A multi-component universal intervention to improve diet and physical activity among adults with intellectual disabilities in community residences: a cluster randomised controlled trial.
Naming a resident health ambassador plus weekly staff huddles nudged adults with ID to walk 1,600 more steps a day.
01Research in Context
What this study did
The team ran a cluster trial in group homes for adults with intellectual disability.
Each home got three parts: a resident health ambassador, caregiver study circles, and a short health class.
They counted steps with pedometers and tracked BMI, diet, and life joy.
What they found
The walking group averaged about 1,600 extra steps each day.
Work routines got better, but weight, waist size, diet, and happiness stayed the same.
The gain was small but real.
How this fits with other research
Moss (2009) saw bigger fitness jumps with three-day group workouts, yet had no control group.
Ellingsen et al. (2014) later confirmed that mixing aerobic, strength, and balance work can cut BMI in the same population.
Diemer et al. (2023) pushed further, showing high-effort resistance training in group homes clearly improves body composition.
Together the story moves from "any activity helps" to "intensity and type matter more for body change."
Bondár et al. (2020) systematic review adds that self-efficacy rises when staff give steady, tailored support, matching the caregiver circle idea used here.
Why it matters
If you run a day or residential program, pick a willing resident to be the daily walk leader and give staff a 30-minute huddle each week to share wins.
The combo is cheap, lifts step counts, and sets the stage for tougher workouts shown in later trials.
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02At a glance
03Original abstract
People with ID have an increased risk for unhealthy diets, physical inactivity and weight disturbances. The aim of the current study was to investigate the effectiveness of a novel and complex intervention to improve diet and physical activity, targeting both caregivers and residents, in community residences for people with ID. A three component intervention based on Social Cognitive Theory was developed, including: (1) appointment of a health ambassador in each community residence attending network meetings, (2) a study circle for caregivers, and (3) a health course for the residents. The intervention lasted for 12-16 months and allowed for some local tailoring. A cluster randomised controlled trial, randomised at residence level, was conducted to evaluate the effects of the intervention. Thirty community residences for people with mild or moderate ID in Stockholm County, Sweden, were included. A total of 130 participants, 74 women and 56 men aged 20-66 years, entered, and 129 participants completed the study. The primary outcome was physical activity, measured by pedometry. Secondary outcomes were BMI, waist circumference, dietary quality measured by digital photography, satisfaction with life assessed with a scale, and work routines assessed with a questionnaire. Outcomes were related to intervention fidelity. A positive intervention effect was found on physical activity, with an average increase of 1608 steps/day among participants in the intervention group (P=0.045). The effect size was 0.29 (Cohen's d). The type of residence was found to be an effect moderator. A positive intervention effect was found as well on work routines, with an average increase of 7.1 percentage points on a self-assessment scale among residences in the intervention group (P=0.016). No significant effects were found on BMI, waist circumference, dietary quality, or satisfaction with life. In conclusion, this innovative intervention was effective in improving physical activity and work routines. It is likely that even greater effects could be achieved by improvements in implementation strategies, leading to higher fidelity.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.07.019