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Background: Professional caregivers are important in the daily support of lifestyle change for adults with mild intellectual disabilities; however, little is known about which behaviour change techniques (BCTs) are actually used. This study aims to gain insight in their use for lifestyle behaviour change using video observations., Methods: Professional caregivers (N = 14) were observed in daily work supporting adults with mild intellectual disabilities. Videos were analysed using the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy and BCTs utilised were coded., Results: Twenty one out of 40 BCTs were used by professional caregivers. The BCTs 'Information about others' approval', 'Identification as role model', 'Rewards on successful behaviour', 'Review behavioural goals' and 'Instructions on how to perform the behaviour' were most employed., Conclusion: Professional caregivers used BCTs to support healthier lifestyle behaviour of adults with mild intellectual disabilities. However, most promising of them as defined previous by professionals were rarely used by professional caregivers., (© 2022 John Wiley & Sons Ltd.)

Background: Behaviour change techniques (BCTs) can be employed to support a healthy lifestyle for people with intellectual disabilities. The aim of this study is to determine whether and which BCTs are used by direct support professionals (DSPs) for supporting healthy lifestyle behaviour of people with moderate to profound intellectual disabilities., Method: Direct support professionals (n = 18) were observed in their daily work using audio-visual recordings. To code BCTs, the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy was employed., Results: Direct support professionals used 33 BCTs out of 42. The most used BCTs were as follows: 'feedback on performance', 'instructions on how to perform the behaviour', 'doing together', 'rewards on successful behaviour', 'reward effort towards behaviour', 'DSP changes environment', 'graded tasks', 'prompt practice' and 'model/demonstrate behaviour'., Conclusions: Although a variety of BCTs is used by DSPs in their support of people with moderate to profound intellectual disabilities when facilitating healthy lifestyle behaviour, they rely on nine of them., (© 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: People with intellectual disabilities (ID) depend on their environment to live healthily. Asset-based health promotion enhances a settings' health-promoting capacity starting with identifying protective or promotive factors that sustain health., Method: This inclusive mixed-methods study used group sessions to generate and rank ideas on assets supporting healthy nutrition and physical activity in Dutch intellectual disability care settings. Participants included people with moderate intellectual disabilities and family and care professionals of people with severe/profound intellectual disabilities., Results: Fifty-one participants identified 185 assets in group sessions. They include the following: (i) the social network and ways "people" can support, (ii) assets in/around "places," and person-environment fit, and (iii) "preconditions": health care, prevention, budget, and policy., Conclusion: This inclusive research provides a user perspective on assets in the living environment supporting healthy living. This gives insight in contextual factors needed for development and sustainable embedment of health promotion in the systems of intellectual disability support settings., (© 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Overweight/obesity and poor physical fitness are two prevalent lifestyle-related problems in older adults with intellectual disabilities, which each require a different approach. To improve healthy ageing, we assessed whether fatness or fitness is more important for survival in older adults with intellectual disabilities., Methods: In the HA-ID study, we measured obesity and fitness of 874 older adults with intellectual disabilities (61.4 ± 7.8 years). All-cause mortality was assessed over a 5-year follow-up period., Results: Fitness, but not obesity, was significantly related to survival (HR range of 0.17-0.22). People who were unfit were 3.58 (95% CI = 1.72-7.46) to 4.59 (95% CI = 1.97-10.68) times more likely to die within the follow-up period than people who were fit, regardless of obesity., Conclusion: This was the first study to show that being fit is more important for survival than fatness in older adults with intellectual disabilities. The emphasis should, therefore, shift from weight reduction to improving physical fitness., (© 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: The cardiovascular disease (CVD) risk is high in adults with intellectual disabilities. This CVD risk can potentially be decreased with a resistance training (RT) programme at vigorous intensity, following previous research on successful High-Intensity Training programmes. Our aim was to explore the feasibility of a vigorous RT-programme for adults with intellectual disabilities with CVD risk factors., Method: Twenty-four adults with intellectual disabilities with at least one CVD risk factor participated in a 24-week RT-programme. The training intensity was increased from novice (50%1RM) to vigorous (75%-80%1RM). Feasibility was based on the achieved training intensity at the end of the RT-programme., Results: Nineteen participants finished the RT-programme. Feasibility was good as 58% (11 out of 19) of the participants worked out at vigorous intensity at the end of the programme., Conclusions: It is feasible for the majority of adults with intellectual disabilities with CVD risk factors to exercise at vigorous intensity., (© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: The very low physical fitness levels of people with intellectual disabilities (ID) may influence their life expectancy. Therefore, we investigated the predictive value of physical fitness for survival in older adults with intellectual disabilities., Method: In the Healthy Ageing and Intellectual Disabilities (HA-ID) study,the physical fitness levels of 900 older adults (≥50 years; 61.5 ± 8.1 years) were measured at baseline. All-cause mortality was collected over a 5-year follow-up period. Cox proportional hazard models were used to determine the association between each physical fitness test and survival, adjusted for age, sex, level of ID, and Down syndrome., Results: The physical fitness components that were independently predictive for survival were manual dexterity (HR = 0.96 [0.94-0.98]), visual reaction time (HR = 1.57 [1.28-1.94]), balance (HR = 0.97 [0.95-0.99]), comfortable gait speed (HR = 0.65 [0.54-0.78]), fast gait speed (HR = 0.81 [0.72-0.91]), grip strength (HR = 0.97 [0.94-0.99]) and cardiorespiratory fitness (HR = 0.997 [0.995-0.999]), with a better physical fitness showing a lower mortality risk., Conclusion: We showed for the first time that physical fitness was independently associated with survival in older adults with intellectual disabilities. Improving and maintaining physical fitness must become an essential part of care and support for this population., (© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.)

Background: Resistance training has beneficial effects on fitness levels, cardiovascular disease risk, risk of sarcopenia and on performing activities of daily living. The focus of this study is to design a total body resistance exercise set for adults with intellectual disabilities (RESID) with minimal equipment required and to test its feasibility., Method: The RESID was selected in an expert meeting, and its feasibility was determined in a cross-sectional pilot study. The feasibility was determined with completion rate, correct execution of exercises and the participant's experience., Results: The expert group (n = 7) selected seven exercises for the RESID. The participants (N = 11) performed the RESID twice during regular sports classes. Completion rate and correctness were excellent for all exercises. The participants did not experience any major problems with the RESID., Conclusions: The RESID is feasible for use in different training settings. A physiotherapist or fitness instructor is required to supervise the training sessions., (© 2018 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.)

Background: Promotion of a healthy lifestyle for individuals with mild intellectual disabilities is important. However, the suitability of behaviour change techniques (BCTs) for these individuals is still unclear., Methods: A Delphi study was performed using the Coventry, Aberdeen & LOndon - REfined (CALO-RE) taxonomy of BCTs (n = 40). Health professionals (professional caregivers, behavioural scientists, health professionals, intellectual disability physicians) participated in an online survey to determine whether BCTs were suitable or unsuitable. Comments from participants were analysed qualitatively., Results: Consensus was reached for 25 BCTs out of 40.The most suitable BCTs were barrier identification (97%), set graded tasks (97%) and reward effort towards behaviour (95%). No significant differences were found for intergroup effects., Conclusion: Regardless of their position and education level, health professionals reached consensus about the suitability of BCTs for individuals with mild intellectual disabilities. Increased use of these BCTs could result in more effective promotion of a healthy lifestyle., (© 2018 John Wiley & Sons Ltd.)

Background: Regular participation of children and adolescents with intellectual disabilites in physical activity is important to maintain good health and to acquire motor skills. The aim of this study was to investigate the habitual physical activity in these children., Methods: Sixty-eight children and adolescents (2-18 years) with a moderate-to-severe intellectual disability were included in the analyses. They wore an accelerometer on eight consecutive days. Data was analysed by use of descriptive statistics and multiple linear regression analyses., Results: The participants took on average 6,677 ± 2,600 steps per day, with intensity of 1,040 ± 431 counts per minute. In total, 47% of the participants were meeting physical activity recommendations. Low motor development was associated with low physical activity., Conclusions: As more than half of the participants were not meeting the recommendations, family and caregivers of these children should focus on supporting and motivating them to explore and expand their physical activities., (© 2018 The Authors. Journal of Applied Research in Intellectual Disabilities Published by 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: Individuals with intellectual disability (ID) have very low physical activity and low peak oxygen uptake (VO 2peak ), potentially explained by physiologically lower peak heart rates (HR peak )., Method: The present authors performed a retrospective analysis of a large data set of individuals with intellectual disability (n = 100), with Down syndrome (DS) (n = 48) and without intellectual disability (n = 224) using multiple linear regression analyses, to determine if individuals with intellectual disability exhibit lower HR peak and VO 2peak than individuals without intellectual disability, controlling for age, sex and body mass index (BMI)., Results: Individuals with intellectual disability on average have significantly lower HR peak and VO 2peak than individuals without intellectual disability, even when controlling VO 2peak for the lower HR peak ., Conclusions: This study suggests potential physiological differences in individuals with intellectual disability and warrants further investigation to determine their relevance to physical activity promotion and exercise testing in individuals with intellectual disability., (© 2017 John Wiley & Sons Ltd.)