Article

Impact Feature Issue on Supporting Wellness for Adults with Intellectual and Developmental Disabilities

Learning Together About Health Promotion:
A Community Partnership in Montana

Author

Andrea Dahl is an Independent Living Specialist with Summit Independent Living Center, Missoula. She may be reached at adahl@summitilc.org or 406/728-1630.

Over the years, many programs have been established that promote improved weight and nutrition for people with disabilities. However, few have been written so that people with intellectual and developmental disabilities (IDD) could fully comprehend what was being taught. Many communities offer programs to prevent diabetes and heart disease through their county health departments, but the materials are written in a way that is not accessible for people who are living with IDD. As a result, very few are participating in the such programs. An important role I have as an employee of Summit Independent Living Center (ILC) in Missoula, Montana, is as a chapter advisor for Missoula Valley People First, a self-advocacy organization for people with IDD.

In the past, some People First members have participated in weight loss programs in their community. They have found it challenging when the program includes written  materials to follow, and some programs promote dietary habits that are not truly healthy or realistic to maintain in the long run.

Wayne and Tiffany (center), are People First members who completed the14 Weeks to a Healthier You class in Missoula, Montana this past summer. It was co-facilitated by Andrea Dahl (right) of Summit ILC, and Connie Lewis (left) of People First.

They need support to learn the vocabulary and develop some basic skills for activities used in programs, such as diet and activity logging. If People First members had a class where they could learn healthier eating habits, they would be able to reach their goals and maintain them afterwards. A new program was needed in our community that teaches the basics of healthy eating habits and exercise in a way that can be easily understood.

The Summit ILC has collaborated with the Rural Institute for Inclusive Communities (RIIC), University of Montana, on several health promotion programs, including: a) a program to develop individualized health portfolios to improve outcomes of medical appointments; b) the Have Healthy Teeth (HHT) program that supported healthy choices in oral hygiene routines; and c) the Women Be Healthy (WBH) program that teaches about women’s health. Participants in the health portfolio program still use their portfolios today, HHT graduates report fewer cavities and gum issues after their dental check-ups, and WBH graduates are scheduling routine women’s health exams. Our latest collaboration is on adopting a health education program focused on nutrition and physical activity for implementation in Montana.

The 14 Weeks to a Healthier You facilitated program is focused on both fitness and nutrition at a comprehendible level. It originally was developed by the National Center on Health, Physical Activity, and Disability (NCHPAD) as an online program . Developers evaluated the online version and saw a need to develop it further for use with people with IDD. They worked with the Illinois Disability and Health Program to create a facilitator manual with tools and resources to teach persons with IDD how to make healthy physical activity and nutrition choices.

Last year, the Montana Disability and Health Program, a partnership of the RIIC and the state health department, organized a workgroup to review the 14 Weeks facilitator manual and plan a one-day training that prepared myself and my co-facilitator, Connie Lewis, to go through the program with local People First members. Each week of class with the People First members, our group covered a physical activity and a nutrition topic, and we noted what education tools worked and did not work. We tailored it for use with people who have IDD in Montana. In week one, we started with basic information on physical activity and on food labels. Each week’s physical activity topics built on one another, from breathing exercises, to aerobic activity, to strength and flexibility training; nutrition topics built from hydration to healthy food choices and habits (fruits, vegetables, fiber, protein, carbohydrates, fats, salt, calcium, eating breakfast, portion control, healthy snacks). Each week’s exercise videos showed basic, adaptable exercises for people who are mobile, have limited mobility or use a wheelchair. They featured peers with IDD performing the exercises and are fun. The activities and worksheets helped break down the nutrition guidelines and food labels into information participants could use to make healthier eating choices. And the peer support that developed around the nutrition topics carried over to support healthy choices by participants as they’re in the community.

In their feedback on this adaptation of the program, People First members noted that they learned that stretching, when done on a regular basis, will help get rid of the “flab,” which they appreciate. They learned the importance of balanced nutritional meals to improve their health. They learned together how fast food is convenient, yet should be avoided in daily eating habits. They learned that they can accomplish more when their body is healthy. And they are beginning to see that they have more possibilities in life if they include exercise and healthy eating in their daily living.

As next steps, we are sharing what we learned about the program to improve it for implementation with people who have IDD throughout the state. We also are meeting with health educators at programs like the community Diabetes Prevention Program to identify options for graduates of the 14 Weeks program to continue learning about and having support to lead healthy lives.