Rural Obesity Counseling for Adults Living With Intellectual and Developmental Disabilities Under the Medicaid Program

초록

Introduction: This study aims to compare the efficiency and outcomes in adults with obesity and intellectual and developmental disabilities in rural areas. Methods: Utilizing the administrative database of the rural health system and Nevada Medicaid (January 1, 2022 and December 31, 2024), 257 adults with obesity and with or without intellectual and developmental disabilities were identified. A propensity score was applied to match demographics and comorbidity conditions between subjects with and without intellectual and developmental disabilities. Logistic regression analysis was used to identify the factors associated with behavioral counseling for obesity. Results: Those with intellectual and developmental disabilities were less likely to have behavioral counseling for obesity than the non-intellectual and developmental disability cohort (16.9% vs 30.7%; OR=0.55; 95% CI=0.24, 0.89; p=0.03). Being aged 45-64 years, being female, having mental health conditions, and being telehealth users were associated with higher probabilities of receiving behavioral counseling for obesity. Conclusions: Primary care workforce training is warranted to reduce health disparities by integrating behavioral counseling for obesity among those with special care needs as well as those with limited access to care. AJPM Focus 2026;5(6):100530 .(c) 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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