Innovative approaches to health promotion for people with intellectual disabilities in Hamburg

People with intellectual disabilities (PwID) are a vulnerable group facing health inequalities. Their access to healthcare is limited, morbidity and mortality rates are higher compared to the general population. Limited knowledge about health, combined with low health literacy, often makes it difficult to find, understand, evaluate and apply health information. In Germany there are few health promoting services tailored to PwID, easy-to-understand information is rare. The project BESSER gesund leben by the Evangelische Stiftung Alsterdorf and partners (2022-2025) aimed to improve the individual health situation, resilience and health-related quality of life of PwID through social participation in services for disease prevention and health promotion. Health experts supported over 250 PwID in Hamburg in developing and implementing individual health plans. Over a 12-month period they advised and supported them in health promoting and coordinated their healthcare process. They also analysed prevention and health promotion services with regard to their accessibility and inclusivity, initiated new specific group formats and established cross-sectoral and interdisciplinary networks. The intervention was accompanied by a multi-method evaluation, including inclusive research. An innovative approach has been developed, helping to bridge a gap in the healthcare system. The access to health services has improved, services are being used more effectively. A clinically relevant impact on their health status has been demonstrated. The follow-up project BESSER Plus (01/2026-12/2028) is now further examining the impact on health literacy. In addition to individual support to identify health issues and resources, it also involves designing and delivering training for peer educators. The project aims to integrate the approach into existing healthcare structures in Hamburg and develop a roadmap for introducing the approach into standard healthcare that can be implemented nationwide.

Key messages

• The project is aimed at a particulary vulnerable group. It promotes the development of accessible, inclusive structures and paves the way for greater equity in the healthcare sector.

• Through personalised support by health experts, the specific needs of PwID can be identified and addressed. This helps to promote participation, self-determination, self-efficacy and improve health.