Comprehensive health assessments during de-institutionalization: an observational study.
A single structured health day caught obesity, vision, skin, mood, and shot gaps in 25 adults leaving institutional care.
01Research in Context
What this study did
Ricciardi et al. (2006) ran a one-time health check called CHAP on 25 adults with intellectual disability. All were leaving a large institution and moving into community homes.
The review took a full day. A nurse and doctor looked at weight, eyes, skin, shots, mood, and more. They wrote a report for each person and sent copies to new family doctors.
What they found
The team spotted many hidden problems. The biggest were obesity, poor vision, skin issues, low mood, and missing shots.
These findings led to 22 referrals to specialists. Each adult left with a clear care plan.
How this fits with other research
Durbin et al. (2016) later moved the same CHAP idea into regular doctor offices. They showed you must tweak the steps to fit each clinic’s style, staff, and rules.
Mount et al. (2011) looked at 16 European countries. They found adults with ID still carry high rates of obesity and missed shots, no matter where they live. The CHAP catch matches their big-picture data.
Rimmer et al. (1995) saw a twist: adults still in institutions had better weight and blood fats than those in group homes. CHAP’s high obesity count seems opposite, but the 1995 group was younger and the CHAP group was leaving care after years inside. Setting and history explain the gap.
Why it matters
If you support adults moving out of any large facility, book a CHAP-style health day before the move. One nurse, one doctor, one checklist can catch vision, weight, skin, mood, and shot gaps that otherwise slip for years. Use the report to brief new caregivers and primary-care doctors so the first community visit targets real needs, not guesswork.
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02At a glance
03Original abstract
BACKGROUND: People with intellectual disability (ID) leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They enter into community care under general practitioners (GPs) who are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both them and their new GPs as they go through that phase. METHODS: This research aimed to investigate the effectiveness of a specially designed health review, the comprehensive health assessment program (CHAP) health review, in a group of adults as they transitioned out of the care of the last institution for people with ID in Tasmania. There were 25 residents reviewed by their GPs. RESULTS: The CHAP reviews picked up a number of health conditions and stimulated health promotion activities. Some of the findings were: a high number of abnormal Body Mass Indexes (19/23), immunizations given (13/23), vision impairment reported (2/23), mental health issues recorded (4/23) and skin abnormalities described (17/23). There were 22 referrals made to other health professionals (Australian Hearing Service 4, dentists 3, optometrists 3, psychiatrists 2, neurologists 2, ophthalmologist 1, urologist 1, ultrasound 1, mammogram 1, family planning 1, physiotherapist 1, continence nurse 1 and respiratory physician 1). These were in addition to various requests for pathology. CONCLUSIONS: The CHAP health review was effective in identifying a number of health issues in the population of people with ID as they transitioned out of institutional care into the general community.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00835.x