Supporting physical activity in adults with learning disabilities: exploring care-givers’ attitudes. Beliefs and motivation

Abstract

Objective: Adults with Learning Disabilities participate in less physical activity (PA) than the general population. Social support (positive and negative), and beliefs about PA from care-givers have been identified as being significant determinants of PA in their clients. The aim was to understand workplace and social norms, organizational ethos and how these influence carers’ perceptions, willingness and ability to support PA, as well as views on issues of choice, responsibility and risk. Method: Adopting a phenomenological approach, interviews with ten care-workers were digitally recorded, transcribed verbatim and thematic analysis was conducted. Triangulation was employed to ensure credibility of identified themes. Results: Views on the importance of PA for all clients, perceptions of client-related barriers and motivation to support PA are influenced by the carer’s own physical activity levels and previous experience of the positive impact of PA on their clients. ‘Levers and drivers’, ‘Choice versus duty-of-care’ and ‘Risk-management’ emerged as main themes, alongside the Theory of Planned Behavior variables of attitude, norms and perceived behavioral control. However, care-givers did not experience support from colleagues and managers, while PA promotion was not common in some organisations. Conclusion: Some factors which impact on carers’ motivation and intentions to support clients’ PA may be amenable to training or organizational changes. There is a clear need for increased understanding of the complexities of the legislation on duty-of-care, capacity, choice, risk and for care plans, which explicitly include physical activity and could impact upon care-givers supporting PA in adults with learning difficulties.