Health promotion for people with intellectual disabilities – A concept analysis

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The American Association on Intellectual and Developmental Disabilities defines an intellectual disability (ID) as ‘a disability characterised by significant limitations in both intellectual functioning and adaptive behaviour, which covers many everyday social and practical skills. This disability originates before the age of 18' 1. The prevalence of ID varies from 1% to 3% globally 2. Although people with ID typically have similar health problems as the general population, this group has a higher prevalence of some health issues, and their health needs are often neither recognised nor met 3. Primary and secondary health conditions commonly experienced by people with ID have been identified 4. Primary conditions include epilepsy and mobility and sensory difficulties, while secondary health conditions are obesity, bone fractures, poor oral health, constipation and gastro‐oesophageal reflux 4. In addition, people with ID often experience poorer health outcomes due to health disparities 5. They often have limited access to quality healthcare and health‐promotion programmes. Women with ID, for example, have lower cancer screening rates than women without ID 8.
Health promotion could help to address, mitigate and prevent these issues. The World Health Organization (WHO) defines health promotion as ‘the process of enabling people to increase control over and to improve their health' 9. Although health promotion is a well‐known concept that has long been practiced in the field of nursing for the general population, there is a lack of knowledge on how it is conceptualised for people with ID and how it needs to be adapted to improve the health and well‐being of this particular group. In general, the WHO's definition of health promotion also applies to people with ID, and health‐promotion programmes are equally – or even more – useful for them as they are for people without ID.
However, the limitations of people with ID in certain areas create specific barriers to accessing standard health‐promotion programmes and information designed for people without ID 10. One barrier to access is transportation, as people with ID often need transportation from professionals, friends or family members to participate in health‐promotion programmes 10. Information access presents another barrier. Leaflets, journals and the Internet are important sources of health‐promotion information but can be inaccessible for individuals with ID as they are hard to find and difficult to understand 11. In addition, healthcare professionals often focus on the disabilities of people with ID and the accompanying limitations and do not consider that these individuals might also benefit from participating in health‐promotion programmes 10. Consequently, people with ID frequently do not get opportunities to benefit from health promotion.
This article investigates the realities and the potential of health promotion for people with ID and has two goals. It analyses how health promotion is being conceptualised for people with ID in the literature and how health promotion can work best in the light of this group's specific needs and limitations to improve their health and well‐being.
This analysis is important not only for academic purposes, it can also make nurses and professionals in other disciplines more aware of the barriers that people with ID are face in accessing regular health‐promotion programmes. It can also provide them with the knowledge required for overcoming these barriers.
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