Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity

walk well cluster-randomised controlled trial

Craig A. Melville, Fiona Mitchell, Kirsten Stalker, Lynsay Matthews, Alex McConnachie, Heather M. Murray, Chris Melling, Nanette Mutrie

Research output: Contribution to journalArticle

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Abstract

Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities. We used a cluster randomised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations. Assessments were carried out blind to allocation. Clusters of participants were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for participants and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. One hundred two participants in 50 clusters were randomised. 82 (80.4 %) participants completed the primary outcome. 66.7 % of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, participants walked 4780 (standard deviation 2432) steps per day, spent 65.5 % (standard deviation 10.9) of time sedentary and 59 % percent had a body mass in the obesity range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95 % confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6 % (95 % CI −2.984 to 6.102), percentage time in MVPA 0.3 % (95 % CI −0.7 to 1.3), BMI −0.2 kg/m 2 (95 % CI −0.8 to 0.4) or subjective well-being 0.3 (95 % CI −0.9 to 1.5). This is the first published trial of a walking program for adults with intellectual disabilities. Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities. Since participants spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach.
Original languageEnglish
Article number125
Number of pages11
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Volume12
DOIs
Publication statusPublished - 29 Sep 2015

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Intellectual Disability
Walking
Randomized Controlled Trials
Exercise
Confidence Intervals
Body Mass Index
Waiting Lists
Health Behavior
Health
Vulnerable Populations
Caregivers
Referral and Consultation
Obesity
Organizations
Control Groups

Keywords

  • walking program
  • physical activity
  • sedentary behavior

Cite this

@article{68d6789d3b694d66bcb623e5829a0429,
title = "Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial",
abstract = "Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities. We used a cluster randomised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations. Assessments were carried out blind to allocation. Clusters of participants were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for participants and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. One hundred two participants in 50 clusters were randomised. 82 (80.4 {\%}) participants completed the primary outcome. 66.7 {\%} of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, participants walked 4780 (standard deviation 2432) steps per day, spent 65.5 {\%} (standard deviation 10.9) of time sedentary and 59 {\%} percent had a body mass in the obesity range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95 {\%} confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6 {\%} (95 {\%} CI −2.984 to 6.102), percentage time in MVPA 0.3 {\%} (95 {\%} CI −0.7 to 1.3), BMI −0.2 kg/m 2 (95 {\%} CI −0.8 to 0.4) or subjective well-being 0.3 (95 {\%} CI −0.9 to 1.5). This is the first published trial of a walking program for adults with intellectual disabilities. Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities. Since participants spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach.",
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Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity : walk well cluster-randomised controlled trial. / Melville, Craig A.; Mitchell, Fiona; Stalker, Kirsten; Matthews, Lynsay; McConnachie, Alex; Murray, Heather M.; Melling, Chris ; Mutrie, Nanette.

In: International Journal of Behavioral Nutrition and Physical Activity, Vol. 12, 125, 29.09.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity

T2 - walk well cluster-randomised controlled trial

AU - Melville, Craig A.

AU - Mitchell, Fiona

AU - Stalker, Kirsten

AU - Matthews, Lynsay

AU - McConnachie, Alex

AU - Murray, Heather M.

AU - Melling, Chris

AU - Mutrie, Nanette

PY - 2015/9/29

Y1 - 2015/9/29

N2 - Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities. We used a cluster randomised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations. Assessments were carried out blind to allocation. Clusters of participants were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for participants and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. One hundred two participants in 50 clusters were randomised. 82 (80.4 %) participants completed the primary outcome. 66.7 % of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, participants walked 4780 (standard deviation 2432) steps per day, spent 65.5 % (standard deviation 10.9) of time sedentary and 59 % percent had a body mass in the obesity range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95 % confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6 % (95 % CI −2.984 to 6.102), percentage time in MVPA 0.3 % (95 % CI −0.7 to 1.3), BMI −0.2 kg/m 2 (95 % CI −0.8 to 0.4) or subjective well-being 0.3 (95 % CI −0.9 to 1.5). This is the first published trial of a walking program for adults with intellectual disabilities. Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities. Since participants spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach.

AB - Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups. The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities. We used a cluster randomised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations. Assessments were carried out blind to allocation. Clusters of participants were randomly allocated to the Walk Well program or a 12-week waiting list control. Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques, written resources for participants and carers, and an individualised, structured walking programme. The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks. Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity (MVPA), body mass index (BMI), and subjective well being. One hundred two participants in 50 clusters were randomised. 82 (80.4 %) participants completed the primary outcome. 66.7 % of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation. At baseline, participants walked 4780 (standard deviation 2432) steps per day, spent 65.5 % (standard deviation 10.9) of time sedentary and 59 % percent had a body mass in the obesity range. After the walking programme, the difference between mean counts of the Walk Well and control group was 69.5 steps per day [95 % confidence interval (CI) -1054 to 1193.3]. There were no significant between group differences in percentage time sedentary 1.6 % (95 % CI −2.984 to 6.102), percentage time in MVPA 0.3 % (95 % CI −0.7 to 1.3), BMI −0.2 kg/m 2 (95 % CI −0.8 to 0.4) or subjective well-being 0.3 (95 % CI −0.9 to 1.5). This is the first published trial of a walking program for adults with intellectual disabilities. Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities. Since participants spent the majority of their time sedentary, home-based programmes to reduce sitting time may be a viable health improvement approach.

KW - walking program

KW - physical activity

KW - sedentary behavior

U2 - 10.1186/s12966-015-0290-5

DO - 10.1186/s12966-015-0290-5

M3 - Article

VL - 12

JO - International Journal of Behavioral Nutrition and Physical Activity

JF - International Journal of Behavioral Nutrition and Physical Activity

SN - 1479-5868

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ER -