Biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation: A systematic review of qualitative research

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First published online 03 July 2024.

Why this study was done

People with disability who live in supported accommodation often experience poorer health outcomes than the general population, including higher rates of physical inactivity, unhealthy diets, obesity, and chronic health conditions. Physical activity and healthy eating are important for maintaining health and wellbeing, but many factors can affect people's ability to make healthy lifestyle choices. This study explored what helps and hinders physical activity and healthy eating for people with disability living in supported accommodation by reviewing qualitative research from around the world.

What the study did

  • Researchers conducted a systematic review of qualitative studies examining:
  • Physical activity among people with disability living in supported accommodation.
  • Healthy eating and nutrition in supported living settings.
  • Personal, social, environmental, and organisational factors that influence health behaviours.

The researchers analysed findings from multiple studies using a biopsychosocial framework, which considers how biological, psychological, social, and environmental factors interact to influence health and wellbeing.

What the study found

  • Health behaviours are influenced by more than individual choice. Participants' opportunities to be physically active and eat well were shaped by a combination of personal, social, organisational, and environmental factors.
  • Support workers play an important role. Staff attitudes, knowledge, skills, and priorities strongly influenced opportunities for physical activity and healthy eating. Supportive staff could help people participate in exercise and make healthier food choices, while limited staff knowledge or competing demands could create barriers.
  • People with disability wanted greater choice and control. Many participants valued being involved in decisions about food, exercise, and daily routines. However, opportunities for self-determination were sometimes restricted by organisational practices and support arrangements.
  • The physical environment can support or limit healthy lifestyles. Access to safe walking areas, recreational facilities, transport, kitchens, and healthy food options influenced participation in physical activity and healthy eating.
  • Organisational policies and resources matter. Funding arrangements, staffing levels, service culture, and organisational priorities affected whether health-promoting activities were available and encouraged.
  • Social relationships influence health behaviours. Family members, peers, support workers, and community connections often played a key role in motivating and supporting healthy lifestyles.

What this means

Improving physical activity and healthy eating for people with disability living in supported accommodation requires more than encouraging individuals to make healthier choices. Services also need to create environments that support health, self-determination, and inclusion. The findings suggest that disability service providers can promote healthier lifestyles by investing in staff training, supporting participant choice and control, improving access to community activities, and developing organisational policies that prioritise health and wellbeing. The study highlights the importance of addressing individual, interpersonal, environmental, and organisational factors together to achieve meaningful improvements in health outcomes for people with disability.

This study was conducted by: Dr Kostas Hatzikiriakidis, Associate Professor Darshini Ayton, Dr Amanda O'Connor, Dr Rachael Cox, Dr Ann MacRae, Ms Hannah Gulline, and Professor Libby Callaway.

To read the full article, visit the journal.

For other accessible formats, please see the column to the right.

Disclaimer: The QDRN has utilised generative AI to refine the wording of this plain language summary. All content has been checked for accuracy, appropriate tone, and clarity and approved by the author.

First published online 03 July 2024.

Why this study was done

People with disability who live in supported accommodation often experience poorer health outcomes than the general population, including higher rates of physical inactivity, unhealthy diets, obesity, and chronic health conditions. Physical activity and healthy eating are important for maintaining health and wellbeing, but many factors can affect people's ability to make healthy lifestyle choices. This study explored what helps and hinders physical activity and healthy eating for people with disability living in supported accommodation by reviewing qualitative research from around the world.

What the study did

  • Researchers conducted a systematic review of qualitative studies examining:
  • Physical activity among people with disability living in supported accommodation.
  • Healthy eating and nutrition in supported living settings.
  • Personal, social, environmental, and organisational factors that influence health behaviours.

The researchers analysed findings from multiple studies using a biopsychosocial framework, which considers how biological, psychological, social, and environmental factors interact to influence health and wellbeing.

What the study found

  • Health behaviours are influenced by more than individual choice. Participants' opportunities to be physically active and eat well were shaped by a combination of personal, social, organisational, and environmental factors.
  • Support workers play an important role. Staff attitudes, knowledge, skills, and priorities strongly influenced opportunities for physical activity and healthy eating. Supportive staff could help people participate in exercise and make healthier food choices, while limited staff knowledge or competing demands could create barriers.
  • People with disability wanted greater choice and control. Many participants valued being involved in decisions about food, exercise, and daily routines. However, opportunities for self-determination were sometimes restricted by organisational practices and support arrangements.
  • The physical environment can support or limit healthy lifestyles. Access to safe walking areas, recreational facilities, transport, kitchens, and healthy food options influenced participation in physical activity and healthy eating.
  • Organisational policies and resources matter. Funding arrangements, staffing levels, service culture, and organisational priorities affected whether health-promoting activities were available and encouraged.
  • Social relationships influence health behaviours. Family members, peers, support workers, and community connections often played a key role in motivating and supporting healthy lifestyles.

What this means

Improving physical activity and healthy eating for people with disability living in supported accommodation requires more than encouraging individuals to make healthier choices. Services also need to create environments that support health, self-determination, and inclusion. The findings suggest that disability service providers can promote healthier lifestyles by investing in staff training, supporting participant choice and control, improving access to community activities, and developing organisational policies that prioritise health and wellbeing. The study highlights the importance of addressing individual, interpersonal, environmental, and organisational factors together to achieve meaningful improvements in health outcomes for people with disability.

This study was conducted by: Dr Kostas Hatzikiriakidis, Associate Professor Darshini Ayton, Dr Amanda O'Connor, Dr Rachael Cox, Dr Ann MacRae, Ms Hannah Gulline, and Professor Libby Callaway.

To read the full article, visit the journal.

For other accessible formats, please see the column to the right.

Disclaimer: The QDRN has utilised generative AI to refine the wording of this plain language summary. All content has been checked for accuracy, appropriate tone, and clarity and approved by the author.