title: Caregivers' perception of factors associated with a healthy diet among people with intellectual disability living in community residences: A Concept mapping method.
abstract: BACKGROUND
  Many people with intellectual disabilities (ID) living in community-based residences have been found to have unhealthy diet and weight disturbances. In Norway, a majority of people with ID live in such residences.
  
  
  OBJECTIVE
  The aim of the study was to examine factors affecting the caregivers' opportunity to promote a healthy diet among the residents.
  
  
  METHODS
  A concept mapping methodology was adopted, including group-based brainstorming, idea synthesising, sorting, rating and analysis of the results. Informants were caregivers in four different community residences for people with mild to moderate ID in the southeast of Norway. A total of 13 informants were recruited (12 females and 1 male), and 10 informants completed two sessions.
  
  
  RESULTS
  Eight clusters were identified as affecting the caregivers' ability to promote a healthy diet: "Availability and accessibility", "Guidance and autonomy", "Competence among staff", "Planning and involvement", "Customization", "External conditions affecting staff", "Legislation, rules and structure" and "Everyday challenges", each including both barriers and facilitators.
  
  
  CONCLUSIONS
  Multiple factors affect the caregivers' ability to promote a healthy diet. Caregivers' opportunity to promote a healthy diet is complex. Availability and accessibility of healthy food is crucial, but a healthy diet also requires time and competence among the caregivers.
authors.affiliation: Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Science, P.O. Box 5003 NMBU, N-1432 Ås, Norway.
authors.forename: Marte Pilskog
authors.initials: MP
authors.lastname: Ruud
authors.affiliation: Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Science, P.O. Box 5003 NMBU, N-1432 Ås, Norway. Electronic address: ruth.raanaas@nmbu.no.
authors.forename: Ruth Kjærsti
authors.initials: RK
authors.lastname: Raanaas
authors.affiliation: Department of Nutrition, University of Oslo, P.O. Box 1046 Blindern, N-0317 Oslo, Norway.
authors.forename: Mona
authors.initials: M
authors.lastname: Bjelland
mesh_terms: D000328:Adult; D000368:Aged; D040561:Assisted Living Facilities; D001291:Attitude of Health Personnel; D017028:Caregivers; D000072001:Diet, Healthy; D005260:Female; D005523:Food Supply; D006293:Health Promotion; D006801:Humans; D008607:Intellectual Disability / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D009664:Norway; D026684:Personal Autonomy; D036301:Qualitative Research; D055815:Young Adult
keywords: Care workers; Deinstitutionalization; Developmental disability; Health promotion; Life style; Nutrition