Background: Behaviour change techniques (BCTs) can be employed to support a healthy lifestyle for people with intellectual disabilities. The aim of this study is to determine whether and which BCTs are used by direct support professionals (DSPs) for supporting healthy lifestyle behaviour of people with moderate to profound intellectual disabilities. Method: Direct support professionals (n = 18) were observed in their daily work using audio-visual recordings. To code BCTs, the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy was employed. Results: Direct support professionals used 33 BCTs out of 42. The most used BCTs were as follows: ‘feedback on performance’, ‘instructions on how to perform the behaviour’, ‘doing together’, ‘rewards on successful behaviour’, ‘reward effort towards behaviour’, ‘DSP changes environment’, ‘graded tasks’, ‘prompt practice’ and ‘model/demonstrate behaviour’. Conclusions: Although a variety of BCTs is used by DSPs in their support of people with moderate to profound intellectual disabilities when facilitating healthy lifestyle behaviour, they rely on nine of them.
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People with moderate to profound intellectual disabilities (ID) have a higher risk of health problems and, therefore, healthy living is of great importance for them. To achieve this, this group requires support from the people around them such as relatives and direct support professionals (DSPs). However, DSPs do not feel sufficiently equipped to provide this support. The objective of Annelies Overwijk’s research was to determine how to facilitate a healthy lifestyle for people with moderate to profound ID by improving the lifestyle support provided by DSPs. To this end, DSPs’ support needs were first explored after which a training and education program was developed, implemented, and evaluated. In this thesis, DSPs indicated that they need knowledge and skills to provide lifestyle support. One of the skills they can help use to stimulate people with ID is the use of behavioral change techniques. This thesis shows that, although a number of these techniques are used in daily practice, they are not yet consciously utilized to improve lifestyle support. Since the attitude of DSPs to support healthy nutrition is important, a practical questionnaire was also developed to measure this. Based on DSPs’ support needs for encouraging a healthy lifestyle, a training and education program was developed together with them and experts. This program consists of an e-learning and three in-person sessions that can be adapted to the support needs of the DSPs and the team and proved to be promising in an implementation study. The products are free and available on: www.dekrachtengebundeld.nl.
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Background: There is a lack of theory-based interventions for direct support professionals (DSPs) to support a healthy lifestyle for people with moderate to profound intellectual disabilities (ID) despite their major role in this. This study aims to evaluate the preparation, implementation, and preliminary outcomes of a theory-based training and education program for DSPs to learn how to support these individuals. Methods: The program consisting of e-learning, three in-person sessions, and three assignments was implemented. The implementation process was evaluated with a mixed method design with the following components: preparation phase, implementation phase, and the outcomes. These components were measured with project notes, questionnaires, interviews, reflections, assignments, food diaries, Actigraph/Actiwatch, and an inventory of daily activities. Results: Regarding the preparation phase, enough potential participants met the inclusion criteria and the time to recruit the participants was 9 months. The program was implemented in four (residential) facilities and involved individuals with moderate to profound ID (n = 24) and DSPs (n = 32). The e-learning was completed by 81% of the DSPs, 72–88% attended the in-person sessions, and 34–47% completed the assignments. Overall, the fidelity of the program was good. DSPs would recommend the program, although they were either negative or positive about the time investment. Mutual agreement on expectations were important for the acceptability and suitability of the program. For the outcomes, the goals of the program were achieved, and the attitudes of DSPs towards a healthy lifestyle were improved after 3 months of the program (nutrition: p = < 0.01; physical activity: p = 0.04). A statistically significant improvement was found for food intake of people with ID (p = 0.047); for physical activity, no statistically significant differences were determined. Conclusions: The theory-based program consisting of a training and education section for DSPs to support a healthy lifestyle for people with moderate to profound ID was feasible to implement and, despite some barriers regarding time capacity and mutual expectations, it delivered positive changes in both persons with moderate to profound ID and DSPs. Thus, the program is a promising intervention to support DSPs.
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