Implementing Health Promotion for People With Disabilities: Process Evaluation of a Pilot HealthMatters Program©

Abstract:

Regular physical activity together with healthy eating habits result in health benefits that include reducing the risks for chronic medical conditions such as cardiovascular diseases and type 2 diabetes (U.S._Department_of_Health_and_Human_Services, 2008). Currently, 40% of adults with a disability are inactive compared to only 19% without a disability in one state’s survey (Sparling et al., 2015). Nationwide, adults with disabilities experience higher health risks and health care utilization indicating the need for better health promotion training for health care providers (Havercamp & Scott, 2015). To address this disparity, a pilot HealthMatters™ Program (Pilot), an evidence-based health promotion program developed specifically for adults with Intellectual and/or Developmental Disabilities (IDD) (Marks, Sisirak, & Chang, 2013), was implemented. To better define best implementation practices the implementation process was retrospectively studied with the following PICOT question: for participating adults with IDD (Population) attending a community day program, how did the implementation of HealthMatters™ Pilot intervention (I) compare (C) to HealthMatters™ Program design with respect to process-oriented outcome (O) measures for this 12-week (T) Pilot? The training of the staff trainers, the curriculum attendance of the 10 participants with IDD, the primary care providers (PCP) responses to Pilot participation notifications, the participants’ weight/BMI and blood pressures prior to and at the conclusion of the 12 week curriculum were analyzed. Pilot costs and survey tools were applied after completion of the Curriculum. Process-oriented measures focused on participation (reach), fidelity (concordance of the Pilot’s implementation compared with the HealthMatters™ Program), context (environment) and the costs of the implementation process (Bodde, Seo, Frey, Lohrmann, & Van Puymbroeck, 2012). Ten (10) participants, and their PCPs, participated in the HealthMatters™ Pilot with 80% and 100% participation rates, respectively. The Pilot’s process strengths included high participation and survey satisfaction with Curriculum and training, relatively low participant and sponsor costs (~ $300/participant). Weaknesses included limited opportunities for caregiver participation and challenges with scheduling staff time leading to inconsistent curriculum fidelity. Opportunities identified included the following: high potential to partner with PCPs and for organizational growth to sustain health promotion goals beyond the 12 week program; favorable cost-value projections for a future statewide implementation of HealthMatters™ Programs for eligible adults with IDD. Pilot Health Promotion programs for individuals with IDD are well suited for process evaluations and the development of curricula for best nursing practices to promote health in adults with disabilities.