Supporting healthy lifestyles for adults with learning disabilities

Healthy Lifestyle Behaviours | Last Updated: 13 Apr 26

Background

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.

What we did

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.

What we found

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.

Project lead: Sophie Westrop

Research team: Dikshyanta Rana, Evi Germeni, Nishant Jaiswal, Craig Melville, Louisa Ells, Olivia Wu, Phillippa Lally, Michael McEwan, Leanne Harris.

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

SLDO Group member(s) involved in this research

25 125 SLDO Staff Arlene Mcgarty 002 staff image

Dr Arlene McGarty

Arlene is a Research Fellow at the Scottish Learning Disabilities Observatory. Arlene is interested in lifestyle behaviours (for example, physical activity and sedentary behaviour) and how these impact the health of people with learning disabilities. She is also interested in finding ways to change these behaviours to help people with learning disabilities lead healthier and happier lives. Some of the projects that Arlene works on include: School-based “active play” for children with learning disabilities. Understanding walking opportunities in adults with learning disabilities. Increasing motor development skills in children with learning disabilities. Measuring energy expenditure in adults with learning disabilities.

Dr Sophie Westrop

Sophie worked with the Observatory as a Research Associate and her ongoing research focus is about understanding the influences on lifestyles of adults with learning disabilities, behaviour change and promoting a healthy lifestyle. Sophie remains an affiliate team member, having moved in early 2024 to take up a lectureship post York St John University. Prior to working at the Observatory, Sophie completed a PhD at the University of Glasgow that considered differences in physical activity and sedentary behaviour between men and women with learning disabilities.

Professor Craig Melville

Craig is a Professor of Neurodevelopmental Psychiatry in the School of Health and Wellbeing at the University of Glasgow. His work focuses on using evidence from research to inform the development of interventions and policy to improve the health of people with neurodevelopmental conditions. Craig has worked on clinical trials of complex interventions, such as psychological therapies, weight management and health checks in primary care. Evidence from epidemiological research has been central to the development of these clinical trials and his work with SLDO centres on how to use Scotland’s national datasets to understand and tackle the health inequalities experienced by people with neurodevelopmental conditions.

Michael McEwan

Michael is a freelance journalist and disability campaigner. He makes news packages for BBC Radio Scotland and BBC Scotland television, as well as having a regular column in the Barrhead News newspaper and hosting and contributing to several podcasts and YouTube shows on topics including Scottish Football and disabilities. Michael has been involved in numerous SLDO research activities including as a contributor to recent studies about heart health research for and with people with learning disabilities and understanding the mechanisms and effectiveness of lifestyle modification interventions in adults with learning disabilities.