@phdthesis{01KE7HXYVVX8R6JG5QCX4PV6EY,
  abstract     = {{BACKGROUND 
Meaningful activities are essential to the well-being, identity, and inclusion of people with intellectual disabilities. Direct Support Professionals (DSPs) are key facilitators of meaningful activities, yet they face complex, multilevel challenges in enabling it effectively. This doctoral research aimed to understand and strengthen the support DSPs need through a series of interconnected studies.

METHODS 
A three-phase research design was developed using human-centered and participatory approaches. Study 1 outlined the protocol, a mixed-method, practice-oriented program. Study 2, a scoping review, mapped general DSP support needs, showing that meaningful activities-specific needs are rarely addressed explicitly but are embedded across policy-, organizational-, and personal-level supports. Study 3 used thematic analysis of in-depth interviews with Flemish DSPs, revealing emotional tensions and practical dilemmas in person-centered support. Study 4 was a quantitative survey with 444 DSPs, identifying priority needs for training, guidance, and structural enablers to foster meaningful activities.

RESULTS 
Across studies, DSPs reported gaps at three interconnected levels. At the policy level, they lacked recognition and clear guidelines. At the organizational level, they called for supportive cultures of co-creation, practice leadership, and peer learning. At the personal level, DSPs emphasized the need for tailored training, resilience-building, and reflective space. Quantitative findings confirmed consensus on critical enabling factors, while uncovering contextual differences across settings, education levels, and perceived barriers.

CONCLUSIONS 
Enabling meaningful activities reveals a central paradox within current disability services. While the field increasingly emphasizes highly individualized, person-centered support, the systems in which DSPs operate remain largely supply-driven. As a result, organizational structures and policy environments strongly shape the ‘playing field’ in which meaningful activities can (or cannot) be realized. Enabling meaningful activities therefore requires more than strengthening DSPs’ skills: it demands a systemic, ecosystem-level approach that aligns policy, organizational practices, and personal}},
  author       = {{Wille, Christophe}},
  keywords     = {{Intellectual Disabilities,Meaningful Activities,Direct Support Professionals,Participatory Action Research,Human-Centered Design,Support Needs,Co-creation}},
  language     = {{eng}},
  pages        = {{185}},
  publisher    = {{Ghent University. Faculty of Medicine and Health Sciences}},
  school       = {{Ghent University}},
  title        = {{Meaningful activities 4 all : direct support professionals' perspectives on enabling meaningful activities for people with intellectual disabilities}},
  year         = {{2025}},
}