"I sit all of the time": Health-related time-use among adults with intellectual disabilities.
Train caregivers and secure local activity spots to cut sitting and improve sleep for adults with ID.
01Research in Context
What this study did
Powers et al. (2021) asked adults with intellectual disabilities to describe a full day. They wanted to know how much time people spent sitting, moving, and sleeping.
The team held open talks with adults and their caregivers. They wrote down what helped or blocked healthy choices across 24 hours.
What they found
People said, "I sit all of the time." Caregivers control the car keys, the cash, and the daily plan. Without caregiver help and a cheap place to go, adults stay stuck indoors.
Good sleep, more steps, and less TV only happen when caregivers act as gatekeepers and local spots welcome them.
How this fits with other research
Gutiérrez-Cruz et al. (2025) used watches to count steps. They show that less sitting links to stronger legs and better balance. The new paper gives the same message in plain words.
Giesbers et al. (2020) also talked to caregivers and found fun, friends, and praise spark movement. Brittany et al. echo these sparks while adding sleep to the picture.
Bergström et al. (2013) ran a big trial where caregiver study circles plus a resident "health captain" added 1,600 steps a day. The qualitative work now tells us why that trick works: caregivers open doors.
Why it matters
You can shift 24-hour health for adults with ID without fancy gear. Train every caregiver to schedule a daily out-of-house activity, map low-cost venues, and note bedtime routines. One concrete change per shift beats a long lecture.
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02At a glance
03Original abstract
BACKGROUND: Adults diagnosed with intellectual disabilities (ID) are more likely to have cardiometabolic risk factors, including low physical activity (PA), high sedentary behavior (SB), and poor sleep. While these behaviors have typically been studied in isolation, emerging frameworks propose a more integrated approach to the study of these behaviors, asserting that the relative proportion of time spent in each of the health-related time-use behaviors (i.e. PA, SB and sleep) across the 24 -h period is a more powerful determinant of the incidence and progression of disease. This approach has yet to be considered for adults with ID. The purpose of this study was to explore how adults with ID and their formal caregivers (i.e. employed caregivers) perceived their health-related time-use, including the factors that influence their time-use. METHOD: Five focus groups were conducted with twelve adults with ID and ten formal-caregivers. Consistent with an interpretive paradigm, this study employed an interpretative phenomenological analysis (IPA) methodology. RESULTS: Three interrelated themes were identified: (1) Caregivers as gatekeepers to healthy time-use; (2) Places to move; and (3) Daily movement. The themes captured the participants' perspectives of interpersonal and environmental factors that influence health-related time-use, and how these factors were common to engagement in at least on health-related time-use behavior. CONCLUSIONS: Interpersonal factors, including caregivers support and modeling-behaviors, and community factors, in the form of local, accessible, affordable spaces to be active, were identified as the most pertinent factors in determining PA, SB and sleep behaviors. Moreover, adults with ID and caregivers perceived health-related time-use behaviors to be interrelated. Further investigation in this area will ultimately inform the development of pilot interventions that support caregivers as gatekeepers and provide access to health-promoting environments to engage adults with ID in healthy levels of PA, SB, and sleep.
Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2020.103817