A health advocacy intervention for adolescents with intellectual disability: a cluster randomized controlled trial

Abstract

Aim: Adolescents with intellectual disability experience poorer heath than their peers in the general population, partially due to communication barriers and knowledge gaps in their health history. This study aimed to test a health intervention package against usual care for a range of health promotion and disease detection outcomes. Method: A parallel-group cluster randomized controlled trial was conducted with Australian adolescents with intellectual disability living in the community. Randomization occurred at school level. The intervention package consisted of classroom-based health education, a hand-held personalized health record, and a health check. Evidence of health promotion, disease prevention, and case-finding activities were extracted from general practitioners' records for 12 months post-intervention. Results: Clinical data was available for 435 of 592 (73.5%) participants from 85 schools. Adolescents allocated to receive the health intervention were more likely to have their vision (odds ratio [OR] 3.3; 95% confidence interval [CI] 1.8–6.1) and hearing (OR 2.7; 95% CI 1.0–7.3) tested, their blood pressure checked (OR 2.4; 95% CI 1.6–3.7), and weight recorded (OR 4.8; 95% CI 3.1–7.6). There was no difference between health intervention and usual care for identification of new diseases. Interpretation: The school-based intervention package increased healthcare activity in adolescents with intellectual disability living in the community.