Health Promotion Across the Life Span for Special Olympics Athletes

Abstract

A life span approach to health promotion serves as a foundational strategy in Special Olympics programming for individuals with intellectual and developmental disabilities (IDD). This global approach integrates two key interventions—Young Athletes and fitness programming—to address barriers to health equity and promote healthy lifestyles for people with IDD. Evaluations demonstrate improvements in motor development and cardiovascular health. Success across programming highlights the use of scalable models to improve health outcomes for people with IDD. (Am J Public Health. 2026; 116(S2):S66–S69. https://doi.org/10.2105/AJPH.2026.308502)

Special Olympics (SO) health prioritizes prevention for people with intellectual and developmental disabilities (IDD), a term used to describe a range of conditions that are usually present (but often not detected) at birth and uniquely affect the trajectory of a person’s physical, intellectual, or emotional development.¹ This article describes the impact of two SO preventative health interventions, highlighting their public health significance and potential for global scalability.

INTERVENTION AND IMPLEMENTATION

Health promotion for individuals with IDD is a critical public health priority. People with IDD experience significant disparities in access to preventive care, health education, and wellness opportunities,² contributing to poorer health outcomes and reduced quality of life.³ SO addresses these inequities through an overarching health strategy that targets the needs of people with IDD through (1) prevention, (2) assessment, (3) training the health care workforce, and (4) health systems strengthening. Two core prevention interventions are Young Athletes (YA)—an early childhood play program—and structured fitness programming that promotes physical activity, nutrition, and hydration across the life span.

Young Athletes

Special Olympics Young Athletes introduces children aged two through seven years with and without IDD to foundational motor skills through play-based activities in schools, communities, and homes. Through use of the YA Activity Guide,⁴ implementation occurs across eight skill areas, from foundational skills to kicking. Within each skill area, activities are organized by difficulty and skill progression, in alignment with stages of motor development. YA implementation is intentionally flexible to accommodate diverse contexts across global SO Programs; however, core implementation includes a minimum of eight weeks, with children meeting in person one to three times per week for 30 to 45 minutes (Box 1).

BOX 1—

Special Olympics Young Athletes and Fitness Program Models

Young Athletes (YA) Implementation
YA 8-week lessons	Structured implementation of YA that includes 3 30-minute lessons to implement each week over a period of 8 weeks. This resource was recently updated to include both 8- and 30-week implementation models to better align with programming in schools.
YA Activity Guide	The YA Activity Guide provides all activities in the program and a structure for coaches to build their session or lesson plans for implementation over a minimum of 8 weeks, with the goal of completing skills 3 times per week. The Activity Guide allows parents and caregivers to replicate play at home when in-person activities are available only once or twice per week.
Special Olympics Fitness Models
SOfit	SOfit is an 8-week Unified program that pairs athletes with Unified partners and a coach to focus on 4 units: nutrition, daily physical activity, social wellness, and emotional wellness. SOfit coaches complete lessons based on the educational topics and tailor them to the interests, goals, and experience levels of the participants.
Unified Fitness Clubs	The Unified Fitness Club model brings together individuals with and without intellectual and developmental disabilities (IDD) for noncompetitive physical activity. The year-round program meets once per week in person or virtually, with participants engaging in a physical activity they choose, such as walking, dancing, cycling, or strength training. Participants are motivated to stay active throughout the week by tracking progress toward goals, typically with a pedometer or fitness tracker. Clubs and participants are recognized and rewarded for achieving goals or other fitness accomplishments.
Fit Families and Friends	Fit Families and Friends is a 6-week fitness challenge designed for individuals with IDD and their supporters. Small groups of families or peers compose teams that work toward a goal of engaging in physical activity for at least 30 minutes a day, 5 days per week. Each team member also creates a personal nutrition goal(s). Daily tracking and journal entries allow members to share their experiences as they make lifestyle changes. Participants earn incentives for completing the challenge to engage in a healthier lifestyle.

Fitness

SO fitness programming promotes active and healthy behaviors for people with IDD from school age to adulthood. Programming complements typical sports training to improve overall health. Fitness programming is implemented in community, school, and sport settings, both in person and virtually, and follows key implementation principles. Fitness programming is flexible to allow for variance across different contexts and settings; however, core implementation of structured fitness programming entails a minimum of six weeks; integrates education on physical activity, nutrition, and hydration; prioritizes behavior change; and supports people with IDD in engaging in physical activity consistent with global guidelines. SO has endorsed three fitness models that align with these guidelines to provide prescriptive implementation for fitness programming: SOfit, Unified Fitness Clubs, and Fit Families and Friends, which are further defined in Box 1. Additionally, the Fitness Implementation Guide was developed to support SO Programs in the implementation of these models.⁵

PLACE, TIME, AND PERSONS

SO’s preventive health interventions allow for the enhancement and adaptation of programming to meet local needs. The global reach of SO’s health promotion programming underscores its scalability and adaptability. Table 1 highlights the geographic reach, participation numbers, initiation dates, and target populations for YA and fitness programming.

TABLE 1—

Reach and Participation of Special Olympics Young Athletes and Fitness Programming

Intervention/Program	Where It’s Implemented	2024 Participation	Programming Start Date	Target Population
Young Athletes	In 123 countries and 42 US states; school, community, and home implementation	294 811 participants with and without IDD	2008	Children with and without IDD aged 2–7 years
Special Olympics Fitness	In 166 countries and 49 US states; school-, community-, and sport-based implementation	432 698 participants with IDD in any fitness programming	2016	Youths aged 8–21 years, adults, aging athletes

Note. IDD = intellectual and developmental disabilities.

PURPOSE

Early intervention is critical for young children with IDD to acquire skills important for optimal development. As people with IDD age into adulthood, providing continued opportunities for health promotion empowers them to lead healthier lives and reduce the burden of preventable disease. SO addresses health promotion for people with IDD through a coordinated, life span approach that includes YA and structured fitness programming.

EVALUATION

SO works cross-departmentally to design evaluations that guide how programming is delivered, assessed, and refined, including process and outcome evaluations to measure implementation quality, program effectiveness, and opportunities for improvement.

Young Athletes

Evaluations of YA have occurred since its inception in 2008, with the most robust noted here as they have informed recommendations for global implementation. The initial evaluation of YA was conducted with 233 children with IDD (aged 3–5 years) across 50 preschool classes in the United States.⁶ Children were randomly assigned to a control group or to the YA intervention, which consisted of 24 lessons delivered three times a week for eight weeks. SO used Hierarchical Linear Modeling, which indicated that children who participated in YA exhibited mean gains of seven to nine months on the Peabody Developmental Motor Scales, compared with three to five months for children not participating in YA. In 2014, SO conducted another evaluation in Kenya to understand the adaptability and feasibility of YA implementation in a global context.⁷ Eighteen children with IDD (aged 3–6 years) and their families participated in the intervention. SO used a pre–post design, and results indicated that there was significant improvement in motor skills over the eight-week period (t = 12.44; P < .001). Implementation and fidelity data indicated that YA could be adapted within the Kenyan context and implemented with a high level of fidelity.

Given these findings and reports by parents and teachers of perceived benefits on school readiness, social, and play skills,^6,7 SO conducted a larger evaluation to examine the impact of YA on the adaptive behavior skills of 5261 children across Pakistan, Thailand, India, and Bangladesh using a waitlist control design.⁸ Multilevel modeling with repeated measures at baseline, eight weeks, and 20 weeks indicated that participating children demonstrated greater gains in adaptive behavior skills eight and 20 weeks after the intervention began compared with children who had not yet participated.⁸ These results highlight the intervention’s effectiveness in promoting development across domains during critical growth periods in US and global contexts.

Fitness

An evaluation was conducted with 383 athletes (mean age = 26 years) across 22 global SO Programs to examine the impact of the three endorsed SO fitness models on cardiovascular disease risk as measured by weight, body mass index (BMI), and blood pressure.⁹ Results indicated no change in BMI from baseline to follow-up but significant decreases in blood pressure, especially for athletes deemed high risk for cardiovascular disease. When SO examined differences by fitness model, results indicated that for high-risk athletes there were statistically significant decreases in blood pressure across all models, and weight loss for athletes in Unified Fitness Clubs. This study points to the potential effectiveness of SO fitness programs in addressing chronic disease risk factors, particularly among high-risk athletes.

To address challenges in regularly collecting biometric data in community-based settings, SO developed the Lifestyle Survey, an assessment tool codeveloped and piloted with athletes and coaches to capture pre- and postprogram changes in core fitness elements, including physical activity, nutrition, and hydration. Although not yet published, Lifestyle Survey data help SO assess the perceived impact of fitness programming and inform continuous improvement efforts. Data from the 2024 survey show that self-reported general fitness significantly improved after programming (P = .0077; W = 1940.5), with 25% (95% confidence interval [CI] = 15.5%, 37.5%) of athletes reporting feeling more fit compared with 6% (95% CI = 1.7%, 14.6%) who felt worse.¹⁰ Similar positive shifts following programming were observed in physical activity habits, where 30% of participants reported greater engagement in physical activity during free time, 41% increased the number of days per week they performed moderate physical activity, and 41% increased the number of days per week they performed strength exercises. Hydration behaviors also improved, with 42% of athletes reporting better hydration practices. These results highlight the influence of fitness programming on health behaviors among participants.

Taken together, evaluation findings from YA and fitness underscore the importance of viewing prevention through a life span lens. Examining these interventions side by side demonstrates how early motor development and later health behavior change are interconnected and mutually reinforcing. This combined evidence shows that SO’s approach can be reliably implemented at a global scale. Because both interventions operate at low to no cost and integrate easily into existing systems, they fill a critical gap in accessible, sustainable health promotion. Evaluating them collectively offers insight into how coordinated prevention efforts can support health and participation from early childhood through adulthood.

SUSTAINABILITY

To ensure that the impact of YA and fitness programming is maintained and scaled globally, sustainability strategies are built directly into implementation. These strategies ensure that the interventions remain viable, effective, and adaptable over time. Key approaches and real-life examples include the following.

• Partnerships with governments. SO works with a ministry of education to integrate YA into the early childhood curricula, ensuring sustainable adoption and recurring budget support.

• Community engagement. A local community recreation center partners to host ongoing fitness programming and provides space, staffing, and local promotion, strengthening long-term ownership.

• Volunteer training. Educators in a school are trained by SO to deliver fitness programming independently.

• Digital technology. The YA app reaches families at home with programming, supporting expanded access and engagement.

PUBLIC HEALTH SIGNIFICANCE

SO’s YA and fitness interventions address the evolving health needs of individuals with IDD as they age, helping to reduce health disparities across communities. Embedding these programs within a life span approach lays the foundation for lifelong health and empowers individuals to navigate their health journey with greater confidence. Their inclusive design promotes physical and mental well-being while fostering key determinants of health, such as social participation. The scalability and global reach of these SO programs across diverse cultural and geographic contexts position them as replicable models for global public health efforts.

Through its health promotion interventions, SO champions for a more inclusive vision, one rooted in empowerment, equity, and opportunity for people with IDD. The integrated model of age-specific interventions and community partnerships offers an evidence-based framework for improving health outcomes. In doing so, SO sets a global standard for inclusive public health practice and long-term impact.