The aim of this research is to address this health inequality so that this group can gain the health benefits associated
Title of Project: Walk fit: Feasibility of a walking intervention for adolescents with intellectual disability to promote physical activity. Supervisors: Dr Laurence Taggart and Prof Marie Murphy Contact Details:
[email protected] Level: PhD Background to the project: People with intellectual disability (ID) have poor health and are more likely to be obese, inactive and sedentary. The aim of this research is to address this health inequality so that this group can gain the health benefits associated with regular physical activity (PA). Walking is a suitable form of PA to elicit health benefit. NICE (2012) reported that having people to walk with is an important factor in sustaining PA. There is moderate evidence that non-ID school-based walking interventions that incorporate pedometers may be effective in increasing PA. Physical Activity Consultations (PAC) has been shown to be an effective method of increasing walking in non-ID adolescents and adults. A systematic review by Heath et al (2012) concluded there is strong evidence that pedometer interventions can also increase PA. In adolescence general social support (incl. family) is another key determinant in increasing PA. Baker et al (2008) found that a pedometer-based, PAC, community-based walking intervention (Walking for WellBeing in the West) was effective in increasing PA levels, improving mood and quality of life in adults, and that these effects were sustained at 12-months. However, no research has been conducted on the feasibility of promoting walking with young people with ID. Some work is currently being conducted by the two PhD supervisors, who are testing a walking intervention in children and adolescents with ID using pedometers and peer buddies: this project builds upon this work. Melville et al. (2015) highlights problems that we intend to address: 1) the lack of capacity of the carers to support the person with ID to walk 2) self-monitoring were too complex for the adults with ID and 3) too few PAC and these did not reflect upon the progress to increase steps. The purpose of this study is to use the evidence of the components of successful walking interventions for increasing steps for both populations, and adapt a walking intervention that will be parent/carer supported, pedometer-based, using PAC to promote PA for adolescents with ID. Aim: To adapt and test the feasibility of a walking intervention to promote increases in objectively measured physical activity PA in adolescents with ID. Objectives: In order to achieve this aim there will be 5 objectives: 1) To explore the barriers and enablers to promoting walking with young people with ID and their parents/carers 2) To adapt an existing community-based, pedometer-based walking intervention for adolescents with ID who will be supported to walk by their parent/carers 3) To adapt how adolescents with ID and their parent/carers use the pedometers and step diaries (goal setting, self-monitoring, feedback) 4) To develop a one day physical activity consultation (PAC) training for delivery by teachers in schools which will be delivered to the adolescents with ID and their parent/carers
5) To assess the feasibility of delivering the walking intervention in order to inform the design of a definitive trial. Design: This will be a 2-arm cluster randomised feasibility trial. Three schools will be randomly assigned to the intervention (n=2) or a non-intervention control group (n=1). In total, 36 adolescents from 3 schools in N Ireland (12 per school) and their parents/carers will be recruited: 24 adolescents will be recruited into the intervention group and 12 into the control group. Phases: This is a mixed methods study involving 3 phases: 1) we will explore the barriers/enablers of walking for adolescents with ID and their parent/carers; 2) we will adapt the walking intervention for parent/adolescent dyads, adapt the use of the pedometers and develop the 1 day PAC training programme so it can be delivered by teachers to the dyads in school; & 3) we will conduct a cluster randomised feasibility trial to assess the feasibility of delivering the intervention in the context of a trial. Skills Required of Applicant: The successful applicant should be from a health or relevant social science background and be familiar with, or have an interest in, research on intellectual disability. Knowledge of physical activity / sports would be advantagous, as is the ability to demonstrate use of semistructured interviews, ideally with experience of conducting interviews within this sensitive topic area. Interest in in undertaking a pilot feasibility trial will also be helpful. The ability to communicate findings clearly and effectively through oral and written means is also a desirable quality for those interested in this opportunity. REFERENCES: Department of Health. Annual Report of the Chief Medical Officer 2012: Our Children Deserve Better: Prevention Pays. Dept of Health: London. Downs SJ, Knowles ZR, Fairclough SJ, Heffernan N, Whitehead S, Halliwell S, Boddy LM. Exploring teachers’ perceptions on physical activity engagement for children and young people with intellectual disabilities. European Journal of Special Needs Education. 2014.29(3), 402-414. doi:10.1080/08856257.2014.906979. Fitzsimons CF, Baker G, Gray SR, Nimmo MA, Mutrie N; Scottish Physical Activity Research Collaboration (SPARColl). Does physical activity counselling enhance the effects of a pedometer-based intervention over the long-term: 12-month findings from the Walking for Wellbeing in the west study. BMC Public Health. 2012 Mar 19;12:206. doi: 10.1186/14712458-12-206. Mitchell F, Melville C, Stalker K, Matthews L, McConnachie A, Murray H, Walker A, Mutrie N. Walk well: a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol. BMC Public Health 2013, 13:620 doi:10.1186/1471-2458-13-620. Medical Research Guidelines. Developing and evaluating complex interventions: new guidance. MRC: London. Accessed 12th Feb 2016: http://www.mrc.ac.uk/documents/pdf/complex-interventions-guidance/ National Institute of Clinical Health and Care Excellence. Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1389.
