Hanze University of Applied Sciences Groningen, Groningen, The Netherlands; Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Hanze University of Applied Sciences Groningen, Groningen, The Netherlands; Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
J Am Med Dir Assoc. 2017 Nov 1;18(11):980-987.e3. doi: 10.1016/j.jamda.2017.06.009. Epub 2017 Jul 27.
Health care organizations supporting individuals with intellectual disabilities (IDs) carry out a range of interventions to support and improve a healthy lifestyle. However, it is difficult to implement an active and healthy lifestyle into daily support. The presence of numerous intervention components, multiple levels of influence, and the explicit use of theory are factors that are considered to be essential for implementation in practice. A comprehensive written lifestyle policy provides for sustainability of a lifestyle approach. It is unknown to what extent these crucial factors for successful implementation are taken into consideration by health care organizations supporting this population.
To analyze the intervention components, levels of influence, explicit use of theory, and conditions for sustainability of currently used lifestyle interventions within lifestyle approaches aiming at physical activity and nutrition in health care organizations supporting people with ID.
In this descriptive multiple case study of 9 health care organizations, qualitative data of the lifestyle approaches with accompanying interventions and their components were compiled with a newly developed online inventory form.
From 9 health care organizations, 59 interventions were included, of which 31% aimed to improve physical activity, 10% nutrition, and 59% a combination of both. Most (49%) interventions aimed at the educational component and less at daily (19%) and generic activities (16%) and the evaluation component (16%). Most interventions targeted individuals with ID and the professionals whereas social levels were underrepresented. Although 52% of the interventions were structurally embedded, only 10 of the 59 interventions were theory-driven.
Health care organizations could improve their lifestyle approaches by using an explicit theoretical basis by expanding the current focus of the interventions that primarily concentrate on their clients and professionals toward also targeting the social and external environment as well as the introduction of a written lifestyle policy. This policy should encompass all interventions and should be the responsibility of those in the organization working with individuals with ID. In conclusion, comprehensive, integrated, and theory-driven approaches at multiple levels should be promoted.
为支持智障人士（ID）而设立的医疗保健组织实施了一系列干预措施，以支持和改善健康的生活方式。然而，将积极健康的生活方式融入日常支持中是很困难的。众多干预措施组成部分、多层次的影响以及明确使用理论被认为是实践中实施的关键因素。全面的书面生活方式政策为生活方式方法的可持续性提供了保障。目前尚不清楚支持这一人群的医疗保健组织在多大程度上考虑了这些成功实施的关键因素。
分析目前用于支持智障人士的生活方式方法中，旨在提高身体活动和营养水平的生活方式干预措施的干预措施组成部分、影响层次、明确使用理论以及可持续性条件。
在这项针对 9 家医疗保健组织的描述性多案例研究中，使用新开发的在线清单表格，对生活方式方法及其伴随的干预措施和组成部分的定性数据进行了汇编。
从 9 家医疗保健组织中，共纳入了 59 项干预措施，其中 31%旨在提高身体活动水平，10%旨在改善营养，59%则旨在同时提高身体活动和营养水平。大多数（49%）干预措施针对教育组成部分，而针对日常活动（19%）和通用活动（16%）以及评估组成部分（16%）的干预措施较少。大多数干预措施的目标人群是 ID 患者和专业人员，而社会层面则代表性不足。尽管 52%的干预措施在结构上得到了嵌入，但只有 10 项干预措施是基于理论的。
医疗保健组织可以通过扩展当前主要集中在客户和专业人员的干预措施的重点，将其目标也指向社会和外部环境，并引入书面生活方式政策，从而改善其生活方式方法。该政策应涵盖所有干预措施，并应由负责与 ID 患者合作的组织成员承担。总之，应在多个层面上推广全面、综合和基于理论的方法。
