Direct Support Professionals and Adults with Developmental Disabilities: A Study of the Role Direct Support Professionals have in the Health Behaviors of their Clients with Developmental Disabilities.

摘要

Introduction: People with developmental disabilities use tobacco, lead sedentary lifestyles, consume poor diets, as well as have higher rates of chronic conditions such as diabetes and heart disease when compared to members of the general population. Direct support professionals (paid caregivers) play a large social role in the lives of their clients with developmental disabilities. Because direct support professionals play such a large social role in the lives of their clients with developmental disabilities, they have the potential to influence the health behaviors of their clients; however, this potential influence has not yet been explored in the literature. The purpose of this study was to better understand the role that direct support professionals have in promoting the health of their clients with developmental disabilities, and to assess the relationship between the health behaviors of direct support professionals and their clients.;Methods: A mixed methods approach was used. Six qualitative focus groups (n=48) were conducted with key members of the developmental disability community to better understand the perceptions of the role of direct support professionals in the health promotion efforts of their clients. Using the findings from the qualitative study, a survey was developed to assess the health behaviors of direct support professionals and their clients. A total of 398 direct support professionals completed this online the survey. Descriptive statistics were calculated for the prevalence of smoking, dietary and physical activity behaviors of direct support professionals and their clients. Chi-square tests and Pearson/Spearman correlations were used to examine the relationship between the health behaviors of direct support professionals and their clients with developmental disabilities.;Results: Findings from this study suggest that direct support professionals experience several barriers when trying to promote the health of their clients with developmental disabilities, with one of the main barriers being fear over violating the rights of their clients. In addition, this study suggests that there is no association between the current smoking status of direct support professionals and their clients with developmental disabilities (chi12=0.300, p=0.584); however, small yet significant associations were found between the dietary and physical activity behaviors (r=0.127-0.333, p<0.05) of direct support professionals and their clients with developmental disabilities.;Discussion: This study was the first to examine the role of direct support professionals in the health promotion efforts of their clients by using both qualitative and quantitative methods. In order to reduce the fear experienced by direct support professionals about violating the rights of their clients, service coordinators should consider including a health promotion section in their clients Individualized Service Plans (ISPs). Disability service organizations that employ direct support professionals should also consider offering health promotion trainings and educational opportunities for both direct support professionals and their clients with developmental disabilities. In addition to assessing the influence of direct support professionals, future research on this topic should consider addressing the social influence of family/guardians and roommates on the smoking, dietary and physical activity behaviors of people with developmental disabilities.