aadmd conference presentation final

Special Olympics Florida

Health and Wellness Approaches Centered on Individuals with Intellectual Disabilities

Karlyn G. Emile, MPH, CHESDHSc. Candidate 2016-Nova Southeastern UniversityDirector, South Florida Healthy Community Special Olympics Florida


Objectives

Background

Discussion

Conclusion

Recommendations


Objectives Embrace the following perspectives:

Become well-versed with the health issues and other concerns facing the IDD population

Cultivate the ability to develop, replicate, or implement appropriate evidence-based intervention programs

Collaborate and advocate for more effective wellness/health programs, and access to quality health care

Health Care Providers

Government and Volunteer Agencies

Family Members

Caregivers

Future Health Care Professionals


Background Nearly 200 million people in

the world live with some form of intellectual or developmental disability, and the prevalence is on the rise (World Health Organization [WHO], 2011).

Individuals with IDD experience poorer health than the general population (Centers for Disease Control and Prevention [CDC], 2012).

The disparities include:

Complex health conditions

Obesity

Overflow of health inequalities

Lack of health promotion programs

Various emotional health & relationship findings

Limited access to quality health care (CDC, 2012)


Discussion


Complex Health ConditionsSome of the myriads of health issues in this population include the following:

Epilepsy Behavioral & mental problems Fractures Skin conditions Poor vision, hearing, and oral health Respiratory disorders

There is a greater risk of inadequate attention to these illnesses as well as other potentially life-threatening conditions(Krahn, Hammond, & Turner, 2006).


Obesity Issues Adults with disabilities

are three times (3X) more likely to have heart disease, stroke, diabetes or cancer, than adults without disabilities (CDC, 2014).

Nearly half of all adults with disabilities get no aerobic physical activity, an important health behavior to help avoid those preventable diseases (CDC, 2012).

39.3% of women and 27.8% of

men with IDD are overweight

or obese vs. 25.1% of women

and 25.7% of men in the

general population (Melville et al.,

2008)

Down syndrome is associated

with increased risk of

overweight and obesity (Melville et

al., 2008)


Overflow of Health Disparities

Disability and Health Data System 2012


Genetic factors Social circumstances Environmental conditions Inadequate knowledge of health promotion Inadequate access to medical care and

preventative health screenings(Krahn, Hammond, & Turner, 2006)

The overflow of health disparities between the general population and people with IDD is a result of the following:


Lack of Health Promotion Programs

People with IDD can lead long, healthy, and productive lives; yet they experience lower rates of preventative care and health promotion practices.

For example: Nutrition counseling services Exercise/recreational programs Social and mental health counseling services Health and wellness programs


Emotional Health & Relationship Findings All individuals with IDD valued being in an intimate relationship,

which fulfilled their needs, and contributed to having a positive impact on their mental health and well-being.

Relationships with friends did not meet the needs of physical expression and planning for the future that intimate relationships fulfilled.

They expressed the desire to share their sexuality, find opportunities for relationships, and receive social support

But they felt that their choices are controlled and constrained by others; mainly parents/caregivers (Rushbrooke, Murray, Townsend, 2014).


Limited Access to Quality Health Care

People with IDD have inadequate access to quality health care service, and as a result, they experience lower rates of preventative care practices (Krahn, Hammond, & Turner, 2006).

Also, there is tendency for under-diagnosing the following chronic conditions:

Hypertension

Glaucoma

Diabetes mellitus

Arthritis

(Krahn et al., 2006)


Conclusion Virtually in all health areas, people with IDD face

poorer health outcomes.

They lack access to quality health care and prevention programs.

They tend to engage in risky health behaviors, including smoking and physical inactivity.

The countless number of health and wellness related issues that plague them are on the rise.

There are very few evidenced-based health interventions tailored to this population.


Recommendations


Complex Health Conditions Reduce the occurrence and impact of associated

comorbid, and secondary conditions

Empower caregivers and family members to meet the health needs of persons with IDD

Promote healthy behaviors and tailored public health

interventions for people with IDD

Develop new strategies to properly sample and identify people with IDD across all ages

Include persons with disabilities into mainstream services where possible, and use condition-specific approaches (Krahn & Fox, 2013)


Obesity Early identification of obesity & related diseases during

childhood and adolescence (Rushbrooke, Murray, & Townsend, 2014)

Effective weight management interventions Clinical services such as nutrition counseling Membership into exercise programs & walking clubs Need for future research to focus on reasons for

increased obesity prevalence in IDD population (Melville et al., 2008)


ExampleSpecial Olympics Florida Health & Wellness Programs


10-Week Nutrition and Physical Activity Program Evidence-based Learning Intervention

HEALTHMATTERS AND HEALTH U CURRICULA

Physical activity, health education, hydration, and nutrition counseling

Meal planning utilizing “my plate” food guides

Individualized meal plans for those requiring dietary

modification due to chronic diseases

Free meal preparation demonstrations and recipes

Pre and post anthropometrics measurements to gauge progress

Inclusion of staff, family members to help reinforce the desired behaviors.


Nutrition Class Set-up


Nutrition Class Sessions


Physical Activity Sessions


Trip to Local Farmers Market


November 17, 2014Height 4’9

Weight 170

BMI 36.8

January 16, 2014

Height 4'9Weight 185BMI 40

• FIU Interns advised her parents of her BMI and at-risk status and provided support

• Her parents adhered to the recommendations

• She along with many others have lost up to 20 pounds

• Up-to-date the program has expanded from 90 to 407 recipients in three different counties

Rebecca!


Emotional Health & Relationship

Effective mental health education, interventions, and clinical services,

such as (a) counseling/psychotherapy, (b) social wellness programs,

and (c) networking opportunities.

Caregivers should assist in providing opportunities for social

contact/education about relationships

Services should consider alternative avenues to address the unmet

needs: increasing social networks & social activities

Since each person with IDD has different needs, support should be

provided on an individual basis

Increase exposure to different types

of relationships via education;

increase social networks and

opportunities for friendships (Rushbrooke, Murray, Townsend, 2014)


ExampleSpecial Olympics Florida Social Wellness Program


9-Week Mental Health Promotion ProgramWeek 1- Communication (Pre-Test)

Week 2- Self-Advocacy

Week 3- Emotions

Week 4- Stress Management

Week 5- Manners

Week 6- Social Skills

Week 7- Understanding the Body

Week 8- Relationships

Week 9- Program Summary/Recap, Education about Resources/Services, Referrals (Post-test)

6-Week Follow-Up—Post Intervention


Health Disparity and Lack of Access to Health CareMultiple personal and environmental factors affect health status, therefore a collaborative approach makes a difference.

Collaborate and advocate at all levels:

Individual level- persons with IDD to practice healthy habits and make healthier options

Intrapersonal level- family members/caregivers to reinforce healthier behaviors at home

Community level- create awareness about the IDD population and seek community support

Institutional- partner with local universities for internship opportunities, volunteerism and curriculum development

Governmental policy-advocate for more favorable policy changes toward this population


Advocating Works!

Intrapersonal Level Individual Level


Family & Community Health Forum

Family & community members are engaged via health forums

They come together to learn about issues that affects their children/community members

They learn to advocate themselves for the needs of their loved ones

Forums are hosted at various organizations and public entities

Community Level


Organizational LevelInstitutional Level

Policy Level


We Can do it Together!


ReferencesCenters for Disease Control and Prevention. Disability and Health Data System. (2012). Retrieved from

http://dhds.cdc.gov.

Centers for Disease Control and Prevention, Adults with Disabilities. (2014). Vital Signs. Retrieved from http://www.cdc.gov/vitalsigns/pdf/2014-05-vitalsigns.pdf

Krahn, G. L., & Fox, M. H. (2014). Health disparities of adults with intellectual disabilities: what do we know? What do we do?. Journal of Applied Research in Intellectual Disabilities, 27(5), 431-446.

Krahn, G. L., Hammond, L., & Turner, A. (2006). A cascade of disparities: health and health care access for people with intellectual disabilities. Mental retardation and developmental disabilities research reviews, 12(1), 70-82.

Melville, C. A., Cooper, S. A., Morrison, J., Allan, L., Smiley, E., & Williamson, A. (2008). The prevalence and determinants of obesity in adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 21(5), 425-437.

Rushbrooke, E., Murray, C., & Townsend, S. (2014). The experiences of intimate relationships by people with intellectual disabilities: a qualitative study. Journal of Applied Research in Intellectual Disabilities, 27(6), 531-541.

World Health Organization. (2011). World report on disability. Geneva, Switzerland: Author. Retrieved from http://www.who.int/disabilities/world_report/2011/accessible_en.pdf


Any Questions?For More Information Please Contact:

Karlyn G. Emile, MPH, CHESDirector, South Florida Healthy Community Special Olympics FloridaPhone: (954) 272-6943 (954) 901-9232Email: [email protected]

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