Geraline L. Leusink

People with intellectual disabilities (ID) have unhealthier lifestyles than the general population. To sustainably improve their lifestyle and health status, a whole-system approach to creating healthy environments is crucial. To gain insight into how support for physical activity and healthy nutrition can be embedded in a setting, asset mapping can be helpful. Asset mapping involves creating a bottom–up overview of promoting and protective factors for health. However, there is no asset mapping tool available for ID support settings. This study aims to develop an asset mapping tool in collaboration with people with ID to gain insight into assets for healthy nutrition and physical activity in such settings. The tool is based on previous research and development continued in an iterative and inclusive process in order to create a clear, comprehensive, and usable tool. Expert interviews (n = 7), interviews with end-users (n = 7), and pilot testing (n = 16) were conducted to refine the tool. Pilot participants perceived the tool as helpful in pinpointing perceived assets and in prompting ideas on how to create inclusive environments with support for physical activity and healthy nutrition. This overview of assets can be helpful for mobilizing assets and building the health-promoting capacities of ID support settings.

To compare use of the GP cooperative and the level of urgency among people with intellectual disabilities (ID) who live in sheltered accommodation with that of the general population. Cross-sectional study. We investigated all healthcare-contact moments in 2014 among 432,582 people living in the servicearea covered by two GP cooperatives in one region of the Netherlands (Boxmeer, Nijmegen). In this region a total of 1,448 people with ID living in sheltered accommodation were identified on the basis of address details. We compared the type and frequency of contact and level of urgency between this group of people and the general population. Among people with ID living in sheltered accommodation, 30.9% (448/1,448) requested care from the GP cooperatives, compared with 18.4% (79,206/431,134) of the general population (relative risk [RR]: 1.7; 95% confidence interval [CI]: 1.6-1.8). The type and frequency of contact and level of urgency also differed between the two groups. Healthcare-contact moments among people with ID were more often conducted by telephone (RR: 2.7; 95% CI: 2.7-3.0) and were generally less urgent than in the general population. People with ID who live in sheltered accommodation make more use of the GP cooperative and more often have low-urgent telephone contacts in comparison with the general population. More insight is needed into the nature of healthcare-contact moments in order to improve the quality and accessibility of care from GP cooperatives for this vulnerable group.

The lack of suitable and reliable scales to measure self-reported health and health behaviour among people with intellectual disabilities (ID) is an important methodological challenge in health research. This study, which was undertaken together with co-researchers with ID, explores possibilities for self-reported health scales by adjusting, testing, and reflecting on three self-reported health scales. In an inclusive process, the researchers and co-researchers with ID adjusted the SBQ (sedentary behaviour), SQUASH (physical activity), and SRH (self-reported health) scales, after which a test-retest study among adults with ID was performed. Test outcomes were analysed on suitability and test-retest reliability, and discussed with the co-researchers with ID to reflect on outcomes and to make further recommendations. Main adjustments made to the scales included: use easy words, short sentences, and easy answer formats. Suitability (N = 40) and test-retest reliability (N = 15) was higher for the adjusted SQUASH (SQUASH-ID), in which less precise time-based judgements are sought, than in the adjusted SBQ (SBQ-ID). Suitability and test-retest reliability were fair to moderate for the SRH-ID and CHS-ID. The main outcome from the reflection was the recommendation to use SQUASH-ID answer options, in which less precise time-based judgements were sought, in the SBQ-ID as well. This study served as a pilot of an inclusive process in which people with ID collaborated in adjusting, testing, and reflecting on self-reported health scales. Although the adjusted self-reported measurements may be reliable and suitable to the target group, the adjustments needed may impair measurement precision. This study’s results contribute to informed decision making on the adaptation and use of self-reported health scales for people with ID.