Association for Behavior Analysis International

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35th Annual Convention; Phoenix, AZ; 2009

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Symposium #162
Advances in Dieting and Other Healthy Lifestyle Behaviors for Adults with Developmental Disabilities
Sunday, May 24, 2009
9:00 AM–10:20 AM
North 129 A
Area: DDA/CBM; Domain: Service Delivery
Chair: Charles Steve Holburn (Institute for Basic Research)
Discussant: Joseph E. Spradlin (University of Kansas)
Abstract: Individuals with developmental disabilities (DD) have poorer health than the general population, including greater risks of diabetes, heart disease, elevated blood pressure and cholesterol, depression, and obesity. With respect to the obesity, the rates in individuals with DD have been estimated as high as 45.2% for males and 50.3% for females. Over a decade ago, Pope (1992) noted that individuals with developmental disabilities are often overlooked when it comes to health promotion, and more recently, Frey, Temple, and Stanish (2006) observed inadequacies in the quality and quantity of available health information for such individuals. Nonetheless, a body of literature is emerging that demonstrates how the health of individuals with developmental disabilities can be influenced by their participation in structured health enhancement programs. One approach to health improvement is to identify an individual’s health issue and treat that particular problem. Two presentations in this symposium used this approach in describing successful methods of weight reduction. Another approach to improved health is a general educational approach with follow up support in any number of identified areas. One presentation in this symposium used this approach in developing and implementing a general heath curriculum. The presentations will be discussed in light of the growing interest in health improvement for individuals with developmental disabilities.
 
Health Education for Support Staff and the Health Advocacy Program: A Curriculum for Adults with Developmental Disabilities
CHRISTINE CEA (New York State Insitute for Basic Research), Charles Steve Holburn (Institute for Basic Research)
Abstract: Individuals with intellectual disabilities (ID) have poorer health than the general population, including greater risks of diabetes, heart disease, elevated blood pressure and cholesterol, obesity, and depression. We developed and assessed the Health Advocacy Program (HAP, Holburn, Cea, Gordon, 2005), a twenty-lesson multimedia curriculum to improve the health and well-being of individuals with intellectual disabilities on Staten Island. In piloting the HAP in day-program classrooms throughout New York City, we found that individuals with ID demonstrated increased health knowledge and health advocacy skills, but many were unable to apply this information in their group homes due to factors such as limited access to healthier food choices, insufficient opportunities for exercise, and inadequate modeling by home support staff. We are now (a) implementing the HAP in group homes; (b) teaching home support staff about healthy lifestyle practices and methods to enhance residents’ health advocacy, and (c) facilitating organizational improvements that foster healthier lifestyles. Accordingly, we are now piloting a complementary Supporting Healthy Lifestyles Curriculum for support staff.
 
Clinic-Based Evaluation of the 5-3-2 Diet for Overweight Adults with Developmental Disabilities
RICHARD R. SAUNDERS (University of Kansas), Muriel D. Saunders (University of Kansas), Joseph Donnelly (Weight Management Center), Bryan Smith (Weight Management Center), Debra Sullivan (Weight Management Center), Brianne Guilford (Weight Management Center), Brian Erickson (Weight Management Center), Mary Rondon (Weight Management Center)
Abstract: We recently completed an analysis of the effectiveness of the 5-3-2 diet with adults with DD living in the community. The diet emphasizes 5 servings of fruits and vegetables, 3 protein shakes, and 2 low-calorie entrees daily. Some participants were seen monthly by project staff in a clinic-like setting at a community employment agency. Their food preferences were color coded in the colors of a stoplight, and the participants were prompted to emphasize green (low calorie) over red (high calorie) items when meal planning, shopping, and selecting snacks. Frozen low-calorie entrees (e.g., Smart Ones, Lean Cuisine) were encouraged for portion control. Participants received cash incentives for tracking intake and for recording steps walked, according to a project-provided pedometer. Monthly 24-hour intake recalls were analyzed for total calories and nutritional balance. Participants were supported on the diet for 6 months and then followed on a maintenance protocol for 6 months. We report on the results from 36 individuals who enrolled and attempted to follow the diet. The majority of the participants lost weight, with average weight loss near 3 lbs per month. Issues related to the clinic approach will be contrasted with those from the in-home intervention.
 
Home-Based Evaluation of the 5-3-2 Diet for Overweight Adults with Developmental Disabilities
MURIEL D. SAUNDERS (University of Kansas), Richard R. Saunders (University of Kansas), Joseph Donnelly (Weight Management Center), Bryan Smith (Weight Management Center), Debra Sullivan (Weight Management Center), Brianne Guilford (Weight Management Center), Brian Erickson (Weight Management Center), Mary Rondon (Weight Management Center)
Abstract: Obesity rates in individuals with DD have been estimated as high as 45.2% for males and 50.3% for females. Recently, we completed an analysis of the effectiveness of an approach to weight loss by adults with DD living in the community. In one phase, participants were seen monthly in their residences by project staff. Their food preferences were color coded in the colors of a stoplight, and the participants were prompted to emphasize green (low calorie) over red (high calorie) items when meal planning, shopping, and selecting snacks. Frozen low-calorie entrees were encouraged for portion control. On colorful pictorial tracking forms, participants recorded daily intake. At monthly meetings with project staff, participants received cash for green-food intake, double cash when weight loss was at least 1 BMI, and received cash for steps walked, according to a project-provided pedometer. Participants were supported on the diet for 6-12 months and then followed on a maintenance protocol for 6 months. We report on the results from 46 individuals. The presentation will include data on waist circumference reductions, weight loss, and participant satisfaction survey data. The majority of the participants lost weight, with average weight loss near 3 lbs per month.
 

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