scholarly journals Web-Based Health Coaching for Spinal Cord Injury: Results From a Mixed Methods Feasibility Evaluation

10.2196/16351 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e16351
Author(s):  
Sonya Allin ◽  
John Shepherd ◽  
Teri Thorson ◽  
Jennifer Tomasone ◽  
Sarah Munce ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mixed Methods ◽  
Self Efficacy ◽  
Management Program ◽  
Self Management ◽  
Web Based ◽  
Secondary Conditions ◽  
Cord Injury ◽  
Before And After

Background Individuals with spinal cord injury (SCI) are at high risk of experiencing secondary conditions like pressure injuries. Self-management programs may reduce the risk of complications, but traditional programs have proven to be insufficiently tailored to the needs of people with SCI. To overcome barriers to self-management support, a web-based, self-management program was developed for Canadians with SCI called SCI & U. Objective This study aims to evaluate the feasibility and potential impact of the SCI & U program in the context of a mixed methods pilot study. Methods The study followed an explanatory, sequential mixed methods design. Participants (N=11) were Canadians with SCI who had been living in the community for more than 1 year. Each took part in a self-paced, six-session self-management program guided by a trained peer health coach. During sessions, participants could discuss a health topic with their coach from a predefined list (eg, skin or bowel management). Quantitative data were gathered before and after program participation to assess program feasibility and impact. Feasibility measures included attrition rates, frequency of topics selected, and recorded goals, whereas impact measures included measures of self-efficacy (University of Washington Self-Efficacy Scale [UW-SES]), mood (Personal Health Questionnaire Depression Scale [PHQ-8]), secondary conditions (Spinal Cord Injury Secondary Conditions Scale [SCI-SCS]), and resilience (Spinal Cord Injury Quality of Life Resilience Scale [SCI-QOL-R]). Qualitative measures were based on postintervention interviews; these were designed to confirm and expand on quantitative Results Of the 11 participants, 10 completed pre- and postassessments, and 6 coaching sessions. Sessions lasted between 31 and 81 min (average 55, SD 13), and the duration of the program ranged from 35 to 88 days (average 56, SD 23). Diet and exercise were selected as topics 40% (20/50 sessions with topics) of the time, whereas topics such as mental health, bladder management, pain, and bowel management were chosen less frequently. Results gathered before and after the pilot study demonstrated improvements with moderate effect sizes on the UW-SES and the electronic health literacy scale (ie, Hedges g>0.5). Effect sizes for measures of resilience (SCI-QOL-R), depression (PHQ-8), and secondary conditions (SCI-SCS) were small (ie, Hedges g>0.3). Qualitative results confirmed a common focus on diet and exercise, and defined coaches as sources of accountability, information, reassurance and affirmation, and emotional and technical support. Conclusions Results demonstrated that a web-based self-management program is feasible and acceptable by Canadians with SCI. Results also indicated a web-based, peer-led self-management program may impact resilience, self-efficacy, mood, and secondary complications. Finally, results illuminated the role of the coach in facilitating behavior change. Future work seeks to validate results in the context of a randomized controlled trial.

scholarly journals Web-Based Health Coaching for Spinal Cord Injury: Results From a Mixed Methods Feasibility Evaluation (Preprint)

2019 ◽  
Author(s):  
Sonya Allin ◽  
John Shepherd ◽  
Teri Thorson ◽  
Jennifer Tomasone ◽  
Sarah Munce ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mixed Methods ◽  
Self Efficacy ◽  
Management Program ◽  
Self Management ◽  
Web Based ◽  
Secondary Conditions ◽  
Cord Injury ◽  
Before And After

BACKGROUND Individuals with spinal cord injury (SCI) are at high risk of experiencing secondary conditions like pressure injuries. Self-management programs may reduce the risk of complications, but traditional programs have proven to be insufficiently tailored to the needs of people with SCI. To overcome barriers to self-management support, a web-based, self-management program was developed for Canadians with SCI called <i>SCI &amp; U</i>. OBJECTIVE This study aims to evaluate the feasibility and potential impact of the <i>SCI &amp; U</i> program in the context of a mixed methods pilot study. METHODS The study followed an explanatory, sequential mixed methods design. Participants (N=11) were Canadians with SCI who had been living in the community for more than 1 year. Each took part in a self-paced, six-session self-management program guided by a trained peer health coach. During sessions, participants could discuss a health topic with their coach from a predefined list (eg, skin or bowel management). Quantitative data were gathered before and after program participation to assess program feasibility and impact. Feasibility measures included attrition rates, frequency of topics selected, and recorded goals, whereas impact measures included measures of self-efficacy (University of Washington Self-Efficacy Scale [UW-SES]), mood (Personal Health Questionnaire Depression Scale [PHQ-8]), secondary conditions (Spinal Cord Injury Secondary Conditions Scale [SCI-SCS]), and resilience (Spinal Cord Injury Quality of Life Resilience Scale [SCI-QOL-R]). Qualitative measures were based on postintervention interviews; these were designed to confirm and expand on quantitative RESULTS Of the 11 participants, 10 completed pre- and postassessments, and 6 coaching sessions. Sessions lasted between 31 and 81 min (average 55, SD 13), and the duration of the program ranged from 35 to 88 days (average 56, SD 23). Diet and exercise were selected as topics 40% (20/50 sessions with topics) of the time, whereas topics such as mental health, bladder management, pain, and bowel management were chosen less frequently. Results gathered before and after the pilot study demonstrated improvements with moderate effect sizes on the UW-SES and the electronic health literacy scale (ie, Hedges g&gt;0.5). Effect sizes for measures of resilience (SCI-QOL-R), depression (PHQ-8), and secondary conditions (SCI-SCS) were small (ie, Hedges g&gt;0.3). Qualitative results confirmed a common focus on diet and exercise, and defined coaches as sources of accountability, information, reassurance and affirmation, and emotional and technical support. CONCLUSIONS Results demonstrated that a web-based self-management program is feasible and acceptable by Canadians with SCI. Results also indicated a web-based, peer-led self-management program may impact resilience, self-efficacy, mood, and secondary complications. Finally, results illuminated the role of the coach in facilitating behavior change. Future work seeks to validate results in the context of a randomized controlled trial.

Using the Exploratory Sequential Design for Complex Intervention Development: Example of the Development of a Self-Management Program for Spinal Cord Injury

2020 ◽  
Vol 15 (1) ◽  
pp. 37-60 ◽  
Author(s):  
Sarah E. P. Munce ◽  
Timothy C. Guetterman ◽  
Susan B. Jaglal
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Complex Intervention ◽  
Intervention Development ◽  
Management Program ◽  
Sequential Design ◽  
Self Management ◽  
Sequential Approach ◽  
Cord Injury ◽  
Exploratory Sequential Design

In the exploratory sequential design, the qualitative phase occurs first and is followed by the quantitative phase. The methodological purpose of this article is to demonstrate how an exploratory sequential approach, including the use of a joint display, can be used for complex intervention development. This article presents and integrates the qualitative and quantitative findings from a series of previously published studies on the considerations for a tailored self-management program for individuals with spinal cord injury. This article serves as a reference for other researchers, clinicians, and/or other stakeholders on using the exploratory sequential design for complex intervention development. The exploratory sequential design should be used more broadly for the development of relevant and sustainable interventions.

scholarly journals Feasibility of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury

2016 ◽  
Vol 43 (5) ◽  
pp. 529-538 ◽  
Author(s):  
Mary H. Wilde ◽  
James M. McMahon ◽  
Eileen Fairbanks ◽  
Judith Brasch ◽  
Robert Parshall ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Urinary Catheter ◽  
Self Management ◽  
Web Based ◽  
Management Intervention ◽  
Cord Injury

scholarly journals Improving Self-Management Skills Among People With Spinal Cord Injury: Protocol for a Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
W Ben Mortenson ◽  
Patricia Branco Mills ◽  
Jared Adams ◽  
Gurkaran Singh ◽  
Megan MacGillivray ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Utilization ◽  
Self Efficacy ◽  
Self Management ◽  
Care Utilization ◽  
Management Skills ◽  
Secondary Complications ◽  
Cord Injury

BACKGROUND Most people with spinal cord injury will develop secondary complications with potentially devastating consequences. Self-management is a key prevention strategy for averting the development of secondary complications and their recurrence. Several studies have shown that self-management programs improve self-management behaviors and health outcomes in individuals living with chronic conditions such as asthma, diabetes, hypertension, and arthritis. Given the burgeoning health care costs related to secondary complications, we developed an alternative electronic health–based implementation to facilitate the development of self-management skills among people with spinal cord injury. OBJECTIVE This study aims to evaluate the efficacy of a self-management app in spinal cord injury populations. The primary outcome is attainment of self-selected, self-management goals. Secondary outcomes include increases in general and self-management self-efficacy and reductions in self-reported health events, health care utilization, and secondary complications related to spinal cord injury. This study also aims to explore how the intervention was implemented and how the app was experienced by end users. METHODS This study will employ a mix of qualitative and quantitative methods. The quantitative portion of our study will involve a rater-blinded, randomized controlled trial with a stepped wedge design (ie, delayed intervention control group). The primary outcome is successful goal attainment, and secondary outcomes include increases in self-efficacy and reductions in self-reported health events, health care utilization, and secondary conditions related to spinal cord injury. The qualitative portion will consist of semistructured interviews with a subsample of the participants. RESULTS We expect that the mobile self-management app will help people with spinal cord injury to attain their self-management goals, improve their self-efficacy, reduce secondary complications, and decrease health care utilization. CONCLUSIONS If the results are positive, this study will produce credible new knowledge describing multiple outcomes that people with spinal cord injury realize from an app-based self-management intervention and support its implementation in clinical practice. CLINICALTRIAL ClinicalTrials.gov NCT03140501; http://clinicaltrials.gov/ct2/show/NCT03140501 (Archived by WebCite at http://www.webcitation.org/73Gw0ZlWZ) INTERNATIONAL REGISTERED REPOR PRR1-10.2196/11069

scholarly journals A Web-Based Physical Activity Portal for Individuals Living With a Spinal Cord Injury: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Max Pancer ◽  
Melissa Manganaro ◽  
Isabella Pace ◽  
Patrick Marion ◽  
Dany H Gagnon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Behavior Change ◽  
Health Care Professionals ◽  
Self Regulation ◽  
Self Management ◽  
Web Based ◽  
Management Platform ◽  
Cord Injury

BACKGROUND The population with a spinal cord injury (SCI) largely remains inactive following discharge from rehabilitation despite evidence on the benefits of physical activity. These individuals need to develop skills to self-manage their condition in order to prevent secondary comorbidities and rehospitalization. A Web-based physical activity portal can address this need. Few Web-based interventions incorporate theoretical frameworks, behavior change techniques, and modes of delivery into their design. CONCLUSIONS This study highlights features of an online self-management platform that can provide individuals with an SCI the motivation and volition to engage in physical activity. These findings will inform the design of a Web-based self-management physical activity portal to increase physical activity adherence and behavior change. METHODS An interpretative phenomenology methodology and participatory design, along with an integrated knowledge translation approach, were used to conduct this study. Convenience sampling was used to recruit individuals with an SCI living in the community, who were either interested or already engaging in physical activity, and HCPs working with individuals with an SCI, from three city-based rehabilitation sites. Individual 1-hour sessions involving navigation of an existing website and a semistructured interview were conducted with all participants. Individuals with an SCI completed a demographics questionnaire prior to the individual sessions, while demographic information of the HCPs was collected during their interviews. Additionally, all participants were asked a question on their intention to use or recommend a portal. An in-depth thematic analysis was used to derive themes from participants’ responses. OBJECTIVE This study aimed to identify the preferred features of a Web-based self-management physical activity portal through stakeholder engagement with individuals with a spinal cord injury and health care professionals (HCPs). RESULTS Thirteen individuals with an SCI and nine HCPs participated in the study. Five core themes emerged: (1) knowledge: guidance and barrier management; (2) possibility of achievement: the risks and benefits of physical activity and modelling; (3) self-regulation strategies: action planning, goal setting, tracking, rewards, and reminders; (4) interactivity: peers and professionals; and (5) format: appearance, language, and ease of use. The mean (median) ratings of the likelihood of promoting and using a Web-based portal tailored to individuals’ needs were 9.00 (8.78) and 7.75 (7.88) for HCPs and individuals with an SCI, respectively.

scholarly journals Development and Feasibility ofHealth Mechanics: A Self-Management Program for Individuals with Spinal Cord Injury

2016 ◽  
Vol 22 (2) ◽  
pp. 121-134 ◽  
Author(s):  
Michelle A. Meade ◽  
Brad Trumpower ◽  
Martin Forchheimer ◽  
Lisa DiPonio
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Management Program ◽  
Self Management ◽  
Cord Injury

Pilot Study of a Self-Management Program for Parents With Spinal Cord Injury or Disease

2020 ◽  
Vol 75 (1) ◽  
pp. 7501205070p1
Author(s):  
Carla Wilson Walker ◽  
Mary Holowatuk ◽  
Jessica Dashner
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pilot Study ◽  
Management Program ◽  
Self Management ◽  
Cord Injury

scholarly journals Using the theoretical domains framework to guide the development of a self-management program for individuals with spinal cord injury: Results from a national stakeholder advisory group

2017 ◽  
Vol 40 (6) ◽  
pp. 687-695 ◽  
Author(s):  
Sarah E.P. Munce ◽  
Sonya Allin ◽  
Dalton L. Wolfe ◽  
Karen Anzai ◽  
Gary Linassi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Theoretical Domains Framework ◽  
Management Program ◽  
Self Management ◽  
Advisory Group ◽  
Cord Injury

scholarly journals Improving Self-Management Skills Among People With Spinal Cord Injury: Protocol for a Mixed-Methods Study

10.2196/11069 ◽  
2018 ◽  
Vol 7 (11) ◽  
pp. e11069 ◽  
Author(s):  
W Ben Mortenson ◽  
Patricia Branco Mills ◽  
Jared Adams ◽  
Gurkaran Singh ◽  
Megan MacGillivray ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Self Management ◽  
Management Skills ◽  
Cord Injury
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