Brief Report
How do children with disabilities view ‘healthy living’? A descriptive pilot study

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Abstract

Background

Childhood obesity is one of the greatest health problems of the 21st Century. Compared with their non-disabled peers, children with disabilities have been shown to be at higher risk of obesity and associated secondary conditions which can hinder independence and community participation. Health promotion initiatives for children are rarely tailored to those with disabilities, and children may have different perceptions of health and well-being than those without disabilities. These need to be understood for future health promotion programs to be effective.

Methods

This pilot study explored how children with disabilities perceive health and well-being and involved four discussion groups with children who were currently inpatients at a children's rehabilitation hospital. Descriptive thematic analysis was used.

Results

Fourteen children (eight girls, six boys; aged 8-13 years) with a range of congenital and acquired conditions participated in one of four discussion groups. There was an awareness of “healthy living” behaviors, nutrition and exercise examples being most commonly cited, although participants particularly discussed “unhealthy” food preferences. Physical capabilities, both before their hospital stay and their expectations for future activities, were also prominent.

Conclusion

Although children in this study had some basic understanding of healthy nutrition, it was not easily translated to their own food choices. Children may need assistance to engage in rewarding physical activities within the constraints of their disability.

Section snippets

Gaps in research

Although substantial research efforts are being made in the area of health promotion for typically developing children [1], [49], [50], those with disabilities are largely excluded from both health promotion initiatives and research [51], [52], [53]. Little work has directly explored children's perceptions about healthy living and health behaviors. It is therefore vital to develop a better understanding of how children with disabilities view healthy living concepts to enable a more holistic

Objective

The objective of this preliminary study was to qualitatively explore the perceptions of children with disabilities about what it means to be healthy. Their understanding of physical activities and healthy eating was also examined, along with the activities the participants were currently engaged in and the food they enjoyed eating. The feasibility of expanding the pilot work to a wider sample was also assessed.

Design

A qualitative focus group design was used for this study, which is particularly useful for exploring issues around health and lifestyle [54].

Sample

The sample was drawn from a large paediatric rehabilitation hospital in Toronto, Ontario, Canada. Ethical approval was obtained from the hospital's Research Ethics Board. Potential participants (n = 14) were all receiving in-patient rehabilitation for musculoskeletal, developmental or neuro-motor conditions, and/or acquired brain injury. They had

Results

Four separate discussion groups were held involving 14 participants (six males, eight females) aged 8-13 years old (Table 1). Seven of the children were admitted for rehabilitation regarding a congenital condition, whilst the remainder had acquired their condition at a later age. (The terms of the ethical approval limited the information we could gather on individuals, so the children's specific conditions and other clinical details are unknown). The participants varied in their level of

Discussion

The children in this pilot study appeared to have a fairly narrow view of “healthy living,” concentrating mostly on nutrition and, to a lesser extent, physical activity. Although the broad physical benefits of exercise to reduce or prevent obesity were reported, participants did not seem to recognize the additional psychosocial benefits that exercise and activity can bring [14], [21], [22], [23]. Indeed, none of the groups mentioned dealing with stress of any form, despite this being an

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    Neither of the authors have any conflicts of interest to disclose.

    The study was funded by a Bloorview Research Institute Start-up Grant.

    The authors are grateful to Kristen English, Andrea DeFinney, Robyn Golder, Amanda Oates and all of the participants. The authors also thank the Youth Advisory Council at Holland Bloorview Kids Rehabilitation Hospital for providing advice on the initial idea for this research.

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