Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, United States.
Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, United States.
Res Dev Disabil. 2021 Jan;108:103817. doi: 10.1016/j.ridd.2020.103817. Epub 2020 Dec 16.
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.
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.
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.
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.
被诊断患有智力障碍 (ID) 的成年人更有可能存在心血管代谢风险因素，包括低体力活动 (PA)、高久坐行为 (SB) 和睡眠不佳。虽然这些行为通常是孤立地进行研究的，但新兴框架提出了一种更综合的方法来研究这些行为，认为在 24 小时内，每个与健康相关的时间使用行为（即 PA、SB 和睡眠）所花费的相对时间比例是疾病发生和进展的更有力决定因素。这种方法尚未被用于研究 ID 成年人。本研究的目的是探讨 ID 成年人及其正式照顾者（即受雇照顾者）如何感知他们的与健康相关的时间使用，包括影响他们时间使用的因素。
对 12 名 ID 成年人和 10 名正式照顾者进行了 5 个焦点小组讨论。本研究遵循解释性范式，采用解释现象学分析 (IPA) 方法。
确定了三个相互关联的主题：(1) 照顾者作为健康时间使用的把关者；(2) 运动的地方；(3) 日常运动。这些主题捕捉了参与者对影响与健康相关的时间使用的人际和环境因素的看法，以及这些因素如何共同参与至少一种与健康相关的时间使用行为。
人际关系因素，包括照顾者的支持和榜样行为，以及社区因素，以活跃的当地、可及且负担得起的空间形式，被确定为决定 PA、SB 和睡眠行为的最相关因素。此外，ID 成年人及其照顾者认为与健康相关的时间使用行为是相互关联的。在这一领域的进一步研究最终将为支持照顾者作为把关者并提供健康促进环境以促进 ID 成年人进行健康水平的 PA、SB 和睡眠的试点干预措施的制定提供信息。
