Exploring physical activity interventions for adults with disabilities

Section A
Title: A Systematic Literature Review of the Cost Effectiveness of Physical Activity for Adults with Disabilities.

Background: Adults with disabilities experience significant health inequalities, which physical activity (PA) interventions can help reduce. However, cost effectiveness research has only focused on the UK general population and disabled adults abroad. Therefore, its relevance to adults with disabilities in the UK is unclear. This review aimed to evaluate the cost effectiveness of PA interventions for this group.

Methods: The systematic literature search was completed on 4th November 2024 using six databases: ASSIA, CINAH, PsycINFO, Social Policy and Practice, SportDiscus and Web of Science. A narrative synthesis was conducted, and an economic quality appraisal tool used. Inclusion criteria involved reports involving adults with disabilities, defined by the Equality Act (2010), and UK-based PA interventions involving primarily exercise, sport or PA, with cost-effectiveness outcomes.

Results: Nine reports from 1,229 records were eligible. Quality ranged from medium to high and findings generally supported cost effectiveness. Although several potential confounding factors were highlighted.

Discussion: While findings were positive, difficulties in variety of disabilities studied, implementation and local value was noted. Further research needs to expand the evidence-base and investigate what factors ensure high-cost effectiveness.

Section B
Background: Adults with learning disabilities (LDs) experience significant health inequalities which physical activity (PA) could help reduce. However, PA participation has declined in the UK, especially among adults with LDs who face multiple barriers requiring support across all levels of the ecological system. Fun and Fitness (F&F) is a beneficial community-based exercise programme co-developed by stakeholders across these levels for adults with LDs. This study aimed to explore what programme elements stakeholders perceived to contribute to its effectiveness and sustainability.

Methods: Reflexive thematic analysis was used to explore 18 stakeholders’ perceptions of the key elements supporting F&F’s success.

Results: Four themes were identified: “Continued Motivation”, “Systemic Network Development”, “Managing and Maintaining Resources” and “Demonstrating Compassion and Inclusivity”. Two sub-themes under motivation were also identified: “Motivation from positive outcomes” and “Motivation from meeting societal goals”.

Discussion: Findings highlighted the importance of systemic interdependence, roles and influence across systemic levels, shared values and addressing barriers for the programme’s effectiveness and sustainability. These insights could inform future initiatives, though further research is needed into engineering the effective elements,
intersectionality and higher-level systemic influences.