Multi-level factors associated with the sedentary behavior of adults with intellectual disabilities in community living arrangements

Background: Sedentary Behavior (SB) is an independent risk factor for cardiometabolic diseases and mortality. Adults with intellectual disabilities (ID) that live in Community Living Arrangements (CLAs) participate in higher SB, however the factors associated with SB are unknown in this group. Objective: The cross-sectional study investigated the multi-level determinants related to SB among adults with ID in community living arrangements (CLAs). Methods: Adults with ID who lived in CLAs wore an activPAL device for seven days so that SB could be estimated. Prolonged SB and total SB duration served as the outcome variables. Electronic surveys assessed factors across the levels of the social-ecological model. Bivariate analyses estimated the association between each of the independent variables with each of the SB outcomes followed by a multivariable analysis using Least Absolute Shrinkage and Selection Operator (LASSO) regressions for both prolonged SB and total SB duration. Results: Study participants (n = 36) had a mean age of 44.1 years (SD = 15.01), were predominantly male (58.33 %) and White (83.33 %). Nearly half (n = 16; 47.22 %) exhibited prolonged SB, spending on average 7.46 h (SD = 2.23) in SB daily. The LASSO regression identified higher independence in activities of daily living (ADL) and low levels of staff conflict as being associated with lower total SB duration and less likelihood of prolonged SB. Conclusion: Our findings underscore the influence of multi-level factors on SB in adults with ID. These data suggest that interventions to reduce SB should consider not just individual traits but also the broader social and environmental contexts.