An exploration of lifestyle/obesity programmes for adults with intellectual disabilities through a realist lens: Impact of a ‘context, mechanism and outcome’ evaluation

Abstract

Background
Obesity is higher in people with intellectual disabilities.

Aims
There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond ‘what works’ and examine the ‘context, mechanisms and outcomes’ (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these programmes could be implemented within practice.

Method
We explored six‐review papers and the individual lifestyle/obesity programmes that these papers reviewed using the CMO framework.

Results
There were few theoretically underpinned, multi‐component programmes that were effective in the short to long‐term and many failed to explore the ‘context and mechanisms’. We developed a logic model and engaged in two co‐production workshops to refine this model.

Discussion
Using a realist approach, programmes need to be underpinned by both individual and systems change theories, be multi‐component, have a closer understanding of the interplay of the ‘context and mechanisms’, and co‐designed using a logic model framework.