Term of Award

Spring 2018

Degree Name

Doctor of Public Health in Community Health Behavior and Education (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Digital Commons@Georgia Southern License


Jiann-Ping Hsu College of Public Health

Committee Chair

Ashley Walker

Committee Member 1

Gavin Colquitt

Committee Member 2

John Dobson

Committee Member 3

Robert Vogel

Committee Member 3 Email



Introduction: Research has shown that obesity among children and adolescents is disconcerting in the Southeast United States. Additionally, children and adolescents with intellectual and developmental disabilities especially those with DS have an exacerbated risk of obesity. Despite the elevated risk of obesity for this population, very few studies have investigated factors that influence healthy eating and engagement in physical activity among children and adolescents with DS. The purpose of this study was to identify facilitators and barriers concerning healthy eating and physical activity for adolescents with DS. Methods: Adolescents with DS along with their parents were recruited from a local DS group of the National Down Syndrome Society and a county school system. Thirteen parents completed surveys pertaining to the dietary, physical activity and social behaviors of their adolescents with DS. The body fat of all thirteen adolescents was assessed using skinfold measurements, bioelectrical impedance analysis and Body Mass Index. Twenty-five interviews with parents and their adolescents with DS aged 10-17 years took place. The theoretical framework was the Social Ecological Model. The World Health Organization International Classification of Functioning, Disability and Health for Children and Youth served as the conceptual framework for this study and acted as the coding guide. Results: Facilitators were engagement in physical activity with family, sports such as dance or cheer, parental management of diet and fitness, close relationships with health professionals and being physically active with peers. Barriers were competitive sports, low motivation to be physically active, multitasking, pain, food aversions, weight maintenance issues and parents not promoting fruit and vegetable consumption. Discussion: The results of this study depict facilitators and barriers to healthy eating and physical activity for adolescents with DS. Although the results are not generalizable, the information from this study can be used to develop and implement tailored programs to better assist adolescents with DS and their families in combatting obesity and meeting the special needs of this population.

Research Data and Supplementary Material