 21.6% losing weight (mean weight loss -8.0 kg, SD 3.0) at 12 months., Conclusion: Further research is justified to investigate the efficacy of weight loss maintenance interventions in adults with intellectual disability and obesity, using controlled study designs., (© 2015 John Wiley & Sons Ltd.)