259984 Adaptation of Smarter Lunchroom Design to the specific needs of children with intellectual and developmental disabilities: Formative research and community collaboration

Tuesday, October 30, 2012

Kristie Hubbard, MS, MPH, RD , Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
Linda Bandini, RD, PhD , EK Shriver Center, UMass Medical School, Waltham, MA
Aviva Must, PhD , Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
The occurrence of secondary conditions such as obesity in children with intellectual/developmental disabilities (IDD) may undermine their ability to live independently, limit future opportunities for employment, and contribute to health disparities experienced as adults. Schools offer important opportunities for the prevention of obesity and other chronic diseases, and the school food environment offers a promising venue for focused efforts to improve child dietary intake. The field of behavior economics and principles of behavioral science guide recent efforts to “steer students to better choices by making low or no-cost changes to the cafeteria environment” – called the Smarter Lunchroom Initiative. Simple techniques including changing prompts by foodservice workers, slicing and peeling fruit to improve accessibility, and offering structured choices positively influence food choice and consumption in school-based interventions with typically developing children. No published research has addressed the extent to which these approaches can be adapted for children with IDD.

We sought to adapt Smarter Lunchroom Design for the specific needs of children with IDD enrolled in a residential school. Recommendations for adaptation strategies solicited through focus groups and key informant interviews with school staff included: communicating with social stories and food photographs, reducing auditory and visual distractions in the eating environment, and taste-testing activities. The Project Advisory Board, comprised of school program directors, parents, community members, and researchers functioning as the expert panel, refined and approved the final adaptation strategies. Engaging the school staff through focus groups and on the expert panel has “prepared the field” for the planned intervention.

Learning Areas:
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. List the principles of Smarter Lunchroom Design. 2. Describe the potential advantages of environmental approaches to health promotion among children with intellectual and developmental disabilities. 3. Identify opportunities for adaptation and inclusion using evidenced based health promotion strategies so youth with disabilities can benefit to the same extent as typically developing peers. 4. Explain how community collaboration can be used to develop adaptation strategies for health promotion for youth with disabilities. 5. Describe specific considerations for developing adaptations.

Keywords: Health Promotion, Disability

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator on the project
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.