Description: The Developmental Disability Health Initiative (DDHI) is a collaborative effort between UMKC-IHD and EITAS (Developmental Disability Services of Jackson County), and a number of community partners from the DD service, public health, and recreation fields. The overarching goal of this initiative is “to change policies and practices that improve nutrition and increase physical activity participation among people with DD in Jackson County.” The objectives for the DDHI are to: 1) identify barriers and assets to nutrition and physical activity and to recommend strategies for change designed to improve policies and practices at the organizational and broader systems levels; 2) Implement policy and practice changes within residential and day service providing agencies; and 3) Advocate for systems and community changes that support improved nutrition and physical activity by adults with developmental disabilities.


Project Contacts:             George Gotto, 816.235.5334, and Megan Steele, 816-235-6439,                                         

Project Period:                 2012-2015

Project Funding:              $41,583 (FY2014)

Funding Source:               Health Care Foundation of Greater Kansas City

Core Functions

Applied Research:  A comprehensive needs assessment was conducted in the first year. Using the results of the needs assessment, the Healthy Lifestyles Policy and Practice Review (HLPPR) Tool was developed. The tool is currently being tested with community service organizations that support people with IDD in residential and community settings.

Community Services and Supports: The institute faculty works closely with the project partners to develop and test materials.

Information Dissemination:Training and information materials are authored and disseminated. Additionally, a peer-reviewed article is currently under review.


Program Need and Historical Context

Environments have a major impact on health and practice of healthy behaviors. For adults with DD, research has shown that agencies providing residential and day services for adults with DD lack clear policies related to health promoting activities and do not adequately train or prepare staff to support healthy behaviors (Temple & Walkley, 2007; Frey et al., 2005). Research studies also indicate that negative support, discouragement, or being stopped by others are often barriers to physical activity for this group. These negative influences can reflect staffing constraints, protective responses, and personal preferences of people in support roles (Temple, 2009). Limits related to transportation, finances, accessibility, and inclusion in the community are also often-cited barriers to participation in health promotion for this population (Bodde & Seo, 2009).


Consumer and Community Involvement

The DDHI includes a Community of Practice (CoP) made up of 20 direct support organizations, parks and recreation organizations, and university partners. The purpose of the CoP is to create and test advocacy strategies that support implementation of the recommended policies and practices within these organizations. The diversity of viewpoints is a strength the group can use to forge new collaborations and find innovative solutions. The DDHI CoP will include a range of perspectives and models for supporting people with DD to make sustainable healthy lifestyle changes and choices.


Significant Project Activities and Outcomes

To date a total of 49 people who work at organizations that are participating in the DDHI have completed the Health Matters Assessment of Needs. The majority of these people (34, 70%) are from organizations that did not participate in the DDHI in Year 1. Preliminary results from the data show that those organizations that have participated in Years 1 and 2 are much more likely to offer health programs (13, 87%) than the organizations that have only participated in Year 2 (4, 12%). Those organizations that have participated in both years of the DDHI are also much more likely to have a wellness committee (11, 73%) than the organizations that began participating in Year 2 (1, 2.9%). Finally, the data demonstrate that the organizations that have participated in Years 1 and 2 of the DDHI are more likely to promote healthy eating (13, 86.7%) and exercise (10, 66.7%) using messaging in their building. The organizations that have only participated in Year 2 lack messaging that promotes healthy eating (5, 14.7%) and exercise (12, 35.3%). Five model sites from Year 1 made at least three changes in policy and practices after using the Policy and Practice Review Tool that was developed in that Year.  Five out the six model sites made (or are in progress and waiting for approval) policy changes/additions to expect healthy practices of staff in their work supporting people with disabilities.


Type of Change Site 1 Site 2 Site 3 Site 4 Site 5
Policy additions and/or changes X X In progress In progress X
Job Descriptions/staff evaluation include health promotion X
Training for staff: cooking, healthy meal planning X X X X X
Resource library X X X
Environmental Changes in office/company sponsored activities X X X X
Environmental changes in homes/programming X X n/a X X
Exercise increase-# of people and frequency (staff and people with disabilities) X X X X X


Institute’s Role

  • Co-facilitate strategic planning activities with participating organizations.
  • Lead needs assessment and evaluation activities
  • Serve as Liaison to community public health and recreation work group
  • Provide technical assistance and support the development of training and products.



The Healthy Lifestyles Policy and Practice Review (HLPPR) Tool will help community living support organizations to revise policies and practices that impact:  (a) social supports that promote healthy lifestyles (i.e., available for clients and employees, promotional messages, wellness committee); (b) physical activity of clients and employees; and (c) healthy food choices of clients and employees.