title: Primary and secondary barriers to physically active healthy lifestyles for adults with learning disabilities.
abstract: OBJECTIVE
  Evidence shows that those with a learning disability are typically amongst the most inactive and sedentary members of the population, yet few studies have focused on the determinants of physical activity. The aim of the present study was to establish whether a group of 24 adults with mild and moderate learning disabilities receive adequate support to be able to make choices to lead a physically active lifestyle.
  
  
  METHODS
  A descriptive study was used based on interviews with 24 adults with learning disabilities (mean age of 34 years) triangulated by day time and residential care workers. Participants volunteered from two residential homes and one social education centre (SEC) in a city in the North of England.
  
  
  RESULTS
  The participants face a set of primary barriers that prevent them from having a choice to adopt the Department of Health's recommendations for physical activity. Identified barriers included: unclear policy guidelines in residential and day service provision together with resourcing, transport and staffing constraints; participant income and expenditure; and limited options for physically active community leisure.
  
  
  CONCLUSIONS
  These are barriers that are widely acknowledged and understood by day and residential staff and participants in the study, but are arguably poorly understood by policy makers, health promotion agencies, commissioners and providers of learning disability services. The current lack of resources and inadequately specified responsibilities associated with community care deny many people with learning disabilities real choices to live a physically active healthy lifestyle.
authors.affiliation: Department of Human Sciences and Medical Ethics, St Bartholomew's and the Royal London School of Medicine and Dentistry, UK.
authors.forename: P R
authors.initials: PR
authors.lastname: Messent
authors.forename: C B
authors.initials: CB
authors.lastname: Cooke
authors.forename: J
authors.initials: J
authors.lastname: Long
mesh_terms: D000328:Adult; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D007859:Learning Disabilities; D007899:Leisure Activities; D008019:Life Style; D008297:Male