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Protocol
Physical Activity With Tailored mHealth Support for Individuals
With Intellectual Disabilities:Protocol for a Randomized Controlled
Trial
Henriette Michalsen1,2, PsyD; Silje Camilla Wangberg3, PsyD, PhD; Gunnar Hartvigsen4, MSc, PhD; Letizia Jaccheri5,
MSc, PhD; Miroslav Muzny1, MSc; André Henriksen6, MSc, MBA; Monica Isabel Olsen1,2, MSc; Gyrd Thrane7,
PhD; Reidun Birgitta Jahnsen8,9, PhD; Gunn Pettersen7, PhD; Cathrine Arntzen1,7, PhD; Audny Anke1,2,9, MD, PhD
1Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
2Department of Clinical Medicine, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
3Department of Health and Care Sciences, University of Tromsø – The Arctic University of Norway, Narvik, Norway
4Department of Computer Science, University of Tromsø – The Artic University of Norway, Tromsø, Norway
5Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
6Department of Community Medicine, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
7Department of Health and Care Sciences, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
8Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway
9Research Centre for Habilitation and Rehabilitation Models and Services, University of Oslo, Oslo, Norway
Corresponding Author:
Henriette Michalsen, PsyD
Department of Rehabilitation
University Hospital of North Norway
Hansine Hansens vei 67
Tromsø, 9038
Norway
Phone: 47 41500304
Email: henriette.michalsen@uit.no
Abstract
Background: Individuals with intellectual disabilities (IDs) have lower levels of physical activity (PA) and greater barriers for
participation in fitness activities compared with members of the general population. As increased PA has positive effects on
cardiovascular and psychosocial health, it is exceedingly important to identify effective interventions for use in everyday settings.
Mobile health (mHealth) methods such as motion sensor games (exergames) and smartphone reminders for PA have been explored
and found to be promising in individuals with IDs.
Objective: The purpose of this study is to examine the effectiveness of an individually tailored PA program with motivational
mHealth support on daily levels of PA in youth and adults with IDs.
Methods: The trial uses a randomized controlled design comprising 30 intervention participants and 30 control group participants,
aged 16 to 60 years, with sedentary lifestyles or low PA levels. While the controls will receive standard care, the intervention
aims to increase the level of PA, measured as steps per day, as the primary outcome. Secondary outcome variables are body mass
index, blood pressure, physical performance, social support for PA, self-efficacy in a PA setting, behavior problems, and goal
attainment. The intervention involves the delivery of tailored mHealth support, using smartphones or tablets to create structure
with focus on the communicative abilities of individual participants. Rewards and feedback are provided in order to motivate
individuals to increase participation in PA. Participants in the intervention group, their close relatives, and care staff will be
invited to participate in a preintervention goal-setting meeting, where goal attainment scaling will be used to select the participants’
PA goals for the intervention period. All participants will be assessed at baseline, at 3 months, and at 6 months.
Results: Enrollment was planned to start in April 2020 but will be delayed due to the pandemic situation. The main contribution
of this paper is a detailed plan to run our study, which will produce new knowledge about tailored mHealth to support PA in
individuals with intellectual disabilities.
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Conclusions: We expect the new intervention to perform better than standard care in terms of improved PA, improved
self-efficacy, and social support for activities. Technology offers new opportunities to promote healthy behaviors. The results of
the study will determine the effectiveness and sustainability of a tailored mHealth support intervention to increase PA in youth
and adults with IDs.
Trial Registration: ClinicalTrials.gov NCT04079439; https://clinicaltrials.gov/ct2/show/NCT04079439
International Registered Report Identifier (IRRID): PRR1-10.2196/19213
(JMIR Res Protoc 2020;9(6):e19213) doi: 10.2196/19213
KEYWORDS
intellectual disability; physical activity; technology; mHealth; mobile phone; goal attainment; social support; self-efficacy
Introduction
The prevalence of intellectual disabilities (IDs) is estimated to
be 1% of the world’s population [1,2]. Compared with the
general population, individuals with IDs have worse health and
lower levels of activity [3-5], and they have greater barriers for
participating in fitness activities [6] and accessing health care
services [7,8].
Physical Activity Guidelines
The World Health Organization (WHO) guidelines for physical
activity (PA) state that typical adults should spend a minimum
of 150 minutes per week engaged in moderate-intensity PA or
75 minutes engaged in vigorous-intensity PA [9]. One systematic
review found that only 9% of individuals with IDs met the
WHO´s minimum PA guidelines [4]. Norwegian guidelines are
in line with the international guidelines and recommend 150
minutes of moderate- to vigorous-intensity PA per week for
adults [10] and 60 minutes per day for children and youths [11].
As high PA is a determinant of health and increased activity
has positive effects on cardiovascular and psychosocial health,
identifying effective interventions for use in everyday settings
is exceedingly important.
Physical Activity Interventions
Some well-designed studies have not been able to demonstrate
improved levels of PA in intervention groups of individuals
with IDs after the intervention period has ended. One
theory-based randomized controlled study of adults with all
types of IDs did not find any significant increases in levels of
PA (steps per day) using a walking program [12]. Furthermore,
the results of a cluster-randomized study of older adults in the
Netherlands showed marginal effects and substantial missing
data, despite being well prepared with a published protocol and
using day-activity centers for the intervention [13]. Past
controlled studies on the effects of PA interventions on
individuals with IDs have primarily included adults with mild
to moderate IDs, and effect sizes have been small [5,14]. Some
studies have reported improved effects on physical fitness
indicators such as balance and muscle strength [15],
psychological well-being [16], perception of social competence
[17], and work routines [14] after increasing levels of PA. One
recent study included individuals with severe or profound IDs
in a technology-aided program for promotion of PA and found
positive results in energy expenditure and independent
engagement in light to moderate PA [18], but with a small
number of participants. Findings from previous studies indicate
that a more flexible approach [19], greater use of theory in
intervention design, stronger research design (as there are few
randomized controlled studies), and better translation of
interventions to community-based settings [20] are needed.
Future studies could also have an ecological approach, where
the interplay between individual, interpersonal, and
environmental factors are considered [1,21]. Motivational issues
have been challenging, particularly for approaches that aim for
sustainable effects [17], and should be considered when
designing future PA interventions.
Mobile Health Interventions
Mobile health (mHealth) provides a wide range of possibilities
for monitoring and motivating individuals in the
self-management of chronic illnesses [22-24]. Motion sensor
games (exergames) have been explored and have been found
to be promising in individuals with IDs [25]. For these solutions
to move out of the lab and into actual use, they need to first
meet users’needs [26]. The mobile platform is ubiquitous, and
the touch interface has proven to have a low level of cognitive
demand and could be used to improve adherence to PA [27].
At present, few mobile apps have incorporated games strategies,
such as goal setting or rewards, to increase PA in individuals
with various disabilities [28]. To our knowledge, there has been
only 1 preliminary report (letter) of a randomized controlled
trial using smartphone support to increase motivation for PA
in youth and adults with IDs [29].
Methods that could facilitate the development of individualized
mHealth support solutions include tailoring, individual goal
setting [30], and adjusting communication to meet the specific
needs of individuals with IDs [31]. Studies on motivation for
PA in the IDs population have shown that predictability with
routine and familiarity, communication of purpose, and
enjoyable and social activities promote motivation and
participation [21,32]. Family and care staff involvement will
be central, and we expect the study’s implementation in a natural
setting to enhance the effect [33]. We also expect the systematic
use of mHealth with rewards and gamification to be beneficial.
In Norway, many individuals with IDs have a smartphone or a
tablet that they can use for tailored PA interventions. However,
this use has not been tested previously. We expect a motivational
app for smartphones and tablets to promote adherence to PA in
individuals with IDs. According to the World Report on
Disability, health promotion efforts targeting this population
can improve lifestyle behaviors [34]. The report states that these
individuals have the right to be included in all PA programs.
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Thereby, the present study aims to examine the effectiveness
of an individually tailored PA program with motivational
mHealth support on everyday levels of PA in youth and adults
with IDs, targeting individual, contextual, and interactional
factors of PA participation [21]. In addition to higher levels of
PA, we expect improvements in psychological health,
self-efficacy in activities [32], and social support for physical
activity participation [35].
Methods
Design
The current study has a randomized controlled clinical design
with assessments at baseline, 3 months, and 6 months.
Participants will receive either the tailored mHealth-supported
PA program or standard care with access to the mHealth support
system once the trial is completed. Family and care staff will
be involved in the program for support and follow-up.
Participants
A total of 60 participants will be recruited into the trial through
health care and other related organizations in the municipality
of Tromsø in northern Norway. Information about the study
will be delivered at meeting places, such as day and activity
centers. If the number of included participants is insufficient,
more municipalities in Northern Norway will be included, or a
multicenter approach will be considered.
Inclusion and Exclusion Criteria
Individuals will be included if they have a sedentary lifestyle
[1] or a low level of PA, determined with the question, “In how
much of your leisure time have you been physically active in
the last year?” [8]. The question has 4 response categories and
has been used in population-based studies of the general
population [36] and in European health indicator studies of
individuals with IDs [8]. Individuals with a sedentary lifestyle
(eg, primarily engaged in reading, watching television, or other
mainly sedentary activities) and a low level of PA (eg, engaged
in walking or other light PA for less than 4 hours a week) will
be included in the study. Other inclusion criteria will be as
follows: (1) diagnosis of ID (mild, moderate, severe, or
profound), (2) aged between 16 and 60 years, (3) ability to
participate in the intervention, (4) ability to walk with or without
support, and (5) able to provide written informed consent or
written informed consent can be obtained from a representative.
Prior to enrollment, all participants will be screened for
readiness, and, if necessary, medical clearance will be obtained.
The Physical Activity Readiness Questionnaire [37] will be
used for this purpose. Exclusion criteria will be as follows: (1)
medical contraindications for participation in programs with
increased exercise as advised by the primary care or ID specialist
physician, (2) high level of physical activity, and (3) inability
to provide written informed consent and written informed
consent cannot be obtained from a representative.
Ethics
This study has been approved by the Regional Committee for
Medical and Health Research Ethics in northern Norway
(number 2016/1770). The protocol has been registered at
ClinicalTrials.gov under the identifier NCT04079439. The
project adheres to the Consolidated Standards of Reporting
Trials guidelines. Written informed consent will be obtained
from each participant, their legal representative, or both prior
to inclusion in the study and baseline assessment. If the
participant has impaired capability to consent, consent will be
sought from the nearest relative or guardian as well as from the
individual with IDs, or as representative consent. Ethical issues
will be continuously considered. Any adverse events will be
recorded.
Randomization
Participants will be randomized with a computer program to
either the PA intervention with mHealth support group or the
standard care control group.
Intervention Group
This randomized controlled trial is part of our project to develop
a tailored mHealth support system that promotes PA in
individuals with IDs [38]. In previous parts of the project, we
conducted a qualitative study on motivation for participation in
PA for individuals with IDs [21], held workshops and
collaborated with mHealth developers, and performed usability
tests. This process is illustrated in Figure 1.
Findings from the qualitative study, discussions in workshops,
and creative meetings among developers and researchers showed
that many individuals with IDs experience difficulties
participating in PA because of individual, interactional, and
contextual factors. Some of these factors include individual
difficulties in initiating activities; preferences for fun and social
activities; and lack of social support, availability of activities,
resources and preparation, predictability, and collaboration in
activities. After examination of these findings, a prototype of
an app was created and presented in one of the workshops. The
feedback was promising, and development of the mHealth
support system continued. The main emphasis in the app is
individually chosen activities, tailored communication,
predictability, use of rewards, and involvement of support
persons. Activities will be chosen during a goal attainment
meeting (using goal attainment scaling) [39] with the individual
with ID and a support person (usually a family member or health
care provider). Goal attainment is widely used as an outcome
measure within rehabilitation medicine [39] and has been used
in studies with individuals with IDs [40]. The research group
is familiar with the use of goalsetting processes in previous
studies with individuals with IDs. The final intervention will
consist of an advanced activity planner based on the platform
for the app Active Leisure (Smart Cognition AS). Actiplan
features and tracks daily physical activities. The app offers
different interface options (symbols only, easy-to-read text,
plain text, and read aloud). See Figure 2 for examples. The
activity planner will mostly be used by the individual with ID
and a support person (caregiver or health care provider). After
completing an activity, a simple reward is available (eg, a
smiling face or sharing a picture with other users of the app).
The use of tailored communication [41] is available through
personalization, including the use of the individual’s first name
in the activity planner, individually chosen activities, adjusted
communication (eg, symbols, easy-to-read text, or plain text),
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preparation and planning, and feedback. Rewards and positive
feedback after activities have been performed are expected to
increase motivation, and thereby lead to higher levels of PA.
In addition, 3 individual exercise apps have been developed as
potential alternatives that can be added to Actiplan: (1) an
exergame or game-inspired app that promotes outdoor PA; (2)
an ergometer bike or outdoor bike placed inside the home, with
a mounted screen showing a video or other visually interesting
features; and (3) a game-inspired, avatar-based health platform
for monitoring PA and motivating users to increase their PA
levels [38].
To explore the participants’ expectations and experiences of
the intervention and the mHealth support, a qualitative pilot
study recruiting 10 of the first participants in the intervention
group will be performed.
Figure 1. Development process of the electronic health support component of the study.
Figure 2. Interface options of the Actiplan app: symbols only, easy-to-read text, or plain text. The app also has read-aloud capabilities.
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Control Group
Participants in the control group will be administered the
assessments at baseline, 3 months, and 6 months, and otherwise
continue with their standard everyday activities during the study
period. They will be invited to use the mHealth support system
at the end of the 6-month intervention period.
Data Collection
Data will be collected at baseline, 3 months, and 6 months, as
seen in Figure 3. Baseline data will include baseline PA activity
level and will be collected before randomization. Follow-up
data will be collected regardless of the participant’s compliance
with the study protocol. Participants and assessors will not be
blinded. Background data on the participants will be collected
at baseline and will include age, gender, educational level,
marital status, living condition, employment status, educational
status, job-related or day center activities, leisure time activities,
smoking habits, level of ID (ie, mild, moderate, severe, or
profound), genetic diagnosis, gross motor function classification
[42,43], communication level [44], medical history/readiness
for the PA intervention, and use of medication. In addition, we
will ask questions about barriers for participation in physical
activities.
Figure 3. Consolidated Standards of Reporting Trials flow diagram of the study. mHealth: mobile health.
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Outcome Measures
Primary Outcome
The primary outcome of this study will be objectively measured
PA, as assessed by steps per day measured with a wrist-worn
commercial accelerometer (Fitbit Versa; Fitbit Inc). The device
will assess level of PA and sedentary time [45]. The watch will
be covered (neutral screen) during baseline and follow-up
assessments in both the intervention and control groups. Screen
neutrality is achieved by running a custom app on the watch
that disables all buttons and prevents screen feedback (except
showing current time). This app cannot be disabled by the
participant. Level of PA will be measured for 7 days at each
assessment, with a minimum of 3 consecutive days of
measurement because previous research has shown that 3 days
of PA can predict the weekly level of PA [14,46]. Many of the
commercial fitness trackers have been validated for use in
research [47], including devices from Fitbit Inc [48,49].
Secondary Outcomes
Secondary outcome measures will include minutes of moderate
PA per day, PA questionnaire, body mass index, blood pressure,
physical performance, social support for physical activity,
self-efficacy in a PA setting, behavior problems, and goal
attainment. See Table 1for a summary of all outcome measures.
Table 1. Summary of outcome measures.
MeasureType of outcomeMeasurement
Fitness trackerPrimary outcomeSteps per day
Fitness trackerSecondary outcomeMinutes of moderate activity
kg/m2
Secondary outcomeBody mass index
Blood pressure monitorSecondary outcomeBlood pressure
Short Physical Performance Battery [50]Secondary outcomePhysical performance
Aberrant Behavior Checklist–Community [51]Secondary outcomeBehavior problems
The Self-Efficacy/Social Support for Activity for
Persons With Intellectual Disability scale [35]
Secondary outcomeSocial support for PA and self-efficacy in PA setting
Goal attainment scaling [39]Method, secondary outcomeGoal attainment
Satisfaction with life scale [52]Control for adverse effectsSatisfaction with life
Physical Activity
The secondary PA outcome is the number of minutes of
moderate PA per day, measured with the commercial
accelerometer.
In addition, the International Physical Activity
Questionnaire-Short Form, adapted to measure PA using proxy
respondents, will be used [53]. The International Physical
Activity Questionnaire-Short Form is a 7-item questionnaire
that assesses PA in the past 7 days at 4 intensity levels: (1)
vigorous-intensity activity, such as aerobics, (2)
moderate-intensity activity, such as leisure cycling, (3) walking,
and (4) sitting.
Body Mass Index and Blood Pressure
Body mass index will be calculated in kg/m2[54]. Blood
pressure will be measured using a blood pressure monitor
(Welch Allyn Inc). Height will be measured in meters with a
stadiometer (Seca GmbH), with the participant wearing no
shoes. Weight will be measured in kilograms with an analog
floor scale (Seca GmbH), with participants wearing no shoes
or outdoor jackets/gear. Waist circumference will be measured
1 cm above the navel.
Physical Performance
The Short Physical Performance Battery (SPPB) will be used
to assess physical performance. The SPPB is a screening test
designed to evaluate physical performance and predict disability
in older adult populations [50]. The SPPB is mainly a measure
of lower-extremity function and consists of 3 subtests: static
balance, gait speed, and lower limb strength. To measure static
balance, the participant is asked to stand with feet in the
side-by-side, semitandem, and tandem positions, for 10 seconds
each, to his or her best ability. Gait speed is measured with a
4-m (13-ft) walk at the individual´s habitual pace. Lower limb
strength is measured by having the participant rise from a chair
with arms folded across his or her chest, to his or her best ability.
Subtest scores range from 0 (inability perform the test) to 4
(highest level of performance). The SPPB has been validated
[55], and reference values have been published [56]. The
Norwegian version of the SPPB appears to have acceptable
reliability as well as good internal consistency in an older
population with and without dementia [57]. The SPPB has been
used in people with mild and moderate IDs [58,59].
Behavior Problems
The Aberrant Behavior Checklist—Community (ABC-C) is a
questionnaire designed to assess challenging behavior in
children, youth, and adults with IDs [51]. The checklist consists
of 58 items divided into 5 subscales: irritability, lethargy,
stereotypy, hyperactivity, and inappropriate speech. It is a proxy
measure requiring knowledge of the person with ID. Each item
is scored on a scale of 0 to 3 (3 indicating the highest severity).
The ABC-C is a widely used behavioral rating scale used among
people with IDs. A Norwegian study [60] examined the
construct validity of the Norwegian ABC in a clinical sample
of children and youths in Norway and found satisfactory
psychometric properties for the ABC, with the exception of the
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inappropriate speech factor. The Cronbach coefficients were
adequate to excellent, with coefficients ranging from .76 to .95.
The ABC subscales were moderately to highly correlated with
one another (r=0.41-0.78, P<.001).
Social Support for Physical Activity and Self-Efficacy in a
PA Setting
The Self-Efficacy/Social Support for Activity for Persons with
Intellectual Disability scale [35] is a questionnaire consisting
of 4 subscales. One subscale measures self-efficacy for
overcoming barriers to leisure PA. The last 3 subscales measure
social support for leisure activity from family members, care
staff, and friends for individuals with IDs. The scale has been
validated for self-reporting from individuals with mild to
moderate IDs and for use by proxy respondents [35]. The
questionnaire will be translated into the Norwegian language
using standard guidelines [61].
Goal Attainment
Goal attainment scaling [39,62] will be used to identify
self-management goals that participants would like to achieve.
The questionnaire will be filled out by the researcher, with
participants and proxy respondents present. Goal attainment
scaling involves several steps. Goals are selected by each
individual, and observable behavior that reflects a degree of
goal attainment is defined [63]. The participant’s pretreatment
or baseline levels are defined in terms of the goal. Five different
goal attainment levels are used, ranging from “no change” to
“much better than expected outcome” (numbered –2 to +2).
Follow-up times for participant evaluation are set after 3 months
and 6 months. Goal attainment is evaluated after the defined
time interval. At the end, the overall attainment score for all
goals are calculated. In this study we will define up to 3 goals
for PA [64]. The scale has been validated for use in
rehabilitations populations [39] and has been used in studies
with individuals with IDs [40,65].
Satisfaction With Life
This study will use the satisfaction with life scale developed by
Bergström and Hochwälder [52], which was designed to assess
satisfaction with the home environment and leisure time in
individuals with mild to moderate IDs. The scale has 4 factors:
(1) satisfaction with housing environment, (2) satisfaction with
life, (3) satisfaction with meals, and (4) satisfaction with
recreational activities. Items are read aloud by a researcher and
answered by participants with 3 response options: good (happy
face=2), in between (neutral face=1), or bad (sad face=0). In
the current study, the scale is used to control for adverse effects.
Data Integrity
Patient- or proxy-reported and assessor-reported data are partly
captured electronically using Research Electronic Data Capture
(REDCap) (Vanderbilt University). REDCap is a web-based
system that is compliant with relevant regulations and security
requirements. The system has an integrated function for
randomization. Questionnaires can be sent electronically to
participants or the proxy respondent. Data not captured
electronically, such as background information and physical
performance test results, are registered at the baseline meeting.
The study coordinator will evaluate the data of all participants
for completeness. In cases of missing data, respondents will be
contacted.
Statistical Analyses
Sample Size
The study will be powered based on the primary outcome of
accelerometer-measured steps per day (mean of 4 days) [4,66].
With a 2-group design and effect size of 0.8, power of 80%,
and of .05, the expected minimum total sample size is 50
participants (25 participants in each group). The effect size in
the current study is estimated based on previous studies, which
have reported Cohen dvalues ranging from 0.29 to 0.91
[14,37,67]. An effect size of 0.8 is considered to be a clinically
relevant difference between the 2 groups, corresponding to an
increase in steps per day of approximately 2000 in the
intervention group, which is also expected to be achievable [14].
To avoid underpowering the study and to prepare for expected
dropout, we will recruit 30 participants per group, for a total
sample size of 60 (Figure 3). The group size estimated is
supported by other randomized controlled study protocols
[27,37] and published results [68] of studies to enhance levels
of physical activity in individuals with ID.
Data Analyses
The randomized controlled trial includes repeated measures in
2 groups, and linear mixed models will be used in the efficacy
analyses of the intervention. In addition to a group variable
(treatment or control), follow-up time (3 months and 6 months)
and mean steps (with baseline comparison) will be added as
covariates. An intention-to-treat approach will be used with a
significance level of P<.05 and a secondary per-protocol
analysis. All analyses will be performed using SPSS 26 software
(IBM Corp).
Results
The project is approved by the Regional Committee for Medical
and Health Research Ethics in northern Norway and is registered
at ClinicalTrials.gov. Enrollment was planned to start in April
2020 but will be delayed due to the pandemic
situation. Participant recruitment for the randomized controlled
study will be initiated as soon as practical difficulties due to the
pandemic situation are solved. Participants will be recruited,
randomized, and administered the intervention individually.
The main contribution of this paper is a detailed plan to run our
study, which will produce new knowledge about mHealth to
support PA in individuals with IDs.
Discussion
The present trial will investigate how modern technology and
mHealth can be used in the promotion of PA in individuals with
IDs. A tailored PA program is expected to increase levels of
PA, and individuals with IDs and low PA have the greatest
chances of improving [13]. Throughout our project, we have
used an ecological approach, and we are currently developing
a theory-based mHealth motivational support system for the
promotion of PA, which we believe will increase the probability
of improved levels of PA. Focusing on the communication
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abilities of each participant and individual goal setting may be
particularly important [64]. As previous research has shown
difficulties in recruitment and data collection, including missing
follow-up data [13], we will be prepared to meet these
challenges.
By including individuals with all types of IDs and low levels
of PA, we can add to the knowledge on whether mHealth
support can be successfully adjusted to individuals with different
levels of functioning and whether it can increase levels of PA
[5]. There is evidence demonstrating that an mHealth
intervention for PA can improve self-efficacy in activities, social
support [32], health conditions such as blood pressure [13], and
the results of physical performance tests [69]. This study has
potentially important implications for both individuals with IDs
and their support networks. If successful, the project will provide
a simple and accessible solution for promoting PA in individuals
with IDs. For widespread clinical implementation, it is necessary
to engage stakeholders who support individuals with IDs
throughout their lives.
Acknowledgments
The study has been and will continue to be conducted with grants from the Northern Norway Regional Health Authority (grant
number HNF1353-17) and has received and will continue to receive support from the Department of Clinical Research, University
Hospital of North Norway, Tromsø, Norway.
Conflicts of Interest
None declared.
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Abbreviations
ABC: Aberrant Behavior Checklist
ABC-C: Aberrant Behavior Checklist—Community
ID: intellectual disability
mHealth: mobile health
PA: physical activity
SPPB: Short Physical Performance Battery
WHO: World Health Organization
Edited by G Eysenbach; submitted 08.04.20; peer-reviewed by C Forbes, T Mettler, K Ng; comments to author 08.05.20; revised
version received 19.05.20; accepted 19.05.20; published 29.06.20
Please cite as:
Michalsen H, Wangberg SC, Hartvigsen G, Jaccheri L, Muzny M, Henriksen A, Olsen MI, Thrane G, Jahnsen RB, Pettersen G, Arntzen
C, Anke A
Physical Activity With Tailored mHealth Support for Individuals With Intellectual Disabilities: Protocol for a Randomized Controlled
Trial
JMIR Res Protoc 2020;9(6):e19213
URL: http://www.researchprotocols.org/2020/6/e19213/
doi: 10.2196/19213
PMID:
©Henriette Michalsen, Silje Camilla Wangberg, Gunnar Hartvigsen, Letizia Jaccheri, Miroslav Muzny, André Henriksen, Monica
Isabel Olsen, Gyrd Thrane, Reidun Birgitta Jahnsen, Gunn Pettersen, Cathrine Arntzen, Audny Anke. Originally published in
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