Healthy living messages for people with learning disabilities
Authors: Laidlaw M. , Spanos D. , Capaldi L. , Robinson N. , Nolan J. 
Published: July 2008

Background:  Obesity, cardiovascular disease and osteoporosis are common nutritional disorders seen in people with learning disability (LD) and complexities of communication, visual, hearing and cognitive difficulties (NHS‐HS, 2004). The national Healthy Living Campaign (HLC) (Healthy Living, 2007) produces health promotion materials with consistent guidance on healthy eating for adults. However, the format could be regarded as inaccessible to the majority of those with LD (NHS‐HS, 2004). A pilot project, ‘Shop, Cook & Eat’, aimed to make the national HLC accessible to people with LD in a day centre/community setting and to empower people to make healthy choices has been initiated. Interactive learning methods including sensory activities, structured visits to supermarkets and allotments, and cooking skills development were used. Information and recipes with pictorial explanations were produced. This study aimed to evaluate this initiative.

Methods:  A participatory appraisal approach was used to pilot delivering of the HLC messages. A healthy eating group (eight participants >30 years) met weekly sessions from September 2006 to June 2008. The effectiveness of the materials was evaluated by a pictorial questionnaire that utilised an augmentative communication method, ‘Talking Mat’ (Murphy & Cameron, 2002). Questionnaires, which measured the impact on service users’ knowledge of healthy eating and living, were administered at the end of the programme to carers. An observation diary was used to record qualitative comments. Data analysis was carried out with Excel 2003.

Results:  Five subjects completed the questionnaire. At week 1, two participants had 90% correct answers on fruit and vegetables and showed no change after 5 weeks; two participants had 60% correct answers and increased their knowledge by 45% increase; one participant had 70% correct answers and showed 18% increase. Questions on fat showed all five participants increased their knowledge within 4 weeks of joining the scheme. Questionnaires completed by family and carers at the end of the learning programme showed that six participants increased consumption of new foods/fruit and vegetables, five demonstrated increased interest and involvement in cooking and shopping at home. Examples from the observation diary include a day centre worker noting improved lunch choices of one member of the group and a parent reporting that her son had advised her to cut the fat off the bacon.

Discussion:  This study shows that this educational programme, developed to suit adults with LD, has the potential to improve their dietary knowledge. However, the low response rate makes extrapolation of these results difficult. Additional factors such as levels of disability and the level of involvement of carers and family members must be considered as well as whether new knowledge is sustained.

Conclusions:  The results of this work suggest that it is possible to change the health knowledge of people with learning disabilities through use of interactive methods and materials in accessible format although larger studies are required. The results from this participatory appraisal approach could inform action planning for future groups on a wider scale.

References  Healthy Living [On line]. Available at http://www.healthyliving.gov.uk/ (accessed on 3 April 2007).

Murphy, J. & Cameron, L. (2002) Let your Mats do the Talking. Speech and Language Therapy in Practice – Spring 2002 p18–20.

NHS Health Scotland. (2004) People with Learning Disabilities in Scotland ‐ Health Needs Assessment Report. Edinburgh: NHS Health Scotland.