Social and environmental determinants of physical activity and dietary choices in adolescents with intellectual disabilities

Mitchell, Fiona and Stevens, Gemma and Jahoda, Andrew and Matthews, Lynsay and Hankey, Catherine and Murray, Heather and Melville, Craig (2017) Social and environmental determinants of physical activity and dietary choices in adolescents with intellectual disabilities. Medicine and Science in Sports and Exercise, 49 (5S). p. 433. ISSN 1530-0315 (

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PURPOSE: The prevalence of obesity is higher in those with intellectual disabilities than the general population. The aim of the study was to understand the determinants of physical activity and dietary patterns in this population during their final year of school. METHODS: Participants were recruited from four additional support needs (ASN) schools in the Greater Glasgow and South Lanarkshire area of Scotland. Qualitative data were generated from 10 interviews with adolescents with mild-moderate intellectual disabilities. A phenomenological approach was utilised to explore their perceptions of factors influencing their lifestyle behaviours. Transcripts were analysed for recurrent themes relating to PA and diet using a deductive thematic analysis, employing Self-Determination Theory (SDT) as a theoretical framework. Themes were identified based on the explicit meanings of the data, until the point of saturation. RESULTS: Three major themes, each with two respective sub-themes, were identified as influencing participants’ engagement with PA and dietary choices. These were: 1) situatedness (sub themes: school culture and family/home culture); 2) motivation (sub themes: self-efficacy and social connectedness); and 3) wider environmental influences (sub themes: weather and availability and price). Overall, the school and home environments were found to have the strongest influence on participants’ lifestyle behaviours, but in very distinct and often conflicting ways. School structure, high self-efficacy, and social connectedness facilitate increased physical activity and healthier diet in adolescents with intellectual disabilities, whereas home life, low self-efficacy and a lack of social connectedness can serve as a barrier to PA and a healthy diet. CONCLUSIONS: Adolescents’ environment and social interactions play a pivotal role in influencing physical activity and dietary patterns. These findings suggest that influences on the young people in this population’s PA and dietary patterns are multifaceted and complex in nature.