Adults with learning disabilities experience high rates of preventable health conditions, including obesity, diabetes, and cardiovascular disease, which leads to a reduced life expectancy. Lifestyle behaviours such as low physical activity, high sedentary behaviour, smoking, alcohol use and poor diet contribute to these inequalities. Although many lifestyle behaviour change programmes have been developed, their effectiveness for adults with learning disabilities has been inconsistent. There has also been limited focus on trying to understand which parts of lifestyle behaviour change programmes work best, and why some people benefit more than others.

This project aimed to examine the effectiveness of lifestyle interventions and the reasons they succeed or struggle in real-world settings. We conducted two complementary evidence syntheses. The first was a large systematic review and meta-analysis of 80 studies involving over 4,800 adults with learning disabilities, examining the effectiveness of lifestyle behaviour change programmes (interventions) and the core components of these. The second was a realist evidence synthesis of 79 studies, exploring how and why lifestyle behaviour change programmes work, for whom, and in what context. Both studies were co-produced with people with lived experience through People First Scotland to ensure the findings reflected real-world needs and priorities.

Lifestyle behaviour change programmes showed mixed effectiveness. Some programmes improved physical activity, diet, or weight outcomes, but effects were modest and inconsistent . Interventions combining structured diet changes, aerobic exercise, and behaviour change techniques showed the most effectiveness, although the quality of the evidence was variable. The realist synthesis showed that engagement and effectiveness of programmes is less about individual components but whether adults can actively engage with the programme. Key factors to support engagement included accessible materials, appropriate support, balancing autonomy with guidance, social connection, and ensuring activities were enjoyable and meaningful. These studies provide the most comprehensive assessment to date of lifestyle behaviour change interventions for adults with learning disabilities and provide guidance for designing more accessible and effective programmes.

This project was led by the University of Glasgow in collaboration with Leeds Beckett University, University College London, University of Surrey and People First (Scotland). This project was funded by the NIHR.

Two papers have been published from this work so far. You can links below for the effectiveness review and the realist review.