Challenges are a promising approach to increase physical activity among population groups. Special Olympics (SO), a global organization providing sports training and competition for individuals with intellectual disabilities (ID), uses challenges to motivate and engage their athletes in physical activity. An understanding of feasibility and implementation of challenges for people with ID is warranted considering the physical activity disparities of this population. PURPOSE: To evaluate the reach, dose, satisfaction, and context of the 2022 SO USA Games Fitness Challenge. METHODS: A 20-week national step challenge was delivered leading up to competition. Participants were challenged to achieve 1,000,000 steps. Behavior-change tools included: self-monitoring via wearable device, tracking with SO FitNow app, performance-based rewards, reinforcement, health education, and leader board comparison. Planning documents and SO FitNow app account information were analyzed to examine reach and dose. Satisfaction and context were examined via post-challenge surveys to athletes and SO Program. RESULTS: Based on needs communicated by local Programs, SO distributed 5,118 app licenses and 3,892 wearable devices. A total of 2,716 individuals (i.e., athletes, Unified partners, coaches, family members) activated their app license, and of those, 1,693 connected a wearable device. In total, 2,230 individuals from 55 SO Programs participated, including 1,440 athletes with ID. Among athletes that connected a wearable device, 58.2% maintained participation to week 20. Weekly health education emails were opened 70% of the time. Survey results indicate that 77% of athletes liked the challenge “a lot” and 89% would participate in another challenge. Technology distribution and uptake impeded participation with 14% of SO Programs reporting they were unable to distribute devices to all athletes, and 24% of athletes reporting they “always” needed help to use the app. CONCLUSIONS: SO Program capacity and athletes’ limited understanding of technology were barriers to implementation. However, athletes who participated were satisfied and adhered to the 20-week challenge. Findings may inform future fitness challenges for individuals with ID.

Background: People with intellectual disabilities (ID) have high prevalence of cardiovascular disease (CVD) risk factors; yet, few behavioral health interventions are designed and implemented for people with ID. Objective: This study examined Special Olympics Inc. (SOI) fitness models as a potential intervention to reduce CVD risk in people with ID. Methods: Data from SOI fitness models implemented in 2016-2018 were assessed. Special Olympics Programs received funding, resources, and technical assistance from SOI to conduct fitness models centered on inclusive physical activity and goal setting. Weight, body mass index, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured at baseline and 4-12 weeks into the model. Multi-level multivariable quintile linear regression assessed change. Results: 383 participants with ID (athletes) and 281 partners without ID met inclusion criteria. Mean weight loss among athletes was 0.67 kg and 132 (31.9%) lost >= 1 kg. Blood pressure decreased in SBP quintile 4 (-7.52mm Hg, 95% confidence interval [CI]: 11.8, -4.0), SBP quintile 5 (-9.52mm Hg, 95% CI: 13.5, -5.6), and DBP quintile 5 (-7.49mm Hg, 95% CI: 13.1, -1.9). Partners had similar results. Strongest effects were in a 'high-risk' group that was in the quintile 4 or 5 in all baseline measures. Conclusion: In fitness models developed to improve fitness for people with ID, there was a reduction in weight and blood pressure. SOI fitness models show promise and potential as a health intervention. This work enables further examination of indicators for successful implementation and evaluation of health. (c) 2019 Elsevier Inc. All rights reserved.

PURPOSE: People with intellectual disabilities (ID) are at greater risk of obesity, diabetes, and cardiovascular disease compared to typically developing peers. People with ID face disparity and lack access to many healthcare services so community-based fitness and physical activity interventions can be crucial ways to improve health in this population at high risk. Yet, most fitness interventions are not designed for people with intellectual disabilities (ID), often due to cost, accessibility, and literacy level. Special Olympics Inc. (SOI), a leading non-profit sports organization for people with ID, has made it a priority to improve health in the ID population through increasing fitness and physical activity. METHODS: This case study describes the process of developing and implementing fitness models for people with ID. Special Olympics Inc. (SOI) assessed fitness activities being done in local Special Olympics Programs (SO Programs) for effectiveness, feasibility, replicability, and scalability. Then, SO Programs were funded to continue fitness activities and collect data. SOI endorsed three of these ‘fitness models’ that showed most promise. SOI then funded other SO Programs to implement the models between 2016-2018. The results from that implementation is assessed. RESULTS: 5481 individuals from 75 SO Programs in 48 countries participated. Key components of fitness models were group fitness sessions, including participants without ID, goal setting, and incentives. Over 90% of SO Programs collected baseline systolic and diastolic blood pressure in >80% of participants. Programs were less likely to have >80% completed baseline data for weight (76.7% of programs), height (75.0%), and BMI (75.0%). For those that started in 2016, >99% had data from two time points. In 2017, 88.8% had two data time points or more and in 2018 70.1% had data from 2 or more time points. SO Programs reported participants were empowered and were motivated by the incentives. Getting buy in from participants families and the community greatly improved the implementation. However, data collection issues were common. CONCLUSION: Based on the ability to enroll participants, collect data, and implement the activities, SOI fitness models may be a feasible fitness intervention for people with ID. Supported by CDC Grant U27 DD001156.