title: Healthy living according to adults with intellectual disabilities: towards tailoring health promotion initiatives.
abstract: BACKGROUND
  A healthy lifestyle can prevent several health problems experienced by adults with intellectual disabilities (ID). For the development of effective and usable health promoting interventions for people with ID, the perspective of the intended audience should be taken into account. The aim of this qualitative study was to gain insight into the perspectives of people with mild to moderate ID on healthy living.
  
  
  METHODS
  Qualitative study. Five semi-structured focus groups were conducted with a total of 21 adults with mild to moderate ID in the Netherlands. Discussions focused on three main themes: (1) perceptions of own health, (2) what participants consider as healthy living and (3) factors experienced to be related to the ability to live healthily. Interviews were analysed thematically resulting in two main domains: (1) perceptions of what is healthy and unhealthy and (2) factors that participants experience to be related to their ability to live healthily.
  
  
  RESULTS
  For participants, healthy living entails more than healthy food and exercising: feeling healthy, happiness and level of independence are perceived as important as well. Factors experienced to relate to their ability to live healthily were (a lack of) motivation, support from others and environmental factors such as available health education, (a lack of) facilities and a(n) (dis)advantageous location of work or residence.
  
  
  CONCLUSIONS
  This qualitative study shows that adults with mild to moderate ID have a good understanding of what being healthy and living healthily constitute. As they face several difficulties in their attempts to live healthily, existing health promotion programmes for people with ID must be tailored to individual preferences and motivations and adapted for individual physical disabilities. Moreover, because of their dependency on others, tailoring should also be focused on the resources and hindering factors in their physical and social environment.
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands.
authors.forename: N M J
authors.initials: NM
authors.lastname: Kuijken
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Naaldenberg
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ Healthcare), Nijmegen, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: Nijhuis-van der Sanden
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, Nijmegen, The Netherlands.
authors.forename: H M J
authors.initials: HM
authors.lastname: van Schrojenstein-Lantman de Valk
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008607:Intellectual Disability; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D036301:Qualitative Research; D055815:Young Adult
keywords: focus groups; health behaviour; health promotion; intellectual disabilities; lifestyle