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Fostering Healthy Relationships in Special Olympic Athletes: Supporting the Intersection of Intellectual Disability and Sexual Health

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Title: Fostering Healthy Relationships in Special Olympic Athletes: Supporting the Intersection of Intellectual Disability and Sexual Health
Language: English
Authors: Stephanie Andreasen, Tessa Allison, Brennah Kamelchuk, Victoria Formusa, Brock Reissner, Stephanie Howe (ORCID 0000-0001-8950-099X), Janet McCabe, Alan S. Martino, Carly A. McMorris
Source: Journal of Applied Research in Intellectual Disabilities. 2025 38(2).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 12
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Descriptors: Intellectual Disability, Athletics, Athletes, Sexuality, Health Behavior, Intimacy, Sex Education, Interpersonal Relationship, Barriers, Foreign Countries
Geographic Terms: Canada
DOI: 10.1111/jar.70032
ISSN: 1360-2322
1468-3148
Abstract: Background: People with intellectual disabilities have equal rights to explore their sexuality and access sexual and reproductive healthcare, yet little is known about their needs and wants when accessing health education. The current study sought to learn about the sexual health interests, attitudes, and educational needs of Special Olympics (SO) athletes. Methods: Thirteen participants completed a questionnaire and a 45-min interview, including SO athletes, coaches and caregivers of SO athletes. Results: Survey responses indicated the importance of access to sexual health education, but significant barriers were noted. Thematic analysis of interview transcripts highlighted the importance of healthy relationships, inequalities in learning, and need for information to promote safety. Conclusions: Findings add to existing evidence that people with intellectual disabilities value healthy relationships and want to learn more about sexual health. Several recommendations are offered to increase the effectiveness of sexual health education.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1468745
Database: ERIC
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  Value: <anid>AN0184768026;e0301mar.25;2025Apr29.07:57;v2.2.500</anid> <title id="AN0184768026-1">Fostering Healthy Relationships in Special Olympic Athletes: Supporting the Intersection of Intellectual Disability and Sexual Health </title> <sbt id="AN0184768026-2">Summary</sbt> <p>Background: People with intellectual disabilities have equal rights to explore their sexuality and access sexual and reproductive healthcare, yet little is known about their needs and wants when accessing health education. The current study sought to learn about the sexual health interests, attitudes, and educational needs of Special Olympics (SO) athletes. Methods: Thirteen participants completed a questionnaire and a 45‐min interview, including SO athletes, coaches and caregivers of SO athletes. Results: Survey responses indicated the importance of access to sexual health education, but significant barriers were noted. Thematic analysis of interview transcripts highlighted the importance of healthy relationships, inequalities in learning, and need for information to promote safety. Conclusions: Findings add to existing evidence that people with intellectual disabilities value healthy relationships and want to learn more about sexual health. Several recommendations are offered to increase the effectiveness of sexual health education.</p> <p></p> <ulist> <item> People with intellectual disabilities have equal rights to sexual health care, but we don't know very much about what they need or want when accessing this information.</item> <p></p> <item> We interviewed thirteen Special Olympics (SO) participants, including athletes, coaches, and caregivers of SO athletes about what they think of sexual health and healthy relationships education for SO athletes.</item> <p></p> <item> We found that athletes value access to sexual health education but still face many challenges. Participants thought healthy relationships were important as well as getting more information to help with safety.</item> <p></p> <item> We recommend that sexual health education be made more accessible for people with intellectual disabilities.</item> </ulist> <hd id="AN0184768026-3">Introduction</hd> <p>The Convention of the Rights of Persons with Disabilities (CRPD) stresses that sexual health, safety in relationships, and meaningful social and intimate relationships are recognised rights for people with disabilities (United Nations [<reflink idref="bib39" id="ref1">39</reflink>]). That is, everyone, including individuals with intellectual disabilities, has the right to experience sexuality in a positive and pleasurable way. Despite ongoing efforts, there has been limited progress in supporting individuals with intellectual disabilities in building and sustaining intimate and personal relationships, including having sex and getting married (Borawska‐Charko et al. [<reflink idref="bib3" id="ref2">3</reflink>]; Eastgate [<reflink idref="bib13" id="ref3">13</reflink>]). One potential contributor to this lack of progress is the high degree of variability in the levels of sexual health knowledge of people with intellectual disabilities, who report a range of knowledge gaps compared to people without intellectual disabilities (Baines et al. [<reflink idref="bib2" id="ref4">2</reflink>]). Learning and understanding sexual health information is important for promoting healthy relationships, reducing risky behaviours, maintaining good sexual health, and enabling people to access needed services and make informed decisions about their sexual behaviours and practices (American Academy of Pediatrics [<reflink idref="bib1" id="ref5">1</reflink>]; Uzdavines et al. [<reflink idref="bib40" id="ref6">40</reflink>]). People with intellectual disabilities not only have lower levels of knowledge about sex compared to those without intellectual disabilities but may also hold negative views toward sex as a result of this limited access to information (Baines et al. [<reflink idref="bib2" id="ref7">2</reflink>]). While individuals with intellectual disabilities have similar sexual interests and expectations about intimate relationships and are as sexually active as people without disabilities (de Wit et al. [<reflink idref="bib12" id="ref8">12</reflink>]), they are less informed about relationships and sexuality than their peers without disabilities.</p> <p>People with intellectual disabilities have highly variable levels of sexual knowledge, but relative to their peers without disabilities, they have a range of gaps in their understanding (Treacy et al. [<reflink idref="bib38" id="ref9">38</reflink>]). In a recent narrative scoping review, Borawska‐Charko et al. ([<reflink idref="bib3" id="ref10">3</reflink>]) described the existing literature on the level of sexual health knowledge of people with intellectual disabilities. Overall, the topic of body parts and physical characteristics were best understood, with birth knowledge, contraception, and sexual trasnmited infections (STIs)s the most lacking, especially related to HIV/AIDS (Borawska‐Charko et al. [<reflink idref="bib3" id="ref11">3</reflink>]). Early research demonstrated inconsistent findings regarding the level of knowledge of individuals with intellectual disabilities related to pregnancy, masturbation and menstruation (Galea et al. [<reflink idref="bib15" id="ref12">15</reflink>]; Garwood and McCabe [<reflink idref="bib16" id="ref13">16</reflink>]). Emerging evidence highlights that neither age nor gender seems to impact the level of knowledge; however, problems with communication and limited reading ability might be associated with limited knowledge (Borawska‐Charko et al. [<reflink idref="bib3" id="ref14">3</reflink>]; Houtrow et al. [<reflink idref="bib22" id="ref15">22</reflink>]). Moreover, it is unclear if previous sexual experience is associated with sexual knowledge.</p> <p>This variable knowledge may be attributed to the fact that people with intellectual disabilities are often left out of the conversation when it comes to sexual health, both intentionally and unintentionally. It is common for healthcare professionals, caregivers, family and peers to assume people with intellectual disabilities do not require sexual health knowledge, since they are commonly seen as childlike or are oversexualized (Eastgate [<reflink idref="bib13" id="ref16">13</reflink>]). Misperceptions about sexual health and intellectual disability commonly lead people to believe that these individuals should not engage in intimate relationships, or that such relationships are against the law (Eastgate [<reflink idref="bib13" id="ref17">13</reflink>]; Meer and Combrinck [<reflink idref="bib27" id="ref18">27</reflink>]). Even though frontline staff, caregivers, and professionals are starting to believe that sex education is essential for people with intellectual disabilities, many of them experience ambivalence or anxiety about discussing the topic of sexuality and relationships (de Reus et al. [<reflink idref="bib11" id="ref19">11</reflink>]; Eastgate [<reflink idref="bib13" id="ref20">13</reflink>]; Rohleder [<reflink idref="bib32" id="ref21">32</reflink>]). Sexual health education that is offered by frontline staff is usually taught reactively, or in response to a problem, rather than proactively to support individuals with an intellectual disability (Colarossi et al. [<reflink idref="bib9" id="ref22">9</reflink>]). Frontline caregiving staff often report being worried about causing harm or believe that providing sexual education will lead to inappropriate sexual behaviour (Borawska‐Charko et al. [<reflink idref="bib3" id="ref23">3</reflink>]). Caregiving staff and family tend to encourage friendship instead of sexual relationships, and staff members may feel under pressure to limit the sexual expression of their clients (de Wit et al. [<reflink idref="bib12" id="ref24">12</reflink>]). Educators and teachers, as well as clinicians, often report a lack of training on sexuality and the sexual development of people with intellectual disabilities and feel inadequately trained for such conversations or handling of sexual assault disclosures (Christian et al. [<reflink idref="bib8" id="ref25">8</reflink>]). Parents of people with intellectual disabilities have been found to be resistant to discussing sex with their child, for fear of negative consequences (i.e., an increase in sexual behaviours), fear of not being able to answer questions, or feeling uncomfortable with the content (Pownall et al. [<reflink idref="bib30" id="ref26">30</reflink>]), and this may influence the ability of healthcare providers to share information with clients (McCabe and Holmes [<reflink idref="bib25" id="ref27">25</reflink>]). In a recent systematic review of the sexual health needs of women with intellectual disabilities, Matin et al. ([<reflink idref="bib24" id="ref28">24</reflink>]) highlight the need for tailored sexual education that fosters the attainment of knowledge that is needed to form relationships, understand sexual and romantic relationships, and practice safe sex.</p> <p>There is a significant and substantial increase in sexual knowledge in people with intellectual disabilities after receiving sexual education (Garwood and McCabe [<reflink idref="bib16" id="ref29">16</reflink>]; Gutiérrez‐Bermejo et al. [<reflink idref="bib18" id="ref30">18</reflink>]; Sala et al. [<reflink idref="bib33" id="ref31">33</reflink>]). While some researchers suggest that the effects of receiving sex education may be short term (O'Callaghan and Murphy [<reflink idref="bib28" id="ref32">28</reflink>]), others have demonstrated increases in knowledge after taking part in training and on follow‐up (e.g., 3 weeks to 12 months following the intervention) (Penny and Chataway [<reflink idref="bib29" id="ref33">29</reflink>]). In their seminal paper, Penny and Chataway ([<reflink idref="bib29" id="ref34">29</reflink>]) found that levels of knowledge continued to increase following the completion of the sexual education, despite no intervention being present. These authors attribute this to informal learning occurring among people who participated in the intervention. Emerging evidence demonstrates that sexual education can improve knowledge for people with intellectual disabilities (Sala et al. [<reflink idref="bib33" id="ref35">33</reflink>]); however, some researchers and clinicians have highlighted the importance of having opportunities to practise those skills in real‐life situations for long‐term impact (Davies et al. [<reflink idref="bib10" id="ref36">10</reflink>]).</p> <p>While plenty of research has been conducted on the vulnerability of people with intellectual disabilities, little is known about the needs, wants and challenges faced by these individuals in accessing information about their sexual health (Baines et al. [<reflink idref="bib2" id="ref37">2</reflink>]). Sexual health clinics are rarely equipped with the appropriate resources to provide services such as STI testing, family planning and sexual health education to people with intellectual disabilities (Greenwood and Wilkinson [<reflink idref="bib17" id="ref38">17</reflink>]; Höglund and Larsson [<reflink idref="bib20" id="ref39">20</reflink>]). Moreover, existing sexual health resources are not designed with the intended use by individuals with intellectual disabilities, and rarely consider design and delivery factors that may impact accessibility (Terras et al. [<reflink idref="bib36" id="ref40">36</reflink>]). To date, little is known about the degree to which individuals with intellectual disabilities value sexual health information, about their experiences navigating these barriers, and suggestions for how to improve the accessibility of sexual health services and resources. Furthermore, there is little evidence as to where healthcare and education systems are failing to protect the sexual health rights of these individuals, and how these may be improved. It is well established that sexual health knowledge creates greater capacity to protect oneself from harm, such as sexual abuse and dating‐related violence, in which people with intellectual disabilities are at heightened risk of experiencing (Tomsa et al. [<reflink idref="bib37" id="ref41">37</reflink>]), and also one's ability to recognise sexual boundaries and expectations to thrive in society.</p> <hd id="AN0184768026-4">Present Study</hd> <p>This study addressed the gaps in knowledge surrounding the attitudes, needs and wants for information about their sexual health and barriers to accessibility for people with intellectual disabilities. We examined the sexual health interest levels, attitudes and education needs of Special Olympics (SO) athletes, one of the largest international organisations that aims to enrich the lives of individuals with intellectual disabilities through sport and health education (Special Olympics Canada, n.d.). Using both quantitative and qualitative measures with SO athletes, coaches and caregivers, the current project: (<reflink idref="bib1" id="ref42">1</reflink>) determined the degree of interest in learning more about their sexual health and what topic areas were most relevant; (<reflink idref="bib2" id="ref43">2</reflink>) identified existing barriers and systemic issues to accessing sexual health education; and (<reflink idref="bib3" id="ref44">3</reflink>) gathered recommendations for what approaches would be best for learning about sexual health and healthy relationships. Identifying the sexual health attitudes, needs, and wants of SO athletes can inform SO programming efforts, as well as sexual health education initiatives for the broader population of people with intellectual disabilities.</p> <hd id="AN0184768026-5">Methods</hd> <p></p> <hd id="AN0184768026-6">Recruitment</hd> <p>Current Canadian SO athletes and their caregivers and coaches were recruited for the current study. It was advertised using a flyer posted on the research team's website and social media platforms for 2 months. The flyers were also sent to some individual SO Canadian Chapters to forward to athletes, coaches, and caregivers in their respective regions. Further, members of the research team individually emailed SO athletes, coaches, and caregivers who had previously participated in other research studies in the lab and consented to being contacted for future research.</p> <hd id="AN0184768026-7">Participants</hd> <p>All participants over the age of 18 years were eligible to participate if they were a current coaches or athletes for a SO Canadian Chapter or caregivers of an SO athlete registered in a Canadian Chapter. Consistent with guidelines of SO participation, no formal documentation of intellectual disability was required for athlete participation, nor were there any requirements surrounding the number of years coaching or caregiving.</p> <p>A total of 13 individuals participated in the study: eight athletes, three coaches, and three caregivers. Athletes ranged in age from 22 to 58 years (<emph>M</emph> = 35.9, SD = 13.3); coaches ranged in age from 29 to 64 years (<emph>M</emph> = 45, SD = 9.2); and caregivers ranged in age from 52 to 55 years (<emph>M</emph> = 53.5, SD = 2.1). Six athletes identified as female (two identified as male), two coaches identified as female (one identified as male), and all three caregivers identified as female. No participants identified as nonbinary or transgender. Additional demographic information is included in Table 1.</p> <p>1 TABLE Participant demographics from Special Olympics athletes, coaches and caregivers.</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center">Athletes</th><th align="center">Coaches</th><th align="center">Caregivers</th></tr><tr><th align="center"><italic>M</italic> (SD, range)</th><th align="center"><italic>n</italic></th><th align="center"><italic>M</italic> (SD, range)</th><th align="center"><italic>n</italic></th><th align="center"><italic>M</italic> (SD, range)</th><th align="center"><italic>n</italic></th></tr></thead><tbody valign="top"><tr><td align="left">Total number of participants</td><td align="center" /><td align="center">8</td><td align="center" /><td align="center">3</td><td align="center" /><td align="center">2</td></tr><tr><td align="left">Age (years)</td><td align="center">33.25 (14.3, 15–58)</td><td align="center" /><td align="center">45 (9.2, 29–64)</td><td align="center" /><td align="center">53.5 (2.1, 52–61)</td><td align="center" /></tr><tr><td align="left">Gender identified</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /></tr><tr><td align="left">Male</td><td align="center" /><td align="center">2</td><td align="center" /><td align="center">1</td><td align="center" /><td align="center">0</td></tr><tr><td align="left">Female</td><td align="center" /><td align="center">6</td><td align="center" /><td align="center">2</td><td align="center" /><td align="center">2</td></tr><tr><td align="left">Non‐binary/other</td><td align="center" /><td align="center">0</td><td align="center" /><td align="center">0</td><td align="center" /><td align="center" /></tr><tr><td align="left">Ethnicity</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /></tr><tr><td align="left">White or European Canadian</td><td align="center" /><td align="center">8</td><td align="center" /><td align="center">3</td><td align="center" /><td align="center">2</td></tr><tr><td align="left">Born in Canada</td><td align="center" /><td align="center">8</td><td align="center" /><td align="center">3</td><td align="center" /><td align="center">2</td></tr><tr><td align="left">Years involved with SO</td><td align="center">11.8 (7.5, 2–26)<xref ref-type="fn" rid="tfn1" /></td><td align="center" /><td align="center">10 (1.4, 6–16)</td><td align="center" /><td align="center">9 (1.4, 8–15)</td><td align="center" /></tr><tr><td align="left">Level of education</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /></tr><tr><td align="left">Some college/university</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center">1</td></tr><tr><td align="left">University undergraduate degree</td><td align="center" /><td align="center" /><td align="center" /><td align="center">1</td><td align="center" /><td align="center">1</td></tr><tr><td align="left">Master's degree</td><td align="center" /><td align="center" /><td align="center" /><td align="center">2</td><td align="center" /><td align="center" /></tr><tr><td align="left">Average household income</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /></tr><tr><td align="left">$50,000–$75,000</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center">2</td></tr><tr><td align="left">$100,000 and over</td><td align="center" /><td align="center" /><td align="center" /><td align="center">2</td><td align="center" /><td align="center" /></tr><tr><td align="left">Prefer not to say</td><td align="center" /><td align="center" /><td align="center" /><td align="center">1</td><td align="center" /><td align="center" /></tr><tr><td align="left">Family status</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /></tr><tr><td align="left">Single‐parent family</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center">1</td></tr><tr><td align="left">Two‐parent family</td><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center" /><td align="center">1</td></tr></tbody></table> </ephtml> </p> <p>1 a <emph>n</emph> = 12, one athlete did not complete the questionnaire.</p> <p>2 <emph>M</emph> = mean, SD = standard deviation.</p> <hd id="AN0184768026-8">Procedure</hd> <p>The current study was approved by the Conjoint Faculties Research Ethics Board at the University of Calgary (Alberta, Canada; REB23‐1413). Interested participants were contacted by the research team via email or phone to first determine eligibility. Eligible participants were then sent the online consent/assent forms, along with a demographic questionnaire and a brief sexual health education survey. After participants completed the online forms and questionnaires, they were contacted by the research team, and a virtual interview was scheduled at a time that was most convenient for the participant.</p> <hd id="AN0184768026-9">Consent</hd> <p>Individuals interested in participating in the study were provided email links to online consent and assent forms, as well as a demographics questionnaire, all available through Qualtrics survey software. To consent, participants had to be 18 years of age or older and exhibit an understanding of the potential risks and benefits of participation, as well as the purpose of the study. Athletes without the capacity to consent who wanted to participate with a caregiver present were provided with assent forms, and caregivers were asked to complete consent forms on behalf of the athlete. Once participants had completed the appropriate consent, assent, and demographic questionnaire forms, research team members scheduled a time for a virtual Zoom interview intended to last 45–60 min.</p> <hd id="AN0184768026-10">Demographic Questionnaire</hd> <p>Participants were asked to provide their age, self‐identification of gender, and racial identity. Participants were also asked about the number of years they have been participating in SO and the SO activities in which they participate as well as whether they were currently in a romantic relationship. For SO coaches and caregivers, their highest level of education was included, as well as household income and family structure for caregivers.</p> <hd id="AN0184768026-11">Sexual Health Education Questionnaire</hd> <p>Next, participants were asked to complete a questionnaire about physical, mental, and sexual health, and healthy relationships. Athletes were reminded they could ask a caregiver or a member of the research team for support with completing the survey. Athletes were asked to provide information about their past experiences learning to care for their physical, mental, and sexual health, from whom or where they learned this information, and comfort levels discussing sexual health. Athletes were asked to provide ratings on a four‐point Likert‐type scales (response options ranged from '<emph>Not important</emph>' to '<emph>Very important</emph>') about their perceived importance of learning about sexual health, interest levels in learning more ('<emph>Yes</emph>', '<emph>No</emph>' or '<emph>Maybe</emph>'), and an open‐ended response for the most effective ways they learn (e.g., conversation, workshop, one‐on‐one). SO coaches and caregivers were asked similar questions on Likert‐type rating scales, such as how much sexual health education they believe SO athletes currently have, their perceptions of the importance of athletes learning about sexual health, possible topics of interest for athletes, and the most effective ways athletes learn.</p> <hd id="AN0184768026-12">Interviews</hd> <p>Athletes, coaches, and caregivers participated in online interviews using Zoom. Two members of the research team were present in each interview with the participant, with one team member leading the interview by asking questions, and the other there for support in the case of technical issues or disclosure of sensitive information. Athletes with the ability to consent were given the choice to have a caregiver present for support, while athletes without the capacity to consent were required to have a caregiver present during the entirety of the interview. Two athletes had caregivers attend their interview with them, while six athletes attended independently. Each interview started with the research team member leading the interview confirming the athlete's ongoing assent or consent to participate. Researchers asked questions from a predetermined and preapproved interview guide that was developed in partnership with SO staff and experts in the field of sexual health in people with intellectual disabilities, specific to participant type (see Supporting Information). Questions were similar across interview guides for athletes, caregivers and coaches, with minor wording changes to athlete questions to ensure accessibility of language. Interviewers were also trained in interview skills to ensure participants understood the questions and felt comfortable participating in the interview. Interview guides were provided prior to the interview to help participants familiarise themselves with the questions. The interview guides included questions to learn about the participant and build rapport, identify knowledge gaps and needs, and how to best support athletes learning about sexual health and healthy relationships. After the interviews, participants were provided with a digital gift card worth $25 as compensation for their time and participation.</p> <hd id="AN0184768026-13">Data Analysis</hd> <p>Participant demographics and responses to the sexual health education questionnaire were outlined using descriptive statistics (e.g., mean, standard deviation, range, frequency). Virtual Zoom interviews were audio recorded, uploaded to a secure OneDrive folder, and transcribed verbatim. Transcripts were analysed using reflexive thematic analysis (Braun and Clarke [<reflink idref="bib4" id="ref45">4</reflink>]). Coding was conducted by two authors (S.A. and B.K.), and final theme development was completed by the lead author (S.A.). One of the lead authors who conducted the qualitative analysis has significant experience supporting children and adults with intellectual disabilities and their families, primarily as a support worker and advocate, and more recently in the role of a researcher.</p> <hd id="AN0184768026-14">Results</hd> <p></p> <hd id="AN0184768026-15">Sexual Health Education Questionnaire</hd> <p>When asked about the importance of sexual health, 8 of the 13 participants who completed the survey indicated that they believed it is important for athletes to learn about sexual health, and the other three indicated that it is somewhat important (Figure 1). Similarly, 10 of the 13 participants expressed that they thought it was very important for athletes to learn about healthy relationships, while one indicated that they felt it was somewhat important.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/E03/01mar25/jar70032-fig-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="jar70032-fig-0001.jpg" title="1 Themes and subthemes from participant interviews." /> </p> <p></p> <hd id="AN0184768026-17">Athletes</hd> <p>When asked about the importance of sexual health information, five athletes indicated that they were interested in learning more about sexual health and healthy relationships. When athletes were asked to reflect on how much knowledge they had on sexual health and healthy relationships, four claimed they knew some but wanted to learn more, while one indicated they knew a lot about sexual health. Athletes reported a range of comfort levels surrounding discussing sexual health with a healthcare professional. One athlete reported they were not comfortable, two reported they only talked to a healthcare professional about sexual health when they had to, one reported they felt comfortable talking about some sexual health topics, but not all, and two reported being very comfortable. Athletes expressed they felt they were more knowledgeable on healthy relationships overall than they were on sexual health. One athlete reported not knowing anything about sexual health, four reported they knew some but wanted to learn more, and one reported knowing a lot about sexual health, while for healthy relationships, three reported knowing some but wanting to learn more, and two identified they knew a lot about healthy relationships.</p> <p>Athletes were asked where they had received sexual health information in the past, such as information about sex, relationships, or puberty, if they had received any at all. Four athletes expressed that they had learned about sexual health at school, three stated they learned from their parents and/or caregivers, and three learned from healthcare professionals. Next, athletes were asked how this material had been delivered to them. Two athletes indicated that they had been spoken to directly, while one indicated they had been shown videos or pictures or given resources, and one other expressed that material was delivered to their caregiver instead of to them directly.</p> <hd id="AN0184768026-18">Coaches and Caregivers</hd> <p>Coaches and caregivers expressed that athletes knew more about healthy relationships than sexual health overall. When asked to reflect on how much athletes knew about sexual health, one participant reported that athletes know very little, one reported athletes knew a little bit, two claimed athletes knew some, and one reported athletes knew quite a lot. When coaches and caregivers were asked to reflect on athlete knowledge of healthy relationships, one reported athletes knew a bit, three reported athletes knew some, and one reported that they did not know how much athletes knew about healthy relationships. When considering how to provide information to athletes about sexual health and healthy relationships, participants were asked to pick which methods they believed athletes would find most effective. The most popular answer was direct conversations with athletes, followed by workshops. Delivery of sexual health material was stated to be more effective in a group setting than one‐on‐one or learning alone.</p> <hd id="AN0184768026-19">Participant Interviews</hd> <p>All 13 participants completed individual interviews with the research team, and five themes were identified within the interview responses, with various subthemes created to enhance the understanding of each theme. Due to the small sample sizes of caregivers and coaches, we decided to combine their results with the athletes to have a more fulsome analysis of the interview themes. A diagram showing all themes and subthemes is included in Figure 1.</p> <hd id="AN0184768026-20">Theme 1: Importance of Relationships</hd> <p>Participants emphasised the importance of different types of relationships for SO athletes, including romantic relationships, friendships and family relationships:</p> <p>My sister, my family, I have my roommate and my boyfriend. I have a lot of friends, a lot of people I have good relationships with. (Sarah*, SO Athlete) (*all names are pseudonyms to protect participants' confidentiality)</p> <p></p> <ulist> <item> (Interviewer) Who do you like to talk to when you need advice? (Cheryl, SO Athlete) My sister</item> <p></p> <item> (Interviewer) What do you like about yourrelationship with your sister? (Cheryl) We do stuff with her</item> </ulist> <p>It was emphasised that everyone deserves to have healthy relationships and there is great value in good relationships. Participants discussed the connection between healthy relationships and mental and emotional health, and some also emphasised the importance of the social connections between athletes and how that supports their physical health as part of their SO participation. Many athletes discussed the long‐term nature of many of their relationships, sharing how their relationships have lasted for many years and continue to be strong:</p> <p>We've been friends for almost all our lives. We were in school together, he's, I'm always his supporter, he's always mine so and we're truly, truly an amazing duo. (Matthew, SO Athlete)</p> <p>Participants also talked about how communication, boundaries, and consent depend on the type of relationship. Some athletes have learned different guidelines about appropriate physical touch, depending on their level of relationships with others. While other athletes have learned that relationships with close family or friends mean there is more physical touch, and the need to respect the boundaries of others.</p> <p>I guess it depends on the person. Like I was like, I'm really huggy with my parents or so, but yeah, I mean, it's a little different with someone else. (Robert, SO Athlete)</p> <hd id="AN0184768026-21">Theme 2: Athletes' Understanding of Sexual Health and Healthy Relationships</hd> <p>While many athletes may know sexual health is important, they do not necessarily know why. SO teaches athletes to care for their bodies and is starting to share information about mental health; however, learning about sexual health and healthy relationships has been less emphasised.</p> <p>I would think so because it just, it, it would, just like your other forms of health it's all important. Like mental health, psychological health or any other type of health. It'd probably be important. I mean it's got the word health in the title. (Robert, SO Athlete)</p> <p>Many participants recognised how sexual health is connected to other health, such physical, mental, and emotional, however there were varying comfort levels of talking about sexual health among athletes, caregivers, and coaches. Several athletes were comfortable talking about certain sexual health topics, but a few declined to discuss sexual health completely. Caregivers and coaches acknowledged that while they are comfortable talking about sexual health, they recognised that is not necessarily the case for other supporters. One coach also discussed how much of SO is group education and less focused on 1:1 support, yet emphasised the need to have options to discuss these topics in a group setting and provide opportunities to follow up with athletes 1:1 later as needed.</p> <p>What I'm trying to say is that a group session would be a great way to introduce. But then introducing the subject and not having ways to follow up when there are questions and requests. They'd be useless. So, it's very important to have the follow‐up and the people available for follow up. (William, SO Coach)</p> <hd id="AN0184768026-22">Theme 3: Barriers to Healthy Relationships</hd> <p>Athletes, coaches, and caregivers all talked about the barriers for athletes in building healthy relationships and this lack of real‐life experience being a limiting factor in learning about sexual health and healthy relationships. One caregiver highlighted the lack of opportunities for athletes to meet peers that would provide the chance to start and develop a relationship:</p> <p>That would be a barrier actually, is the opportunities for them to meet other peers that they could actually date. (Rhonda, Caregiver)</p> <p>The complexity of starting and maintaining a relationship was also highlighted as a challenge in learning how to have healthy relationships, including struggles with social communication, understanding social cues, and recognising when someone is not interested in the same type of relationship.</p> <p>And it's so frustrating for me because I don't know about social cues and stuff, and it's really hard for me to, like, know the social cues about who likes me, if I like someone and they're being reciprocated. It's very difficult for me, because you know I'm special needs, I'm on the spectrum. (Matthew, SO Athlete)</p> <p>The safety risks inherent in relationships, particularly in sexual or romantic settings were highlighted, with a focus on issues such as consent and recognising when others might be trying to take advantage of an athlete.</p> <p>Really, being able to understand how to stay safe in a relationship and understand what consent means...how to keep themselves safe from getting taken advantage of. (Cindy, SO Coach)</p> <hd id="AN0184768026-23">Theme 4: Ways Athletes Learn About Sexual Health and Healthy Relationships</hd> <p>When asked about specific sexual health and healthy relationship topics, it was clear that athletes had learned from many different perspectives and contexts. Some athletes learned about sexual health from being taught in school, but most found this learning to be very limited:</p> <p>Cause when I was doing gym and everything in my school, we got taught about it very little but not a whole lot and everything. (Melissa, SO Athlete)</p> <p>Some athletes had learned about sexual health through community learning, with one athlete explaining his community program taught him most about sexual health and healthy relationships:</p> <p>We had to go to the [Local Sexual Health Centre] to have talks with, like, what those kinds of relationships were. (Robert, SO Athlete)</p> <p>Other athletes have learned about their sexual health and relationships through close family relationships.</p> <p>I just like, I just like it, I just like [learning about sexual health] in private with my family. (Rachel, SO Athlete)</p> <p>Finally, several coaches and caregivers of SO athletes shared how media is influencing how athletes learn about sexual health and healthy relationships but not necessarily in a positive way. They observed that athletes have limited learning from family or community and then make assumptions or don't understand what they are seeing and that it is not necessarily reality.</p> <p>But definitely she has an interest from all the shows she sees, and just the age she's at, that she's getting an interest and curiosity in it. (Rhonda, Caregiver)</p> <p>And so, I think that there's a gap between what is portrayed in popular culture and in social media and an understanding of what, what a real relationship looks like and what it means to be in a relationship. (Cindy, SO Coach)</p> <hd id="AN0184768026-24">Theme 5: How to Support Athletes Learning More About Sexual Health</hd> <p>With participants agreeing that SO athletes could benefit from learning more about sexual health and healthy relationships, there were several suggestions and ideas about how to provide effective learning opportunities. Athletes, coaches, and caregivers all agreed that learning about sexual health and healthy relationships is challenging for SO athletes:</p> <p>There is right consent or the wrong consent. I think there's a difference. (Lindsay, SO Athlete)</p> <p>Because not all athletes are aware of what sexual health is and what things are okay, what things are not okay, you know, levels of relationships, you know, what is their relationship? (Jennifer, SO Athlete)</p> <p>A couple of them really were inappropriate with people. And they really could have used somebody to step in and say 'Hey' and you know, that's, that's not how you behave. (Marianne, Caregiver)</p> <p>Participants emphasised that learning needs to be available and accessible for athletes, including multiple methods of delivery (online, in person, group, individual, printed, interactive), easy to read and understandable language, customised based on interest level of athlete, and be flexible in how material is delivered in different locations and with different groups of athletes.</p> <p>We learn differently and then it's like, like, it's, we learn differently and then all the sudden if we're not understanding, we're the ones with the problem, and I don't see why it should be that way...I think if people are interested they should have the opportunity to learn about it, and maybe help them understand it. (Robert, SO Athlete)</p> <p>It is also important to consider who is providing the information to athletes, in particular, participants agreed it should be someone familiar who has a trusting relationship with the athlete, such as a coach, family member, or medical professional. It was also emphasised that whoever this person is, they need to have training on how to approach this conversation for the athlete to be most comfortable and effectively learn:</p> <p>Cause I like, I like to have like a support group, I guess is a way to put it. You know, like athletes that are on the same content as me and they like to learn about the same different kinds of things. (Lindsay, SO Athlete)</p> <p>It would be nice if family or friends or support workers would sit with them. Just to help with the 'do you get what they're saying' like the one under abuse and that talks about the financial. (Marianne, Caregiver)</p> <p>Consider providing something not for the athletes but for volunteers and caregivers? So to help us identify issues and to help us broach subjects with the, with the athletes? (William, SO Coach)</p> <p>Finally, participants also said that making learning fun for athletes is important. They suggested activities that could be made into games, videos, eye‐catching graphics, group presentations, and being able to talk about the material in small groups of familiar peers would all help with making learning accessible and effective.</p> <p>Visual aids and start making a game out of it. (Matthew, SO Athlete)</p> <p>(Interviewer): What do you think of the pictures? (Cheryl): I like them.</p> <p>One of most important things I think is their social, is being with their peers. (Rhonda, Caregiver)</p> <p>'I would say videos or information that's like short and easy to read and understand. And yeah, conversations or like group presentations.' (Lucy, SO Coach)</p> <hd id="AN0184768026-25">Discussion</hd> <p>People with intellectual disabilities have long been faced with inequalities in accessing comprehensive sexual health information, which directly impacts their physical health, mental health, and overall well‐being (Carter et al. [<reflink idref="bib6" id="ref46">6</reflink>]). Existing literature has focused on the negative physical health outcomes related to poor sexual health education for these individuals, such as sexual assault and dating‐related violence (Borawska‐Charko et al. [<reflink idref="bib3" id="ref47">3</reflink>]), but very little research exists on the steps that should be taken to remedy the underlying issues that continue to perpetuate this public health problem. This study uncovered the lived experience of the value of having healthy relationships, as well as the needs and wants of people with intellectual disabilities when it comes to learning about sexual health topics, such as consent, body empowerment, and healthy relationships, as well as how they would like to receive this information. Overall, athletes, as well as coaches and caregivers, strongly believe that athletes and people with intellectual disabilities more broadly should have access to high‐quality and comprehensive sexual health information and identified a variety of barriers and potential solutions to overcome these barriers.</p> <hd id="AN0184768026-26">Perceived Importance of Sexual Health Information for Athletes</hd> <p>Athletes self‐reported knowing some to quite a lot about sexual health and healthy relationships, despite research showing that individuals with intellectual disabilities commonly demonstrate poor knowledge of sexual health topics (Borawska‐Charko et al. [<reflink idref="bib3" id="ref48">3</reflink>]; Galea et al. [<reflink idref="bib15" id="ref49">15</reflink>]). However, this evidence from past research was brought to light when several athletes were unable to report their own definition of the terms 'body language', 'consent', and 'sexual health' during interviews, and by reports from coaches and caregivers of athletes knowing very little about sexual health. Athletes expressed having difficulties with understanding if someone is showing interest in them as more than a friend, and how to potentially reciprocate these feelings. This supports previous literature showing individuals with intellectual disabilities and other neurodevelopmental conditions find it difficult to read social cues and body language, which can relate to their increased risk of sexual violence (Charpentier and Carter [<reflink idref="bib7" id="ref50">7</reflink>]).</p> <p>Previous research with adults with intellectual disabilities revealed that pop culture is a generally positive, informal way to learn about sexual health; however, there are still challenges with how information portrayed in media is interpreted by people with intellectual disabilities (Schmidt et al. [<reflink idref="bib34" id="ref51">34</reflink>]). The current study's athletes talked about learning about sexual health from movies and friends. However, data collected from coaches and caregivers in this study challenged the reliability of the information from these sources, with participants reporting that pop culture and social media can be extremely harmful in filling in the knowledge gaps athletes have about their sexual health, as they lead to unrealistic expectations and an understanding of what romantic relationships look like. This is consistent with research with adolescents and young adults where the portrayal of sex and relationships as risk‐free and without consequence could lead to inaccurate assumptions regarding safety and sexual activities in general (Kunkel et al. [<reflink idref="bib23" id="ref52">23</reflink>]; Schmidt et al. [<reflink idref="bib34" id="ref53">34</reflink>]). In addition, individuals with intellectual disabilities are not well represented in the media potentially influencing how they are viewed by others as well as in how they view themselves and their identity (McInroy and Craig [<reflink idref="bib26" id="ref54">26</reflink>]).</p> <p>The theme of the importance of relationships echoes previous research using focus groups and interviews, in which people with intellectual disabilities were given the chance to speak on their own sexual health and relationships. For example, Healy et al. ([<reflink idref="bib19" id="ref55">19</reflink>]) collected the perspectives of individuals with intellectual disabilities on their sexual health and showed that many aspire to romantic relationships and marriage. These same authors found that these individuals understood their right to sexual health and recognised that many barriers, both environmental and social, stood in the way of this being fulfilled (Healy et al. [<reflink idref="bib19" id="ref56">19</reflink>]). Consistent with this, all participants in the current study classified the importance of athletes learning about sexual health and healthy relationships as somewhat or very important, showing that knowledge of the right to sexual health information is present and highly valued. Similarly, the importance of sexual health information is reflected in other research, where adults with intellectual disabilities described romantic relationships in various ways, but all emphasised their importance (Charpentier and Carter [<reflink idref="bib7" id="ref57">7</reflink>]).</p> <hd id="AN0184768026-27">Barriers to Accessibility and Improving Sexual Health Resources and Services</hd> <p>Findings from the current study demonstrated that not only is there a lack of sexual health resources accessible to people with intellectual disabilities, but the resources that are available often do not consider accessibility factors such as text size and density, colour palette, text to visuals ratio and language complexity. Considering these design details will be important when creating new and improved sexual health resources since the accessibility of health‐related resources is directly tied to health inequalities (Terras et al. [<reflink idref="bib36" id="ref58">36</reflink>]). This study adds to existing knowledge that sexual health initiatives for the intellectual disability population should consider a universal design for learning by providing multiple media types with clear and concise language (Roden et al. [<reflink idref="bib31" id="ref59">31</reflink>]). Participants highlighted a need for a variety of delivery methods of sexual health and healthy relationship information so athletes can choose which is most closely aligned with their own personal strengths.</p> <p>Themes that emerged in this study adds to existing evidence that people with intellectual disabilities have limited opportunities for sexual health education when compared to their neurotypical peers, and that the predominance of ableist spaces perpetuates this issue (Sitter et al. [<reflink idref="bib35" id="ref60">35</reflink>]). Reports from coaches and caregivers that parents should be nurturing the sexual health education of their children with intellectual disabilities early in life align closely with the suggested framework of embracing comprehensive sexual health versus abuse prevention education (Capolongo [<reflink idref="bib5" id="ref61">5</reflink>]). This uncovers the possibility that effective and comprehensive sexual health education of caregivers may be just as important as that of their children with intellectual disabilities and supports the need to target caregivers as a population of interest for improved sexual health education (Yıldız and Cavkaytar [<reflink idref="bib41" id="ref62">41</reflink>]). If parents are not available to provide this support, athletes, coaches, and caregivers all agreed that someone familiar to athletes should be responsible for providing information and resources about sexual health education (e.g., health professionals, experienced staff). There are some mixed perspectives about who should be responsible for delivering or discussing sexual health education with people with intellectual disabilities, with some believing only trained professionals (e.g., sex educators and medical professionals) should be responsible, while others think that everyone should be trained and have some responsibility (Colarossi et al. [<reflink idref="bib9" id="ref63">9</reflink>]). More research along with consultation with people with lived experience is needed to determine best approaches to teaching, as well as determining what scenarios may require more advanced skills and knowledge in this area. Value gained from including athletes, coaches, and caregivers gives insight into different perspectives, which is important since all stakeholders involved in creating sexual health resources and curricula should work to align their intentions for the delivery of material to be most effective (Capolongo [<reflink idref="bib5" id="ref64">5</reflink>]). Many participants in our study wanted more individualised information about sexual health and to learn more about the nuances of healthy relationships and not just safety. Focusing on the positives of healthy sexual relationships including communication, intimacy, and sexual diversity, as well as supporting a healthy learning dynamic with the inclusion of a co‐facilitator with an intellectual disability has been recommended in the past to ensure a positive learning experience (Hole et al. [<reflink idref="bib21" id="ref65">21</reflink>]).</p> <hd id="AN0184768026-28">Limitations and Future Directions</hd> <p>A limitation of the present study was that the mean age of participants in the study was 39.9 years of age (SD 14.1, range 15–64). Sexual health curricula in academic settings have changed significantly over the past decade by becoming more inclusive of people with varying levels of intellectual and physical abilities (Davies et al. [<reflink idref="bib10" id="ref66">10</reflink>]). An increase in the number of participants between the ages of 18–20 years would potentially demonstrate how the recent shift to more comprehensive and inclusive sexual health education has impacted knowledge gaps and the perceived importance of sexual health for individuals with intellectual disabilities.</p> <p>Second, a larger sample size would be beneficial and work to alleviate the influences that various biases may have had on results. Recruiting participants solely from SO may have biased our results to be from individuals who highly value health and inclusivity in general, and recruiting participants with intellectual disabilities in the community who are not athletes in SO should be considered to participate in future research investigating this topic, in order for results to be more representative of the intellectual disability population as a whole. There was limited racial representation as all participants identified as White or European Canadian and were born in Canada, causing the sample to not be fully representative of individuals with intellectual disabilities from diverse racial and cultural backgrounds. This is especially important to consider, since Black, Indigenous, people of colour (BIPOC) with intellectual disabilities tend to have less control over their daily schedule, who they live with, and the services they access, which can all directly impact an individual's ability to have healthy relationships and their access to sexual health information (Friedman [<reflink idref="bib14" id="ref67">14</reflink>]).</p> <p>Lastly, sample bias was naturally present in the study, since the athletes, coaches and caregivers who volunteered to participate most likely had a predetermined positive opinion toward sexual health for the intellectual disability community. This is a major limitation, and future studies should aim to collect information from a larger, more diverse sample that includes individuals who may feel opposed to athletes learning more about their sexual health. These opinions are just as valuable as the ones collected in this study, and these individuals should also be given the opportunity to speak freely. Recruitment materials could be altered to make this clear to potential participants and to align more closely with the aims of the study.</p> <hd id="AN0184768026-29">Conclusion</hd> <p>This study contributes to the understanding of the systematic inequalities regarding the accessibility of effective and comprehensive sexual health information for individuals with intellectual disabilities. There is significant interest in sexual health knowledge from athletes with intellectual disabilities and a need for transforming currently existing sexual health services and resources. This opens an exciting avenue for next steps in redesigning and restructuring sexual health resources and services aimed at individuals with intellectual disabilities, especially for organisations such as SO that have the unique opportunity to provide education and resources to athletes through initiatives such as Healthy Athletes. Understanding the needs, wants, and challenges of individuals with intellectual disabilities in accessing information about their sexual health will support the real and long‐lasting systematic change that must happen if the right to sexual health is to be fulfilled for this population.</p> <hd id="AN0184768026-30">Author Contributions</hd> <p> <bold>Stephanie Andreasen:</bold> data collection, data analysis (lead), writing – original draft (lead), writing – reviewing and editing (equal). <bold>Tessa Allison:</bold> data collection, formal analysis (supporting). <bold>Brennah Kamelchuk:</bold> data collection, formal analysis (supporting), writing – reviewing and editing (equal). <bold>Victoria Formusa:</bold> conceptualisation (supporting), methodology (supporting), writing – reviewing and editing (equal). <bold>Brock Reissner:</bold> conceptualisation (supporting), methodology (supporting), writing – reviewing and editing (equal). <bold>Stephanie Howe:</bold> methodology, data collection. <bold>Janet McCabe:</bold> conceptualisation (supporting), writing – reviewing and editing (equal). <bold>Alan S. Martino:</bold> conceptualisation (supporting), results/data administration (reviewing). <bold>Carly A. McMorris:</bold> conceptualisation (lead), methodology (lead), project administration, supervision, writing – reviewing and editing (equal).</p> <hd id="AN0184768026-31">Acknowledgements</hd> <p>The authors thank all the Special Olympics athletes, coaches and caregivers who participated in this study.</p> <hd id="AN0184768026-32">Conflicts of Interest</hd> <p>V.F. and B.R. are employed by Special Olympics but did not receive any additional financial benefits from the study. The other authors declare no conflicts of interest.</p> <hd id="AN0184768026-33">Data Availability Statement</hd> <p>The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.</p> <p>GRAPH: Data S1. 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  Group: Ti
  Data: Fostering Healthy Relationships in Special Olympic Athletes: Supporting the Intersection of Intellectual Disability and Sexual Health
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Stephanie+Andreasen%22">Stephanie Andreasen</searchLink><br /><searchLink fieldCode="AR" term="%22Tessa+Allison%22">Tessa Allison</searchLink><br /><searchLink fieldCode="AR" term="%22Brennah+Kamelchuk%22">Brennah Kamelchuk</searchLink><br /><searchLink fieldCode="AR" term="%22Victoria+Formusa%22">Victoria Formusa</searchLink><br /><searchLink fieldCode="AR" term="%22Brock+Reissner%22">Brock Reissner</searchLink><br /><searchLink fieldCode="AR" term="%22Stephanie+Howe%22">Stephanie Howe</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-8950-099X">0000-0001-8950-099X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Janet+McCabe%22">Janet McCabe</searchLink><br /><searchLink fieldCode="AR" term="%22Alan+S%2E+Martino%22">Alan S. Martino</searchLink><br /><searchLink fieldCode="AR" term="%22Carly+A%2E+McMorris%22">Carly A. McMorris</searchLink>
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  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Applied+Research+in+Intellectual+Disabilities%22"><i>Journal of Applied Research in Intellectual Disabilities</i></searchLink>. 2025 38(2).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Label: Peer Reviewed
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  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 12
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  Label: Publication Date
  Group: Date
  Data: 2025
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  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Intellectual+Disability%22">Intellectual Disability</searchLink><br /><searchLink fieldCode="DE" term="%22Athletics%22">Athletics</searchLink><br /><searchLink fieldCode="DE" term="%22Athletes%22">Athletes</searchLink><br /><searchLink fieldCode="DE" term="%22Sexuality%22">Sexuality</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Behavior%22">Health Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Intimacy%22">Intimacy</searchLink><br /><searchLink fieldCode="DE" term="%22Sex+Education%22">Sex Education</searchLink><br /><searchLink fieldCode="DE" term="%22Interpersonal+Relationship%22">Interpersonal Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Barriers%22">Barriers</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/jar.70032
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1360-2322<br />1468-3148
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: People with intellectual disabilities have equal rights to explore their sexuality and access sexual and reproductive healthcare, yet little is known about their needs and wants when accessing health education. The current study sought to learn about the sexual health interests, attitudes, and educational needs of Special Olympics (SO) athletes. Methods: Thirteen participants completed a questionnaire and a 45-min interview, including SO athletes, coaches and caregivers of SO athletes. Results: Survey responses indicated the importance of access to sexual health education, but significant barriers were noted. Thematic analysis of interview transcripts highlighted the importance of healthy relationships, inequalities in learning, and need for information to promote safety. Conclusions: Findings add to existing evidence that people with intellectual disabilities value healthy relationships and want to learn more about sexual health. Several recommendations are offered to increase the effectiveness of sexual health education.
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  Label: Entry Date
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  Data: 2025
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  Data: EJ1468745
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        Value: 10.1111/jar.70032
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
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      – SubjectFull: Intellectual Disability
        Type: general
      – SubjectFull: Athletics
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      – SubjectFull: Athletes
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