Disability Policy Research: Health Promotion

Community-based persons with mental retardation: opportunities for health promotion.

Ridenour N, Norton D. Graduate Nursing Program, Texas Tech University Health Sciences Center School of Nursing, Lubbock 79430, USA. Nurse Pract Forum 1997 Jun;8(2):45-9

The public policy of supporting the mentally retarded in community-based, group home environments provides an exciting opportunity for nurses to develop health promotion and self-care programs to increase the independent living capacity of this population. This article discusses the issues raised and solutions developed by nurse practitioners working with adults with serious medical problems and diminished cognitive capacity.


Improving the oral hygiene of institutionalized mentally retarded clients.

Lange B, Cook C, Dunning D, Froeschle ML, Kent D. Department of Dental Practice Management, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA. J Dent Hyg 2000 Summer;74(3):205-9

Purpose: The quality of oral health care of persons with mental retardation has been reported in the literature to be less than that of their normal peers. The purpose of this study, set in a Midwest institution for persons with developmental retardation, was to determine if a change in policy followed by staff training and monitored by an interested third party would improve the oral hygiene of clients living on wards. p. Methods: Methods used to train staff in proper toothbrushing were developed. Three living units were randomly selected for study: control, training plus accountability (experimental group I), and training without accountability (experimental group II). The direct care staff of both experimental groups were trained in proper toothbrushing techniques. Staff of the control group received no training. A dental hygienist visited the living unit periodically to evaluate and provide feedback on the plaque index scores taken by the caregivers in both experimental groups. p. Results: The plaque indexes of group I showed significant improvement over the control group and group II. p. Conclusion: The results of this pilot study support the other findings of higher plaque indexes for residents with mental retardation and that modifying toothbrushing policies and staff training are not as critical to the improvement of the clients’ oral hygiene as is the presence of an involved, interested third party.


Physical activity among persons with disabilities–a public health perspective.

Heath GW, Fentem PH. Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Exerc Sport Sci Rev 1997;25:195-234

Regular physical activity, sports participation, and active recreation are essential behaviors for the prevention of disease, promotion of health, and maintenance of functional independence. This health behavior is essential for persons with and without disabilities. Population-based surveys have consistently demonstrated that persons with disabilities are less likely to be physically active, compared to persons without such limitations. However, these observations are based on relatively few surveys and are dependent on physical activity assessment methods that may not be sensitive and specific enough for persons with disabilities. Studies clearly demonstrate that many persons, representing a variety of selected disabilities, can adapt to increased levels of physical activity, as evidenced by alterations in various components of physical fitness. More importantly, other studies consistently provide evidence that participation in regular physical activity among persons with selected impairments and disabilities results in improved functional status and quality of life. Further efforts are critically needed in the area of the development of physical activity assessment methodology for persons with disabilities. Methods need to be developed that will provide survey researchers and those in public health the capacity to measure and monitor activity patterns of persons with disabilities. This information is important not only for public health officials but also health policy analysts, service providers, and disability advocacy groups. Further understanding of the role of physical activity in the maintenance of function and independence among persons with disabilities is needed. The understanding of environmental and social barriers to physical activity among persons with disabilities needs further exploration. Finally, physical activity determinants research among persons with disabilities, including the role of assistive technology as well as maximizing the intrinsic capacity of functional anatomy and physiology, needs to be addressed.


Position of the American Dietetic Association: nutrition in comprehensive program planning for persons with developmental disabilities.

J Am Diet Assoc 1997 Feb;97(2):189-93


Primary and secondary barriers to physically active healthy lifestyles for adults with learning disabilities.

Messent PR, Cooke CB, Long J. Department of Human Sciences and Medical Ethics, St Bartholomew’s and the Royal London School of Medicine and Dentistry, UK. Disabil Rehabil 1999 Sep;21(9):409-19

Purpose: Evidence shows that those with a learning disability are typically amongst the most inactive and sedentary members of the population, yet few studies have focused on the determinants of physical activity. The aim of the present study was to establish whether a group of 24 adults with mild and moderate learning disabilities receive adequate support to be able to make choices to lead a physically active lifestyle.|
p. Methods: A descriptive study was used based on interviews with 24 adults with learning disabilities (mean age of 34 years) triangulated by day time and residential care workers. Participants volunteered from two residential homes and one social education centre (SEC) in a city in the North of England.
p. Results: The participants face a set of primary barriers that prevent them from having a choice to adopt the Department of Health’s recommendations for physical activity. Identified barriers included: unclear policy guidelines in residential and day service provision together with resourcing, transport and staffing constraints; participant income and expenditure; and limited options for physically active community leisure.
p. Conclusion: These are barriers that are widely acknowledged and understood by day and residential staff and participants in the study, but are arguably poorly understood by policy makers, health promotion agencies, commissioners and providers of learning disability services. The current lack of resources and inadequately specified responsibilities associated with community care deny many people with learning disabilities real choices to live a physically active healthy lifestyle.