Service Delivery

Caregivers' perception of factors associated with a healthy diet among people with intellectual disability living in community residences: A Concept mapping method.

Ruud et al. (2016) · Research in developmental disabilities 2016
★ The Verdict

Healthy diets in ID homes hinge on stocked fridges, staff know-how, and shift length more than on client willpower.

✓ Read this if BCBAs running residential or day-program services for adults with ID.
✗ Skip if Clinicians who only see clients in clinic or home-based ABA.

01Research in Context

01

What this study did

Ruud et al. (2016) asked caregivers who work in group homes to map what helps or blocks healthy eating for adults with intellectual disability.

They used concept mapping: staff wrote ideas on cards, sorted them into piles, and rated how important each one felt.

The final map shows eight clusters that matter most to frontline staff.

02

What they found

The top clusters were: good food access, caregiver nutrition knowledge, and enough staff time.

Caregivers said cheap junk food is everywhere, fresh food is hard to keep on hand, and rushed shifts push them toward microwave meals.

They also said they need simple training on portions, textures, and special diets.

03

How this fits with other research

Prigge et al. (2013) ran a weight-loss program and heard the same thing: lack of tailored food guides and poor staff talk sank the diet.

Goodwin et al. (2012) counted that one in seven adults with ID already need mealtime support, so the time barrier Pilskog found is real and measurable.

Bravo-Garrido et al. (2023) showed that adding structured cooking workshops cut pica and aggression in one resident, hinting that giving staff time and tools can change both diet and behavior.

04

Why it matters

If you supervise group homes, audit your kitchen first: is fresh food stocked, are staff scheduled long enough to cook, do they know what a balanced plate looks like? One hour of hands-on nutrition training and a locked snack cupboard can shift the whole house toward healthier meals.

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Post a one-page color guide on portions next to the group-home fridge and lock the chip cabinet during shift change.

02At a glance

Intervention
not applicable
Design
qualitative
Sample size
10
Population
intellectual disability
Finding
not reported

03Original abstract

BACKGROUND: Many people with intellectual disabilities (ID) living in community-based residences have been found to have unhealthy diet and weight disturbances. In Norway, a majority of people with ID live in such residences. AIMS: The aim of the study was to examine factors affecting the caregivers' opportunity to promote a healthy diet among the residents. METHODS AND PROCEDURES: A concept mapping methodology was adopted, including group-based brainstorming, idea synthesising, sorting, rating and analysis of the results. Informants were caregivers in four different community residences for people with mild to moderate ID in the southeast of Norway. A total of 13 informants were recruited (12 females and 1 male), and 10 informants completed two sessions. RESULTS: Eight clusters were identified as affecting the caregivers' ability to promote a healthy diet: "Availability and accessibility", "Guidance and autonomy", "Competence among staff", "Planning and involvement", "Customization", "External conditions affecting staff", "Legislation, rules and structure" and "Everyday challenges", each including both barriers and facilitators. CONCLUSIONS AND IMPLICATIONS: Multiple factors affect the caregivers' ability to promote a healthy diet. Caregivers' opportunity to promote a healthy diet is complex. Availability and accessibility of healthy food is crucial, but a healthy diet also requires time and competence among the caregivers.

Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2016.09.006