1. Accessible Health Zone: Promoting Healthy Lifestyles for People with Disabilities Randi Garber, Israel Unlimited Carmela Koresh-Avlagon, The National Insurance Institute Yossi Freier-Dror, Mashav Applied Research Yaara Assenheim-Stahl, Academic College at Wingate

2. Project Goals Providing skills and support systems for people with disabilities that will enable them to acquire lifelong healthful habits Developing health promotion leaders within the disability community Ensuring accessibility of universal health promotion programs and infrastructure for people with disabilities Building a knowledge base of evidence-based health promotion practices for people with disabilities

3. Project Components Interventions to promote healthy lifestyles among people with disabilities: –Peer-led Healthy Living Workshops (Oregon Institute on Disability; Center on Community Accessibility; Oregon Health and Science University) –Friends for Health Interventions to promote a supportive environment for healthy living: –Workshops for health and fitness professionals –Mapping of community resources

4. Research Methodology ToolsT1 (Pre)T2 (Post)T3 (Post +6 mos) Informed Consent Healthy Lifestyle Self-Efficacy Physical & Leisure Activity Nutrition Sleep Emotional Health Social Belonging & Participation Satisfaction from workshop In-depth interviews participants & professionals

5. Research Sample 17 workshops conducted in 3 zones 157 participants 70 pre/post pairwise June 2012-Feb 2014 Convenience Sample ZoneN Participants N pre/post pairwise Netanya6725 Ashdod4817 M. Haemek4228 Total15770

6. Self-efficacy in context of healthy lifestyle Quantitative Significant positive change in the areas of: Physical activity [d=0.29 p<.01] Nutrition [d=0.29 p<.05] General healthy lifestyle [d=0.35 p<.01]. Qualitative "I understood that I needed to take care of myself and not just others, to take care of my health. The minute I will be healthy emotionally, I will be able to give more to others. Now I know to keep my distance from situations that influence me the wrong way, such as being in the vicinity of smokers, or unhealthy food, I avoid these and it is much more pleasant. I know how to plan my day, set and attain realistic goals. The workshop gave me the opportunity to get to know people who are different."

7. Physical Activity Quantitative At this point: No significant change in frequency and amount of activity Significant change [d=0.26 p<.05] in satisfaction from amount of physical activity Qualitative "Sport has become part of my life. It helps my body more that the pills I previously took. Before the workshop, I did little physical activity, afterwards I invested more time and energy in it." "Through the workshop, I learned to love the activity I do – taking long walks. Beforehand, I had to force myself to do it, now I really enjoy it."

8. Nutrition Quantitative Significant positive change in: Interest and learning about nutrition [p<.001] Importance attached to nutrition [p<.01] Significant decrease drinking sweetened drinks [p<.05]. No other significant change in foods consumed. Qualitative The workshop helped strengthen the knowledge about the topic, to recognize the special characteristics, qualities and advantages of different foods. Following the workshop, there was a greater awareness to the choices available and how to adapt to individual need, to the specific disability, to the person. Participants expressed great interest to adhere and realize what was learned in the workshop – reducing salt intake and sweets, fried foods and snacks and many of the participants reported success in this area. Specifically, people with diabetes reported that the workshop helped them to balance their diet and produced positive outcomes accordingly such as weight reductions and a feeling of general well-being

9. Sleep Quantitative Significant positive change in: Quality of sleep reported [d=0.19, p<.05] Satisfaction regarding number of hours of sleep [d=0.26, p<.05] Qualitative

10. Emotional Status Quantitative Significant positive change [d=0.28, p<.05] in emotional status Qualitative I have greater self-confidence, ability to set and achieve goals, work on themselves, to think about others (not just myself), to see people with greater difficulties and how they deal with it, this encouraged me. The workshop strengthened my ability to communicate with others and understanding of social dynamics. There were many stories I identified with. It was fun to come to the meetings. I really loved the facilitators. I wrote an article for the local paper about the workshop. I can't wait for the next meeting. My soul is healthy – happier, this is a change from one extreme to the other.

11. Social Belonging Quantitative Significant positive change in feeling of social belonging [d=0.30 p<.05]. Qualitative "I meet friends more often, go to the theater and concerts. I prefer not to be at home, but to be active all the time". "I chose to contribute more time to volunteering." There is interest and newfound skills to pull other people into healthy lifestyle.

12. Satisfaction from Workshop

13. Workshop Quilt Being Healthy is Possible, Meaningful Activity, Connection, Participation, Consideration of Others