Empowering nutrition through graphic-style stories: CO-designing an acceptable and feasible community-based program with adults with intellectual and developmental disabilities and their caregivers

The National Institute for Minority Health and Health Disparities awarded the University of Cincinnati's Sponsored Research Services Division $202,500 on September 1, 2026, under the Minority Health and Health Disparities Research program (CFDA 93.307) to co-design and test a nutrition education program for adults with intellectual and developmental disabilities and their caregivers.

The funded research addresses poor dietary quality in adults with intellectual and developmental disabilities, who experience overweight and obesity at approximately two times the rate of the general population and face increased risks for chronic diseases. The recipient will iteratively co-design an engaging, narrative-based nutrition education program called "Empower Adults with IDD" in partnership with adults with mild intellectual and developmental disabilities, their caregivers, and community partners. The program will be tested for acceptability and feasibility at adult day service and community settings. The research will examine the program's preliminary efficacy on food and beverage consumption, food selectivity in adults with intellectual and developmental disabilities, and food literacy in their caregivers to promote healthy eating. The determinants assessment will include 45 dyads of participants and caregivers.

Performance will occur in Cincinnati, Ohio, with a period of performance from September 1, 2026, through February 29, 2028. The award is structured as a project grant, an assistance type supporting time-limited research activities.

Abstract

Adults with IDD often have poor dietary quality, characterized by high intake of refined carbohydrates, saturated FAT, sodium, and processed foods, along with insufficient intake of fruits and vegetables. In addition, food selectivity and a propensity to overeat contribute to poor eating patterns. This, in turn, is associated with a higher prevalence of overweight and obesity that is approximately two times higher than what is found in the general population. As a result, they encounter increased risks for chronic diseases. With too few resources specifically tailored for this uniquely vulnerable population, there is a critical need for an engaging and easy-to- implement community-based nutrition education program that targets both adults with IDD and their caregivers. Previous studies have demonstrated that narratives are engaging, memorable, and actionable in promoting healthy lifestyles in community settings, particularly in adults with lower health literacy levels, such as adults with IDD. Therefore, we will CO-design an innovative, theory-based nutrition education program, empower adults with IDD, in partnership with adults with IDD, their caregivers, and community partners. There are two specific aims: (1) to iteratively CO-design, empower adults with mild IDD, an engaging and easy-to- implement nutrition education program with adults with IDD, their caregivers, and community partners and to test its acceptability and feasibility at adscs, and (2) to determine the preliminary efficacy of empower adults with IDD on food and beverage consumption, and food selectivity in adults with IDD, and their caregivers' food literacy to promote healthy eating in adults with IDD. In order to examine aim 1 a determinants assessment will be conducted with 45 dyads of adults and their caregivers to inform the development of graphic style stories and other educational materials. Topics may include myplate food groups, portion control, incorporating fruits and vegetables into meals and snacks, water consumption, and alternatives to process foods in the context of interaction between adults with IDD and their caregivers. The iterative CO-designed graphic style stories and other educational materials will be tested for acceptability with 6 dyads and then 6- week short version of the program that incorporated those materials will be implemented for feasibility test with 10 dyads. After the revision based on the feedback through this process, the program will be finalized. To examine aim 2, the preliminary efficacy of the full 6-month program will be tested with 45 dyads on food consumption, food selectivity, motivation for healthy eating in adults with IDD and caregiver's food literacy using a one-group pre- and post-test design at three adscs, with baseline, 3-, 6-, and 9-month assessments. We expect that the program iteratively CO-designed with adults with IDD and their caregivers will be engaging and feasible to implement within community adult day service centers and improve food consumption of adults with IDD. If successful, the program will greatly impact the lives of countless adults with IDD and help them to ward off unnecessary chronic diseases caused by unhealthy eating habits with overall health and well-being.