Feasibility and Effectiveness of the “321go!” Wellness Program for Adults With Down Syndrome

Abstract

Background: People with Down syndrome (DS) have a higher prevalence of chronic conditions such as obesity, diabetes, Alzheimer’s disease, and depression. Chromosomal and physiological differences may predispose individuals with DS to these conditions, but lifestyle factors play a role in prevention, mitigation, and treatment. Health education programs have been effective in improving health outcomes and increasing positive behaviors among people with intellectual disabilities. The aim of this study was to assess the feasibility and effectiveness of a wellness program for individuals with DS, the 321go! program

Methods: Based on the Social Cognitive Theory, the 321go! program is an eight-week wellness program for individuals with DS and their selected partner that encourages physical activity, healthy eating, and emotional wellness. This pilot study assessed the feasibility of the program by assessing reach, fidelity, dose delivered, dose received, and satisfaction. Effectiveness measures included knowledge, self-efficacy, social support, physical activity (PA) minutes, sleep, body mass index and self-reported health.

Results: Ten partner dyads enrolled and completed the program, attending an average of 6.95 sessions (SD = 0.87). The instructor adhered to the curriculum 88.1% (SD = 6.1) of the time and sessions lasted 94.9% (SD = 8.1) of the expected session time. Participants with and without DS engaged in program activities, completing nutrition handouts, emotional wellness journals, and goal trackers 75.0%, 76.8%, and 90.0% of the time, respectively. They received 5.85 (SD = 5.9) minutes of moderate to vigorous PA per session. All participants were satisfied with the program with 90% liking the program “a lot” and 10% liking the program “a little.” Participants with DS increased knowledge, self-efficacy, and social support compared to baseline with medium to large effect sizes of 1.12, 0.58, and 0.67, respectively. Mean daily light PA minutes and vigorous PA minutes increased, exerting small to medium effects of 0.24 and 0.55, respectively. Moderate PA minutes (effect size = -0.14) and sleep hours (effect size = -0.11). were unaffected. BMI reduced from 33.42 kg/m² (SD = 9.65) to 33.12 kg/m² (SD = 9.78), with an effect size of 0.54. Self-reported health was unchanged for 9 of the 10 participants.

Discussion: This pilot demonstrates that the 321go! program is a potentially feasible and effective model for programming for individuals with Down syndrome. A larger, experimental trial is needed to confirm these findings.