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The Gatekeepers to Fitness: A Correspondence Study to Examine Disabling Practices Among Fitness Center Personnel

Sean Healy

Fitness centers may be an ideal setting for physical activity, yet qualitative findings suggest social-level barriers constrain access for people with disabilities. To further test this, I employed an online message correspondence study to investigate the effect of impairment status on the responsiveness of a national sample of fitness centers to requests for services. Email requests were sent to 800 fitness centers, of which 200 were tailored to each of the four investigative conditions (i.e., control, vision loss, spinal cord injury, or being autistic). The odds of receiving a positive response were 40.5% lower for individuals with vision loss (p = .011) and 33.3% lower for individuals with spinal cord injury (p = .055), as compared with individuals without an impairment. Specifically, the odds of receiving a positive response for personal training were 58.8% lower among individuals with vision loss (p = .003) and 41.1% lower for individuals with spinal cord injury (p = .065).

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Factors Related to Physical Activity in Adults With Intellectual Disabilities in Group Home Settings: A Systematic Literature Review

Paige Laxton, Freda Patterson, and Sean Healy

This systematic review of literature aimed to synthesize the multilevel factors related to physical activity (PA) among adults (age 18–65) with intellectual disability living in group homes. Keyword searches were used to identify articles from electronic databases, resulting in the inclusion of 10 articles for full-text review. Data were extracted relating to study and sample characteristics and study findings. Methodological quality of the studies was also evaluated. Factors related to PA in group homes were identified at all levels of the social–ecological model. Intrapersonal factors (e.g., health and functional status, attitude to PA), interpersonal factors (e.g., staff attitude, encouragement for PA, and coparticipation in PA), and organizational factors (e.g., program offerings, staff education, and staff–client ratios) were prominent findings in the reviewed studies. The findings support a social–ecological approach for PA promotion in group homes that target intrapersonal, interpersonal, and organizational factors.

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The Individual, Social, and Environmental Correlates of Physical Activity and Screen Time in Irish Children: Growing Up in Ireland Study

Jeanette M. Garcia, Sean Healy, and David Rice

Background:

The aim of this study was to use a social-ecological approach to examine the influence of individual, social, and environmental factors on moderate-to-vigorous physical activity (MVPA) and screen-time in a sample of 9-year-old children in Ireland.

Methods:

The sample was 1509 boys and girls from the Growing Up in Ireland (GUI) national study. MVPA, screen time, and individual, social, and environmental variables were assessed via questionnaires completed by children, their parents, and their teachers. Multiple regression was used to identify factors that correlated with children’s MVPA and screen-time levels.

Results:

For boys, factors such as activity with friends (P < .0001) and popularity (P < .01) were associated with MVPA, while factors such as BMI (P < .01) and MVPA (P < .01) were associated with screen time. Similarly for girls, factors such as activity with friends (P < .0001) and sociability were associated with MVPA, however factors such as BMI (P < .05), and access to play space (P < .05) were more closely associated with screen time.

Conclusion:

Social factors were more closely associated with MVPA, while individual factors were significantly correlated with screen time for both boys and girls. Correlates differed for boys and girls, suggesting that interventions should consider both the target population as well as the activity behavior.

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A Pilot Study of a Parent-Mediated, Web-Based Motor Skill Intervention for Children With Down Syndrome: Project SKIP

Amanda Young, Seán Healy, Lisa Silliman-French, and Ali Brian

To inform the development of scalable and sustainable fundamental motor skill interventions for children with Down syndrome, this study examined the feasibility and preliminary effectiveness of Project Skill Intervention Implemented by Parents (Project SKIP), a web-based, parent-mediated intervention intended to improve ball skills among children with Down syndrome. Twenty-four families enrolled in the study (including 13 boys and 11 girls; M age = 4.92). Fourteen children were assigned to an experimental group and participated in the 6-week intervention, and 10 children served as the inactive comparison group. The Test of Gross Motor Development-3 was administered preintervention and postintervention. In addition, parents of children in the experimental group completed a postintervention survey to assess their perceptions of Project SKIP. Following the intervention, there was a significant improvement in ball skills (p = .023, d = 0.86) for children in the experimental group, whereas the comparison group did not show significant improvement. Moreover, parents perceived Project SKIP to be feasible and effective; all parents reported being satisfied with their overall experience in the program, and 11 parents indicated that their child’s fundamental motor skills were positively influenced by the intervention. Engagement was high, with the majority of parents (n = 8, 57%) interacting with Project SKIP content three to four times a week.

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Prevalence of Meeting Physical Activity, Screen-Time, and Sleep Guidelines Among Children and Adolescents With and Without Visual Impairments in the United States

Justin A. Haegele, Carrie J. Aigner, and Sean Healy

The purpose of this study was to compare the degree to which children and adolescents with and without visual impairments (VIs) met national physical activity, screen-time, and sleep guidelines. This observational, cross-sectional analysis of the 2016 National Survey of Children’s Health focused on children (age 6–12 yr) and adolescents (age 13–17 yr) with and without VIs. The sample included 241 (weighted n = 472,127) and 17,610 (weighted n = 28,249,833) children, and 255 (weighted n = 505,401) and 17,417 (weighted n = 20,071,557) adolescents with and without VIs, respectively. Chi-square statistics were computed to examine the degree to which participants with and without VIs met health-behavior guidelines. Children (p = .02) with VIs were less likely to meet screen-time guidelines, but adolescents with VIs were not (p = .87). VI status was not associated with the likelihood of meeting physical activity or sleep guidelines (p < .05). Low numbers of children and adolescents with and without VIs meeting health-behavior guidelines warrant targeted interventions aimed at enhancing engagement.

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The 24-Hour Movement Guidelines and Body Composition Among Youth Receiving Special Education Services in the United States

Justin A. Haegele, Xihe Zhu, Sean Healy, and Freda Patterson

Background: The purposes of this study were to examine the proportions of youth receiving special education services in the United States who individually and jointly met physical activity, screen time, and sleep duration guidelines, and to examine the impact of meeting none, one, two, and three of the guidelines on overweight and obesity. Methods: This cross-sectional analysis utilized data from the 2016 to 2017 National Survey for Children’s Health data set on 3582 youth aged 10–17 years who received special education services. The frequency of the participants’ compliance with the 24-hour movement guidelines and body weight status (based on the age- and sex-specific percentile cutoffs) were estimated. Meeting guidelines was defined as: 9–11 hours/night (5–13 y) or 8–10 hours/night (14–17 y) of sleep, ≤120 minutes per day of screen time, and ≥60 minutes per day of moderate to vigorous physical activity. A multinomial logistic regression analysis was conducted to estimate the impact of meeting none, one, two, or three guidelines on body weight status, adjusted for potential confounders. Results: Overall, 8.1% of youth met all three guidelines, 42.0% met two guidelines, 38.0% met one guideline, and 11.9% did not meet any guideline. Meeting all three guidelines was associated with an approximately 50% decreased likelihood of overweight than meeting no guideline, or sleep or screen time guidelines independently. Conclusions: This study extends the 24-hour movement framework to children receiving special education services and should prompt the continued study of its utility for understanding health disparities experienced by this population.

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A Systematic Review of Digital Interventions to Promote Physical Activity in People With Intellectual Disabilities and/or Autism

Debbie Van Biesen, Tine Van Damme, Natalia Morgulec-Adamowicz, Aleksandra Buchholz, Momna Anjum, and Séan Healy

This systematic review synthesized the literature on digital health interventions for the promotion of physical activity (PA) among people with intellectual disabilities and/or autism. From an initial screening of 553 records, 10 studies underwent full-text review. Data were extracted relating to study, intervention, and sample characteristics and PA-related findings. Methodological quality was evaluated using the Crowe Critical Appraisal Tool. There were mixed findings pertaining to the effectiveness of digital health interventions for promoting PA among these populations. Positive results were reported for three of five active-video-game interventions, two of three social-media-based interventions, and one of two e-learning/multicomponent interventions. Digital health interventions can potentially be effective for promoting PA among people with intellectual disabilities and/or autism. However, the large variation in the samples and intervention types and a reliance on pre- and quasi-experimental research designs suggest that inferences should be made with caution and additional research is needed.

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Irish Para Report Card on Physical Activity of Children and Adolescents With Disabilities

Kwok Ng, Sean Healy, Wesley O’Brien, Lauren Rodriguez, Marie Murphy, and Angela Carlin

For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D−), Sedentary Behaviors (D−), Family & Peers (C), School (C−), Community & Environment (B−), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities.

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U.S. Physical Activity Para Report Card for Children and Adolescents With Disabilities

Heidi Stanish, Samantha M. Ross, Byron Lai, Justin A. Haegele, Joonkoo Yun, and Sean Healy

The U.S. Report Card on Physical Activity for Children and Youth has tracked 10 physical activity (PA) indicators common to the Active Healthy Kids Global Matrix since 2014. This article expands on the U.S. report cards by presenting PA indicator assessments among children and adolescents with disabilities. Grades for indicators were assigned based on a search of peer-reviewed articles presenting nationally representative data. The Global Matrix 3.0 benchmarks and grading framework guided the process. Grades for overall PA, sedentary behaviors, organized sports, and school were F, D+, D+, and D, respectively. Insufficient evidence existed to assign grades to the remaining six indicators. There is a need in the United States for targeted PA promotion strategies that are specific to children and adolescents with disabilities. Without a commitment to this effort across sectors and settings, the low grades identified in this para report card are expected to remain.

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24-Hour Movement Behaviors Among US Adults With Functional Disabilities

Samantha M. Ross, Justin A. Haegele, Bridgette M. Schram, and Sean Healy

This study aimed to quantify and compare physical activity, sitting time, and sleep behaviors among US adults with and without disabilities using the 2020 Canadian 24-hour movement framework. The weighted prevalence of 24-hour movement guideline adherence was estimated among a nationally representative sample from the 2017 to 2018 National Health and Nutrition Examination Survey of US adults (18–65 years old) with (n = 1070) and without (n = 33,370) functional disabilities in vision, hearing, mobility, cognitive, and self-care domains. The adjusted odds of single and combination guideline compliance were estimated by disability type, in reference to adults without disabilities, using separate multivariable logistic regressions. After adjusting for age, sex, and income, adults with disabilities in mobility, cognitive, or self-care domains had approximately half the odds of meeting all 3 guidelines, compared with adults without disabilities (adjusted odds range: 0.49–0.77). Significantly lower adherence was observed among adults with functional disabilities, compared with no disabilities, for sleep, and moderate to vigorous physical activity, but not sedentary guidelines. This report establishes baseline prevalence estimates for guidelines compliance among US adults with functional disabilities ages 18–65 years old. Low guideline adherence, and evidence for significant differences in physical activity and sleep, signals a need to further explore combination health behaviors among adults with disabilities.