Perspectives of Direct Support Professionals (DSPs) on Barriers and Facilitators to Physical Activity and Healthy Eating Among People with Intellectual Disabilities (PWID)

Research suggests that PWID demonstrate low levels of physical activity, unhealthy eating practices, and high levels of overweight/obesity. Health promotion interventions can reduce morbidity and mortality and increase quality of life for PWID. The potential role of DSPs in health promotion interventions for PWID has been understudied. The present study explored DSP perspectives on barriers, facilitators, and change strategies relevant to physical activity and healthy eating. Twenty DSPs from the Greater New Orleans area participated in three 2-hour focus groups. DSPs identified lack of motivation as the major barrier to physical activity among PWID; social companionship and encouragement/praise from others were perceived as key facilitators. Preference for unhealthy foods, frequent fast food dining, and difficulty controlling overeating were seen as major barriers to healthy eating among PWID; facilitators included encouragement for healthy choices and a supportive social network. DSPs endorsed similar facilitators for their own behavior change (i.e., encouragement and a network of like-minded others), but tended to frame their barriers externally (e.g., culture/food traditions, competing time demands). DSPs reported promoting healthy behaviors among PWID by serving as role models, setting up buddy systems, and providing encouragement and reminders for healthy choices. DSPs emphasized social support strategies as powerful, universal facilitators for health behavior change. DSPs were interested in future participatory health promotion research efforts for themselves and the people they support. Inclusion of DSPs in health promotion interventions for PWID holds promise for the adoption and maintenance of physical activity and healthy eating behaviors in both groups.