Supporting active engagement of adults with intellectual disabilities in lifestyle modification interventions: A realist evidence synthesis of what works, for whom, in what context and why

Westrop, S. C., Rana, D. , Jaiswal, N. , Wu, O. , Mcgarty, A. M. , Melville, C. , Ells, L., Lally, P., McEwan, M. and Germeni, E. (2024) Supporting active engagement of adults with intellectual disabilities in lifestyle modification interventions: A realist evidence synthesis of what works, for whom, in what context and why. Journal of Intellectual Disability Research, (doi: 10.1111/jir.13120) (PMID:38379511) (Early Online Publication)

Abstract

Background: Lifestyle modification interventions for adults with intellectual disabilities have had, to date, mixed effectiveness. This study aimed to understand how lifestyle modification interventions for adults with intellectual disabilities work, for whom they work and in what circumstances. Methods: A realist evidence synthesis was conducted that incorporated input from adults with intellectual disabilities and expert researchers. Following the development of an initial programme theory based on key literature and input from people with lived experience and academics working in this field, five major databases (MEDLINE, EMBASE, CINAHL, PsycINFO and ASSIA) and clinical trial repositories were systematically searched. Data from 79 studies were synthesised to develop context, mechanism and outcome configurations (CMOCs). Results: The contexts and mechanisms identified related to the ability of adults with intellectual disabilities to actively take part in the intervention, which in turn contributes to what works, for whom and in what circumstances. The included CMOCs related to support involvement, negotiating the balance between autonomy and behaviour change, fostering social connectedness and fun, accessibility and suitability of intervention strategies and delivery and broader behavioural pathways to lifestyle change. It is also essential to work with people with lived experiences when developing and evaluating interventions. Conclusions: Future lifestyle interventions research should be participatory in nature, and accessible data collection methods should also be explored as a way of including people with severe and profound intellectual disabilities in research. More emphasis should be given to the broader benefits of lifestyle change, such as opportunities for social interaction and connectedness.

• Item Type: Articles
• Additional Information: We would like to thank the NIHR for funding this study, and express our gratitude to Dr Leanne Harris who conceptualised the idea for this wider research project that received the successful NIHR grant funding and kindly offered to proofread the final draft.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wu, Professor Olivia and Rana, Miss Dikshyanta and Germeni, Dr Evi and Jaiswal, Dr Nishant and Westrop, Miss Sophie and Melville, Professor Craig and Mcgarty, Dr Arlene
• Authors: Westrop, S. C., Rana, D., Jaiswal, N., Wu, O., Mcgarty, A. M., Melville, C., Ells, L., Lally, P., McEwan, M., and Germeni, E.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Journal of Intellectual Disability Research
• Publisher: Wiley
• ISSN: 0964-2633
• ISSN (Online): 1365-2788
• Published Online: 21 February 2024
• Copyright Holders: Copyright © 2024 The Authors
• First Published: First published in Journal of Intellectual Disability Research 2024
• Publisher Policy: Reproduced under a Creative Commons license