Self-determination and health promotion in adults with intellectual disabilities: A systematic review

Despite major improvements in the conceptual and functional approach of disability, some fundamental inequities remain. Among them, lacks in health access and health status are of importance both for research and public health policies. Particularly as regards intellectual disability (ID), in which major inequities remain and contrast with specific and sometimes increased somatic and mental health needs. In this context, health promotion initiatives designed for adult with intellectual disabilities should succeed to integrate several variables such as a holistic view of health, the importance of individual-environmental interaction, as well as the concept of self-determination. These variables have indeed been largely documented as key component in the field of ID. The purpose of this study is to analyse the available literature on health promotion for adults with ID as regards the integration of these variables, both in form and content. The results suggest several lacks in the conception of health promotion initiatives; such as an over-focus on individual abilities at the expense of environmental actions, and low consideration for the concept of global health or the volitional dimension of behaviours. Therefore, once more pointing the gap between knowledge and practice in the field of ID. Results are discussed in terms of future direction for research and clinical practice. (C) 2020 Association ALTER. Published by Elsevier Masson SAS. All rights reserved.