Community Supports for Adults with Intellectual Disabilities: Development of Nutrition Supports Scale

People with intellectual disabilities (ID) have higher prevalence of overweight and obesity compared to the general population with highest rates among people living in community settings. For people with ID, social support often comes from direct support professionals (DSPs) who are key in promoting sound nutrition and informed choice along with maintaining person's autonomy. Moreover, nutrition knowledge, training needs, barriers and supports to meal planning, food purchase and preparation among DSPs are not known. A paucity of information and lack of validated instruments exist concerning meal planning, food purchase, and preparation among DSPs who support people with ID living in community homes. Understanding the resources that are needed to support staff working in community homes can lead to greater understanding of how to improve dietary intake and subsequently decrease health disparities of people with ID who live in community settings. The purpose of this dissertation was to develop a reliable and valid measurement scale to evaluate nutrition supports needed among DSPs who provide services to individuals with ID residing in community homes. A three-phase exploratory mixed method design approach was used including focus groups, expert panel review, cognitive interviews, and a quantitative survey. Two hundred individuals (n=200) participated in the three phases of the study from five community based organizations in Illinois and New Mexico. The final Nutrition Supports Scale (NSS) consists of 45 items and six domains (Financial, Preparation and Storage, Knowledge, Cultural Values and Lifestyles, Organizational Culture, and Time). NSS meets psychometric criteria for reliability and construct validity using Factor Analysis and Rasch Analysis. Six domains had unidimensional psychometric properties and can be used independently. Understanding available nutrition supports among staff can lead to greater understanding of how to improve dietary intake and decrease health disparities of people with ID. This information may optimize staff training and workforce development by focusing only on the competencies and supports communicated through the Nutrition Supports Scale and in turn meet the Core Residential Community Competencies