title: People with learning disabilities, carers and care workers awareness of health risks and implications for primary care.
abstract: BACKGROUND
  People with learning disabilities have become increasingly exposed to health risk with the move to community living. Yet, health promotion is poorly developed with a heavy reliance on primary care.
  
  
  OBJECTIVE
  To elicit the perceptions of people with learning disabilities, carers and care workers regarding risk factors associated with cardiac disease.
  
  
  METHODS
  A qualitative approach was adopted incorporating semi-structured interviews based on vignettes. Twenty people with mild learning disabilities, 10 carers and 10 care workers were recruited. Data were analysed using Miles and Huberman's five-fold process.
  
  
  RESULTS
  In total, 29 women and 11 men were interviewed. A range of health risks was identified with different patterns across groups. There were common concerns around diet. Approximately 50% of participants also had worries regarding 'excessive computer usage', often related to physical inactivity, and a similar proportion identified social isolation as a risk. The importance of safeguarding personal autonomy was stressed in all three groups.
  
  
  CONCLUSIONS
  We demonstrated the feasibility of engaging with people with mild learning disabilities regarding health improvement. Participants recognized not only risks but also the subtle interplay of different factors, reflecting a grasp of the complexity of health promotion. Approaches within primary care to health improvement need to acknowledge this level of awareness.
authors.affiliation: Health Services Research Group and Elmwood Learning Disabilities Service, Royal Cornhill Hospital, 26 Cornhill Road, Aberdeen AB25 2ZH. ext.young@rgu.ac.uk
authors.forename: Anita F
authors.initials: AF
authors.lastname: Young
authors.forename: Rosemary A
authors.initials: RA
authors.lastname: Chesson
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D007407:Interviews as Topic; D007859:Learning Disabilities; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D012606:Scotland