Use of behaviour change techniques in lifestyle change interventions for people with intellectual disabilities: A systematic review.
Most lifestyle programs for adults with ID pile on behavior-change tricks but skip the theory that tells you when to use each one.
01Research in Context
What this study did
Willems et al. (2017) read 45 lifestyle-change papers for adults with intellectual disability. They counted which behavior-change techniques each program used. They also checked if the program followed any theory.
The team used the CALO-RE list to tag each technique. They did not pool numbers or run a meta-analysis.
What they found
Every study used at least one behavior-change technique. Most used many. Few said why they picked them. Quality scores were low. No theory guided most programs.
How this fits with other research
Rana et al. (2024) is the big update. Their 2024 review adds meta-analysis and lived-experience input. It now shows that diet plus exercise plus clear BCTs is the only package that trims weight. Mariël’s 2017 map is still useful, but D et al. gives you effect sizes.
Maïano et al. (2014) looked at youth, not adults. They found activity programs cut weight and BMI. Mariël saw the same BCTs, but in adults and without weight-loss numbers. The two reviews line up: move more, add BCTs, see body changes.
Chiviacowsky et al. (2013) focused only on tobacco and alcohol. They also cried poor quality and begged for theory. Mariël widened the lens to all lifestyle BCTs but echoed the same fix: tie your tricks to a real theory.
Why it matters
Your program probably already uses prompts, rewards, or goal setting. This paper says that is not enough. Pick a theory first — Social Cognitive, Health Action Process, whatever — then choose BCTs that fit. Use Rana et al. (2024) to pick the trio that actually cuts weight: diet plan, aerobic exercise, and explicit BCTs. Drop the rest until you have data.
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02At a glance
03Original abstract
BACKGROUND: People with intellectual disabilities (ID) experience more health problems and have different lifestyle change needs, compared with the general population. AIMS: To improve lifestyle change interventions for people with ID, this review examined how behaviour change techniques (BCTs) were applied in interventions aimed at physical activity, nutrition or physical activity and nutrition, and described their quality. METHODS AND PROCEDURES: After a broad search and detailed selection process, 45 studies were included in the review. For coding BCTs, the CALO-RE taxonomy was used. To assess the quality of the interventions, the Physiotherapy Evidence Database (PEDro) scale was used. Extracted data included general study characteristics and intervention characteristics. OUTCOMES AND RESULTS: All interventions used BCTs, although theory-driven BCTs were rarely used. The most frequently used BCTs were 'provide information on consequences of behaviour in general' and 'plan social support/social change'. Most studies were of low quality and a theoretical framework was often missing. CONCLUSION AND IMPLICATIONS: This review shows that BCTs are frequently applied in lifestyle change interventions. To further improve effectiveness, these lifestyle change interventions could benefit from using a theoretical framework, a detailed intervention description and an appropriate and reliable intervention design which is tailored to people with ID.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2016.10.008