For people with intellectual disabilities, maintaining health and wellness is essential to being self-sufficient, achieving or maintaining independence, participating in society, and preventing the onset of secondary health conditions. Yet people with intellectual disabilities typically have poorer health than the general population and higher rates of obesity and physical inactivity. Data from the Kentucky National Core Indicators survey found that in Kentucky, over 70% of adults with intellectual disabilities are overweight or obese, and only 19% engage in at least 30 minutes of moderate exercise for at least 3 days a week.
Social relationships play an important role in achieving and sustaining healthy behavior changes, providing encouragement, motivation, and accountability. Knowing this, researchers at the University of Kentucky Human Development Institute (HDI) set out to develop an inclusive health promotion program to help people with intellectual disabilities that also would work for anyone. To do this, they worked with universal design experts to incorporate a partner approach.
An inclusive health promotion program called Health Partners was created by adapting the Healthy Lifestyles for People with Disabilities curriculum out of the Oregon Health and Science University. Health Partners served pairs of people (or “health partners”) that included a person with intellectual disabilities and a person without intellectual disabilities. In order to offer health promotion curriculum that met the needs of everyone, a panel of experts in universal design helped make learning methods and materials appropriate for a wide audience. Additionally, four consultants with intellectual disabilities were paid to assist in curriculum development.
Health Partners programming was implemented statewide beginning in 2016 and was co-taught by people with and without intellectual disabilities. The 12 week curriculum provided participants with education about exercise, nutrition, and social and emotional health to support their progress in having healthy behaviors.
The primary challenge encountered was recruitment of participants willing to commit to the partner model. Many organizations (such as group homes and day programs) were interested in the program, but because of the one-to-one ratio necessary for the partner approach they could not participate due to staffing issues, time commitment, and lack of resources. It was also difficult to get buy-in from caregivers and family members of people with intellectual disabilities to add an additional activity to their already busy schedules.
Health Partners participants enjoyed significant benefits. Both individuals with and without intellectual disabilities reported improving their overall health, as well as increasing knowledge and positive behaviors in the areas of physical, social, and emotional health. Also, participants enjoyed working together to achieve goals. They reported that the social support and encouragement received by working together helped them to sustain health changes longer than if they had attempted it alone. Also, because Health Partners programming was held at community locations (e.g. libraries, community centers), participants learned about new community resources and organizations, and community organizations gained new consumers.
Additionally, based on the universal design adaptations made to create Health Partners, a new edition of the original curriculum (Healthy Lifestyles for People with Disabilities), was published in 2017 and retitled, Healthy Lifestyles: Making Opportunities for Healthy Living. This new edition is no longer targeted at people with disabilities; it now targets ALL people who want to live a healthier life.
Through the Health Partners program, much was learned about effectively designing inclusive health promotion programming. The following strategies helped enhance understanding for ALL participants:
- Creating clear learning objectives
- Providing diverse and accessible instructional methods, such as using videos with captions, physical activities modified for all ability levels, PowerPoints and handouts that contained words and pictures to convey information
- Allowing for active learning opportunities, such as role-playing scenarios
- Including people with ID in curriculum development as a very effective way to ensure the program was accessible for all
Overall, Health Partners was found to be an effective program for ALL people, including people with and without intellectual disabilities. The program can be used for any group of people and is inclusive of all populations.
More information about the Health Partners program and other inclusive health programming can be found on the University of Kentucky Human Development Institute’s Health and Wellness Initiative website at www.wellness4ky.org.