title: Process evaluation of the Walk Well study: a cluster-randomised controlled trial of a community based walking programme for adults with intellectual disabilities.
abstract: Walking interventions can be effective in encouraging sedentary populations to become more active; however, limited research has explored the effectiveness of walking interventions for adults with intellectual disabilities. This process evaluation explored the delivery of a community based walking intervention for adults with intellectual disabilities.
  
  
  
  Walk Well was a single-blind cluster randomised controlled trial of a 12-week physical activity consultation-led walking intervention. 102 participants were randomised to the Walk Well intervention or a waiting list control group. Participants in the intervention group received three physical activity consultations with a walking advisor at baseline, 6 & 12-weeks. They were encouraged to use a pedometer to set goals and monitor their daily step count. Primary outcome was change in daily step count at 12-weeks. Process evaluation measures included qualitative interviews with key stakeholders (n = 6) and quantifiable data collected as part of the intervention. Additional process data were extracted from a sub-set of qualitative interviews with participants and carers (n = 20). Data were analysed for process information related to context, recruitment and retention, reach, implementation, and fidelity.
  
  
  
  Walk Well was not effective in significantly increasing levels of physical activity. The process evaluation did, however, highlight several important areas for consideration in future studies, including: a successful recruitment and retention strategy reaching a representative sample of adults with intellectual disabilities in the community; feasible and (for most) enjoyable methods of engaging adults with intellectual disabilities in activities to support behaviour change; potential need for greater intervention duration and frequency of contact; advantages and disadvantages of using pedometers as a behaviour change tool; the need for strategies which engage carers in supporting participants; and the complex issue of 'freedom of choice' in relation to lifestyle behaviours and study participation.
  
  
  
  Walking interventions for adults with intellectual disabilities can be feasibly delivered in the community in relation to reach, recruitment, retention and intervention fidelity. More intensive intervention methods need to be explored as well as strategies to engage and motivate carers in their support of participants.
  
  
  
  Current Controlled Trials ISRCTN50494254 (3(rd) April 2012).
authors.affiliation: Institute of Health and Wellbeing, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland. lynsay.matthews@glasgow.ac.uk.
authors.forename: Lynsay
authors.identifier: 0000-0002-5760-1080
authors.initials: L
authors.lastname: Matthews
authors.affiliation: Department of Physical Activity for Health, University of Strathclyde, Glasgow, Scotland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Mitchell
authors.affiliation: Glasgow School of Social Work, University of Strathclyde, Glasgow, Scotland.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Stalker
authors.affiliation: Institute of Health and Wellbeing, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland.
authors.forename: Alex
authors.initials: A
authors.lastname: McConnachie
authors.affiliation: Institute of Health and Wellbeing, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland.
authors.forename: Heather
authors.initials: H
authors.lastname: Murray
authors.affiliation: Social Work Services, Glasgow City Council, Glasgow, Scotland.
authors.forename: Chris
authors.initials: C
authors.lastname: Melling
authors.affiliation: Institute for Sport, Physical Education and Health Sciences, Moray House School of Education, University of Edinburgh, Edinburgh, Scotland.
authors.forename: Nanette
authors.initials: N
authors.lastname: Mutrie
authors.affiliation: Institute of Health and Wellbeing, Academic Unit for Mental Health & Wellbeing, University of Glasgow, Glasgow, Scotland.
authors.forename: Craig
authors.initials: C
authors.lastname: Melville
mesh_terms: D056044:Actigraphy; D000328:Adult; D015444:Exercise; D005260:Female; D006293:Health Promotion; D006801:Humans; D008607:Intellectual Disability; D008297:Male; D008875:Middle Aged; D017064:Process Assessment, Health Care; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking
keywords: Behaviour change; Intellectual disabilities; Pedometers; Physical activity; Process evaluation; Randomised-controlled trial; Walking