The Gym Buds study: development and feasibility RCT of a peer-supported gym intervention for adults with intellectual disabilities

Abstract

Background: Adults with intellectual disabilities experience poorer health outcomes, lower life expectancy and very low levels of physical activity (PA) compared with the general population. Although research on PA promotion has increased, many interventions lack theoretical underpinning, demonstrate limited effectiveness and fail to consider the wider systems influencing behaviour. Consequently, there is a need for theory-informed, community-based interventions developed using established frameworks.

Aim: This doctoral study aimed to develop and test Gym Buds, a community gym-based exercise intervention for adults with intellectual disabilities, guided by the Medical Research Council framework for developing and evaluating complex interventions and underpinned by critical realism, behaviour change theory and systems theory.

Methods: A multi-phase mixed-methods design was employed. Intervention development involved a systematic review and qualitative research with key stakeholders to identify barriers and enablers to gym participation. A feasibility randomised controlled trial with process evaluation assessed recruitment, retention, intervention acceptability, fidelity, implementation and outcome measure feasibility.

Results: The systematic review identified limited evidence for effective community-based PA interventions and highlighted methodological weaknesses, limited theoretical underpinning and a lack of community gym-based programmes. Qualitative findings informed the development of Gym Buds, which combined community gym access, physical activity consultations and undergraduate student gym buddy support. Recruitment (70.6%) and participant retention (83.3%) were good. Most outcome measures were acceptable, although accelerometer compliance was lower (56.4%). No adverse events occurred. However, poor adherence to intervention sessions (42.9%), prescribed session duration (16.0%) and gym buddy retention (31.6%) indicated that refinements are required before a definitive trial.

Discussion: Gym Buds is the first theory-informed, peer-supported community gym intervention developed for adults with intellectual disabilities. The intervention demonstrated good feasibility and acceptability, although refinements to the intervention structure, implementation procedures and peer-support model are required before evaluating effectiveness in a fully powered randomised controlled trial.

Thesis is embargoed until 31 December 2028.

Date of Award	Dec 2026
Original language	English
Awarding Institution	Queen's University Belfast
Sponsors	Northern Ireland Department for the Economy & Queen's University Belfast
Supervisor	Lynne Marsh (Supervisor), Laurence Taggart (Supervisor) & Gary McDermott (Supervisor)