Prevalence of chronic health conditions and hospital utilization in adults with spinal cord injury: an analysis of self-report and South Carolina administrative billing data

BACKGROUND Technological solutions, particularly mobile health (mHealth), have been shown to be potentially viable approaches for sustaining individuals’ self-management of chronic health conditions. Theory-based interventions are more successful, as evidence-based information is an essential prerequisite for appropriate self-management. However, several reviews have shown that many existing mobile apps fail to be either theoretically grounded or based on evidence. Although some authors have attempted to address these two issues by focusing on the design and development processes of apps, concrete efforts to systematically select evidence-based content are scant. OBJECTIVE The objective of this study was to present a procedure for the participatory identification of evidence-based content to ground the development of a self-management app. METHODS To illustrate the procedure, we focused on the prevention and management of pressure injuries (PIs) in individuals with spinal cord injury (SCI). The procedure involves the following three steps: (1) identification of existing evidence through review and synthesis of existing recommendations on the prevention and self-management of PIs in SCI; (2) a consensus meeting with experts from the field of SCI and individuals with SCI to select the recommendations that are relevant and applicable to community-dwelling individuals in their daily lives; and (3) consolidation of the results of the study. RESULTS In this case study, at the end of the three-step procedure, the content for an mHealth intervention was selected in the form of 98 recommendations. CONCLUSIONS This study describes a procedure for the participatory identification and selection of disease-specific evidence and professional best practices to inform self-management interventions. This procedure might be especially useful in cases of complex chronic health conditions, as every recommendation in these cases needs to be evaluated and considered in light of all other self-management requirements. Hence, the agreement of experts and affected individuals is essential to ensure the selection of evidence-based content that is considered to be relevant and applicable.

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Selecting Evidence-Based Content for Inclusion in Self-Management Apps for Pressure Injuries in Individuals With Spinal Cord Injury: Participatory Design Study

JMIR mhealth and uhealth ◽

10.2196/15818 ◽

2020 ◽

Vol 8 (5) ◽

pp. e15818 ◽

Cited By ~ 3

Author(s):

Maddalena Fiordelli ◽

Claudia Zanini ◽

Julia Amann ◽

Anke Scheel-Sailer ◽

Mirjam Brach ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Community Dwelling ◽

Chronic Health Conditions ◽

Health Conditions ◽

Self Management ◽

Evidence Based ◽

Chronic Health ◽

Cord Injury ◽

Selection Of

Background Technological solutions, particularly mobile health (mHealth), have been shown to be potentially viable approaches for sustaining individuals’ self-management of chronic health conditions. Theory-based interventions are more successful, as evidence-based information is an essential prerequisite for appropriate self-management. However, several reviews have shown that many existing mobile apps fail to be either theoretically grounded or based on evidence. Although some authors have attempted to address these two issues by focusing on the design and development processes of apps, concrete efforts to systematically select evidence-based content are scant. Objective The objective of this study was to present a procedure for the participatory identification of evidence-based content to ground the development of a self-management app. Methods To illustrate the procedure, we focused on the prevention and management of pressure injuries (PIs) in individuals with spinal cord injury (SCI). The procedure involves the following three steps: (1) identification of existing evidence through review and synthesis of existing recommendations on the prevention and self-management of PIs in SCI; (2) a consensus meeting with experts from the field of SCI and individuals with SCI to select the recommendations that are relevant and applicable to community-dwelling individuals in their daily lives; and (3) consolidation of the results of the study. Results In this case study, at the end of the three-step procedure, the content for an mHealth intervention was selected in the form of 98 recommendations. Conclusions This study describes a procedure for the participatory identification and selection of disease-specific evidence and professional best practices to inform self-management interventions. This procedure might be especially useful in cases of complex chronic health conditions, as every recommendation in these cases needs to be evaluated and considered in light of all other self-management requirements. Hence, the agreement of experts and affected individuals is essential to ensure the selection of evidence-based content that is considered to be relevant and applicable.

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Association of Secondary Health Conditions With Future Chronic Health Conditions Among Persons With Traumatic Spinal Cord Injury

Topics in Spinal Cord Injury Rehabilitation ◽

10.46292/sci20-00020 ◽

2020 ◽

Vol 26 (4) ◽

pp. 283-289

Author(s):

Yue Cao ◽

Nicole DiPiro ◽

James S. Krause

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Anxiety Disorder ◽

Chronic Health Conditions ◽

Blood Cholesterol ◽

Health Conditions ◽

Traumatic Spinal Cord Injury ◽

Chronic Health ◽

Cord Injury

Background: Secondary health conditions (SHC) are physical and mental health conditions that are causally related to disabilities. Studies have found that SHC increase risk of negative health outcomes among people with traumatic spinal cord injury (TSCI). However, little has been done to assess the association of SHC with the risk of chronic health conditions (CHC) after TSCI. Objectives: To identify the prevalence of CHC in adults with TSCI, changes in CHC at follow-up, and the associations of baseline SHC with future CHC. Methods: Participants included 501 adults with TSCI of at least 1-year duration, identified through a population-based surveillance system. Baseline and follow-up self-report assessments were completed. We measured seven SHC: fatigue, spasticity, pain, pressure ulcers, subsequent injury, fracture, and anxiety disorder, and measured seven CHC: diabetes, heart attack, coronary artery disease, stroke, cancer, hypertension, and high blood cholesterol. Control variables included gender, race/ethnicity, age at injury, years post injury, injury severity, smoking status, binge drinking, and taking prescription medication. We implemented a Poisson regression model for the multivariate analyses. Results: The total number of CHC, the percentage of participants having at least one CHC, and prevalence of three individual CHC (diabetes, cancer, and high cholesterol) increased from baseline to follow-up. After controlling for demographic, injury characteristics, and behavioral factors, pain interference and anxiety disorder at baseline were associated with the total number of CHC at follow-up. Conclusion: CHC are common among adults with TSCI and increase significantly over time. Pain and anxiety disorders appear to be risk factors for future CHC.

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Health-related behaviors and multiple chronic health conditions among persons with traumatic spinal cord injury

Spinal Cord ◽

10.1038/s41393-018-0227-3 ◽

2018 ◽

Vol 57 (5) ◽

pp. 367-371

Author(s):

Yue Cao ◽

Melinda Jarnecke ◽

James S. Krause

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Chronic Health Conditions ◽

Health Conditions ◽

Traumatic Spinal Cord Injury ◽

Chronic Health ◽

Cord Injury ◽

Health Related Behaviors ◽

Health Related

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Resilient Coping Types in People With Spinal Cord Injury: Latent Class Analysis

Rehabilitation Counseling Bulletin ◽

10.1177/0034355221990736 ◽

2021 ◽

pp. 003435522199073

Author(s):

Chungyi Chiu ◽

Jessica Brooks ◽

Alicia Jones ◽

Kortney Wilcher ◽

Sa Shen ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Life Satisfaction ◽

Latent Class Analysis ◽

Latent Class ◽

Psychosocial Interventions ◽

Self Report ◽

Class Analysis ◽

Multivariate Tests ◽

Cord Injury

Resilience is central to living well with a spinal cord injury (SCI). To provide a timely, targeted, and individualized intervention supporting resilience, it is necessary to assess an individual’s resilience level and characteristics of resilience on an ongoing basis. We aimed to validate the different types of resilient coping among people with SCI (PwSCI), using the Connor–Davidson resilience scale, and to identify the relationships between resilience and other psychosocial factors among the types of resilient coping. We recruited 93 PwSCI, who took the self-report measures of resilience, depression, life satisfaction, and spirituality. Using latent class analysis, we found three types: (a) goal-pursuing, bouncing-back, and persevering, named GP; (b) uncertainty about coping with setbacks, named UC; and (c) loss of resilient coping, named LOSS. The multivariate tests indicated that the three types differed on a linear combination of resilience, depression, and life satisfaction, with a large effect size. We discussed the three types of resilient coping and the implications for psychosocial interventions. We also recommended that rehabilitation clinicians examine PwSCI’s resilience levels and types of resilience during initial and follow-up visits. In doing so, PwSCI will have timely, targeted supports for developing and/or re-building their resilience.

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