Date Presented 04/13/21 Individuals with intellectual disabilities have a high risk for obesity. The effectiveness of community-based interventions at improving obesity-related outcomes was assessed. Results showed low to moderate evidence for nutritional, physical activity, and health knowledge and self-efficacy outcomes and low evidence for physical fitness. OTs are well suited to align community-based interventions with meaningful outcomes to improve the health and well-being of people with intellectual disabilities. Primary Author and Speaker: Yasmeena Ougayour Additional Authors and Speakers: Stacey Reynolds

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Research has focused on diet, exercise, and cognitive–behavioral therapy as the core components of weight loss programs. However, a sustainable weight loss is still challenging, maybe because of an individual perspective. Our long-term aim is to develop a holistic evidence- and OT-based weight loss program. Our studies show that the three usual components should be extended with habit, social relations, and occupational balance integrated into everyday life. Primary Author and Speaker: Christina Jessen-Winge Additional Authors and Speakers: Anette Enemark Larsen, Svetlana Solgaard Nielsen, and Jeanette Reffstrup Christensen

OBJECTIVE. We sought to describe the occupational performance issues of a sample of bariatric surgery candidates and to explore the relationships among occupational performance, satisfaction with performance, demographic characteristics, and mental health factors. METHOD. We reviewed the health records of 241 bariatric surgery candidates and analyzed their scores on the Canadian Occupational Performance Measure (COPM) and standardized mental health questionnaires. RESULTS. Exercise and eating behavior were the most common occupational performance issues. Cognitive and affective issues were reported more frequently than physical issues. Occupational performance and satisfaction correlated negatively with anxiety and depression and positively with self-esteem. Self-esteem contributed 27% of the variance in occupational performance. CONCLUSION. COPM scores revealed a wide range of occupational performance issues and significant associations with mental health factors, supporting a psychosocial approach to occupational therapy with this population. Routine mental health screening can help ensure that mental health factors are adequately addressed.

OBJECTIVE. The Health Promoting Activities Scale (HPAS) measures the self-rated frequency with which adults participate in activities that promote health. We evaluated the internal consistency, construct validity, and intrarater reliability of the HPAS with a cohort of mothers (N = 56) of school-age children. METHOD. We used an online survey that included the HPAS and measures of mental and physical health. Statistical analysis included intraclass correlation coefficients (ICCs), measurement error, error range, limits of agreement, and minimum detectable change (MDC). RESULTS. The HPAS showed good internal consistency (Cronbach’s α = .73). Construct validity was supported by a significant difference in HPAS scores among participants grouped by physical activity level; no other differences were significant. Results included a high aggregate ICC of .90 and an MDC of 5 points. CONCLUSION. Our evaluation of the HPAS revealed good reliability and stability, suggesting suitability for ongoing evaluation as an outcome measure.

Obesity is a public health concern for the population in general and for children with autism spectrum disorder (ASD) specifically. The purpose of this study was to understand relationships between sensory patterns, obesity, and physical activity engagement of children with ASD (N = 77) sampled from a specialized community-based swimming program. This retrospective correlational study analyzed program data. Results show that almost half (42.2%) of the children were overweight or obese, and sensory avoiding behaviors were related to higher body mass index (BMI). Children participated in few formal and informal physically active recreation activities. Sensory seeking behaviors were associated with increased participation in informal activities, and higher BMI was associated with less participation in both formal and informal activities. Practitioners should consider sensory processing patterns and BMI when developing community-based programs to promote physical activity of children with ASD.

Little research is available about youth with disabilities, who experience numerous inequalities in health outcomes compared with youth without disabilities. Youth with disabilities experience many environmental and attitudinal barriers in maintaining healthy lifestyles, which put them at risk for obesity. Strong evidence has suggested that obesity rates are higher among youth with disabilities than among their nondisabled peers. The purpose of this study was to implement and examine the benefits of a culturally tailored healthy lifestyles program for Latino youth with disabilities and their families. Several cultural adaptations were made to align with the target population’s cultural norms. Seventeen Latino families identified 67 behaviors they wanted to change or new habits they wanted to establish. The postassessment data showed that several family routines improved, and families reported engaging in many of the healthy habits they had identified for themselves. Implications of culturally appropriate and accessible programming are discussed.

Children with physical disabilities who use assistive mobility devices (AMDs) are at risk for obesity and other secondary health conditions. Habitual physical activity is one lifestyle factor that may prevent obesity and contribute to overall health, and an active lifestyle in childhood improves prospects for lifelong healthy behaviors. Child, family, and environmental facilitators and barriers influence health-promoting physical activity (HPPA) for children without disabilities, but comparable models and levels of understanding for children who use AMDs are lacking. In this scoping review, we identified a similar set of child, family, and environmental facilitators and barriers relevant to HPPA participation among children who use AMDs. Noted gaps in the literature included limited reporting of AMD use, inconsistent HPPA definitions, and inadequate measurement tools for children who are nonambulatory. The identified child, family, and environmental factors provide a framework for occupational therapy practitioners and interprofessional teams to develop HPPA opportunities and interventions for an underserved population.

OBJECTIVE. This study examined the relationship between childhood obesity and overweight and functional activity and its enjoyment. METHOD. A cross-sectional design was used to analyze data from the 2012 National Health and Nutrition Examination Survey National Youth Fitness Survey. Multivariate logistic regression models were used. RESULTS. Data for 1,640 children ages 3–15 yr were retrieved. Physical activity was negatively associated with risk of obesity (odds ratio [OR] = 0.93; 95% confidence interval [CI] [0.87, 0.98]). Although children who were obese and overweight were more likely to have functional limitations (ORs = 1.58–1.61), their enjoyment of physical activity participation was not significantly different from that of the healthy-weight group. CONCLUSION. Physical activity lowered the risk of obesity. Children who were obese had functional limitations compared with healthy-weight children, but both groups enjoyed physical activity equally. Future studies are needed to determine barriers to participation among these children in recreation and sporting activities.

OBJECTIVE. In this study, we explored the impact of an occupational therapy wellness program on daily habits and routines through the perspectives of youth and their parents. METHOD. Data were collected through semistructured interviews with children and their parents, the Pizzi Healthy Weight Management Assessment^©, and program activities. RESULTS. Three themes emerged from the interviews: Program Impact, Lessons Learned, and Time as a Barrier to Health. The most common areas that both youth and parents wanted to change were time spent watching television and play, fun, and leisure time. Analysis of activity pie charts indicated that the youth considerably increased active time in their daily routines from Week 1 to Week 6 of the program. CONCLUSION. An occupational therapy program focused on health and wellness may help youth and their parents be more mindful of their daily activities and make health behavior changes.

Obesity is a complex, multidimensional challenge that compromises occupational participation for children and families. Children who are overweight or obese are at serious risk for being stigmatized, bullied, or marginalized, and they often are medically compromised. They cope daily with occupational participation issues at home, in school, on playgrounds, and in their communities. Prevention and health promotion assessment and intervention in occupational therapy are imperative for the profession to make a significant and sustainable difference in the lives of these children and families. Innovative client- and occupation-centered programming promotes health, well-being, and quality of life for this population. It is incumbent upon occupational therapy practitioners to prevent occupational marginalization, deprivation, and alienation while promoting occupational justice for children who are overweight or obese.

Obesity is a health disparity related to environmental, social, and physical health issues, including ethnicity, education, and gender. The purpose of this study was to examine the relationship among obesity, age, education, and socioeconomic status and the relationship between obesity and depression among African-American women living in Omaha, Nebraska. A convenience sample of 378 African-American women completed the African-American Female Health Survey, which included the Center for Epidemiologic Studies Depression scale. Body mass index (BMI) was used to measure obesity. Results indicated that 87% of the women were overweight; mean BMI was 32.78 with high cardiovascular disease risks. There was a statistically significant and positive relationship between depression and BMI (r = .201, p < .01). Occupational therapists may provide primary, secondary, and tertiary intervention through culturally relevant and meaningful health education programs.