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Randomized Controlled Trial
. 2018 Apr;11(2):315-323.
doi: 10.1016/j.dhjo.2017.10.008. Epub 2017 Oct 27.

Reducing barriers to healthy weight: Planned and responsive adaptations to a lifestyle intervention to serve people with impaired mobility

Andrea C Betts  1 , Katherine Froehlich-Grobe  2 , Simon Driver  2 , Danielle Carlton  3 , M Kaye Kramer  4
Affiliations
Randomized Controlled Trial

Reducing barriers to healthy weight: Planned and responsive adaptations to a lifestyle intervention to serve people with impaired mobility

Andrea C Betts et al. Disabil Health J. 2018 Apr.

Abstract

Background: People with impaired mobility (IM) disabilities have a higher prevalence of obesity and obesity-related chronic conditions; however, lifestyle interventions that address the unique needs of people with IM are lacking.

Objective: This paper describes an adapted evidence-based lifestyle intervention developed through community-based participatory research (CBPR).

Methods: Individuals with IM, health professionals, disability group representatives, and researchers formed an advisory board to guide the process of thoroughly adapting the Diabetes Prevention Program Group Lifestyle Balance (DPP GLB) intervention after a successful pilot in people with IM. The process involved two phases: 1) planned adaptations to DPP GLB content and delivery, and 2) responsive adaptations to address issues that emerged during intervention delivery.

Results: Planned adaptations included combining in-person sessions with conference calls, providing arm-based activity trackers, and adding content on adaptive cooking, adaptive physical activity, injury prevention, unique health considerations, self-advocacy, and caregiver support. During the intervention, participants encountered numerous barriers, including health and mental health issues, transportation, caregivers, employment, adjusting to disability, and functional limitations. We addressed barriers with responsive adaptations, such as supporting electronic self-monitoring, offering make up sessions, and adding content and activities on goal setting, problem solving, planning, peer support, reflection, and motivation.

Conclusions: Given the lack of evidence on lifestyle change in people with disabilities, it is critical to involve the community in intervention planning and respond to real-time barriers as participants engage in change. A randomized controlled trial (RCT) is underway to examine the usability, feasibility, and preliminary effectiveness of the adapted intervention.

Keywords: Disability; Healthy lifestyle; Impaired mobility; Obesity.

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Figures

Figure 1
Figure 1
Conceptual model for process of adapting the DPP GLB* to the GLB AIM† * Diabetes Prevention Program Group Lifestyle Balance™ † Group Lifestyle Balance Adapted for individuals with Impaired Mobility ‡ Randomized Controlled Trial
Figure 2
Figure 2
Summary of barriers, consequences, and responsive adaptations
See this image and copyright information in PMC

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