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 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

Enhancing Physical Activity Guidelines: A Needs Survey of Adults With Spinal Cord Injury and Health Care Professionals

2012 ◽  
Vol 29 (4) ◽  
pp. 329-345 ◽  
Author(s):  
Brianne L. Foulon ◽  
Valérie Lemay ◽  
Victoria Ainsworth ◽  
Kathleen A. Martin Ginis
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Professionals ◽  
Survey Questionnaire ◽  
Physical Activity Guidelines ◽  
Risks And Benefits ◽  
Cord Injury

The purpose of this study was to determine preferences of people with spinal cord injury (SCI) and health care professionals (HCP) regarding the content and format of a SCI physical activity guide to support recently released SCI physical activity guidelines. Seventy-eight people with SCI and 80 HCP completed a survey questionnaire. Participants with SCI identified desired content items and their preferences for format. HCP rated the helpfulness of content items to prescribe physical activity. All content items were rated favorably by participants with SCI and useful by HCP. The risks and benefits of activity and inactivity, and strategies for becoming more active, were rated high by both samples. Photographs and separate information for those with paraplegia versus tetraplegia were strongly endorsed. These data were used to guide the development of an SCI physical activity guide to enhance the uptake of physical activity guidelines for people with SCI. The guide was publically released November 11, 2011.

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.

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 A Web-Based Physical Activity Portal for Individuals Living With a Spinal Cord Injury: Qualitative Study

10.2196/12507 ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. e12507 ◽  
Author(s):  
Max Pancer ◽  
Melissa Manganaro ◽  
Isabella Pace ◽  
Patrick Marion ◽  
Dany H Gagnon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Qualitative Study ◽  
Web Based ◽  
Cord Injury

scholarly journals Feasibility of an online intervention delivery to promote exercise for people with spinal cord injury: A Pre-Post Design Pilot Study (Preprint)

2020 ◽  
Author(s):  
Christa Ochoa ◽  
Maria Cole ◽  
Katherine Froehlich-Grobe
Keyword(s):  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pilot Study ◽  
Disease Risk ◽  
Activity Monitor ◽  
Web Based ◽  
Cord Injury ◽  
Exercise Equipment ◽  
Weekly Group

BACKGROUND People with spinal cord injury (SCI) are less likely to be physically active (PA) and have higher chronic disease risk than those in the general population due to physical and metabolic changes that occur post-injury. Few studies have investigated approaches to promote increased PA for those with SCI despite evidence that they face unique barriers that include lack of accessible transportation and exercise equipment. OBJECTIVE To address these obstacles, we adapted an evidence-based phone-delivered intervention that promoted increased PA among people with SCI into a web-based platform. The adapted program provides participants with weekly skill-building information and activities, basic exercise equipment, and ongoing support through weekly group videoconferencing. METHODS We assessed feasibility of the web-based program by delivering an abbreviated, four-week version to 10 participants with SCI. Rates of weekly videoconference attendance, activity completion, and exercise activity as tracked by an arm-based activity monitor were recorded for all participants. RESULTS Participants’ average rate of engagement across the four-weeks was 82.5% for attending weekly group videoconferences, 85% for completing online modules, and 57.5% for syncing their arm-based activity monitor. Ninety percent of the sample synced their arm-based physical activity monitor and overall engagement as a function of each component across the 4 weeks was 75%. CONCLUSIONS The intervention had sufficiently high levels of engagement to be used in a full randomized-controlled trial (RCT) to test its effectiveness in improving levels of physical activity among people with spinal cord injury. The knowledge we gained from this pilot study informed improvements that were made in the full RCT.

scholarly journals Co-designing a Self-Management App Prototype to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Julia Amann ◽  
Maddalena Fiordelli ◽  
Mirjam Brach ◽  
Sue Bertschy ◽  
Anke Scheel-Sailer ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Care Professionals ◽  
Usability Testing ◽  
Design Approach ◽  
Self Management ◽  
Evidence Based ◽  
High Fidelity ◽  
Cord Injury

BACKGROUND Spinal cord injury is a complex chronic health condition that requires individuals to actively self-manage. Therefore, an evidence-based, self-management app would be of value to support individuals with spinal cord injury in the prevention of pressure injuries. OBJECTIVE The main objectives of this study were to (1) establish a co-design approach for developing a high-fidelity prototype app for the self-management of individuals with spinal cord injury, (2) design the prototype that resulted from this process, and (3) conduct the first usability assessment of the prototype app. METHODS We adopted a co-design approach to develop an evidence-based app prototype. Starting from a preliminary content model (based on clinical guidelines for the prevention of pressure injuries) and three research-based user personas, we conducted an ideation workshop involving individuals with spinal cord injury and health care professionals. The ideation workshop formed the basis for two consecutive design sprints. The result of this co-design phase was an interactive app prototype. The prototype was evaluated in two rounds of usability testing (N=4 and N=15, respectively) using a combination of qualitative and quantitative methods. RESULTS The co-design process resulted in a high-fidelity prototype with two key components: a self-management component and a communication component. The final prototype included a combination of features to support individuals with spinal cord injury in the prevention of pressure injuries, namely a smart camera, pressure injury diary, expert consultation, reminders, and knowledge repository. Findings of the usability testing showed that most participants navigated the app fluently with little back and forth navigation and were able to successfully complete a set of assigned tasks. These positive results are supported by the average system usability score achieved (78.5/100; range 47.5-95.0) and our qualitative analysis of the semistructured interviews. Despite an overall positive evaluation of the app prototype, we identified areas for improvement (eg, inclusion of a search function). CONCLUSIONS Individuals with spinal cord injury often need to navigate competing interests and priorities, paired with uncertainty about the accuracy and relevance of clinical recommendations. Understanding what matters to individuals with spinal cord injury can help guide the design of behavioral interventions that are useful and acceptable to these individuals in their daily lives. This study shows that involving individuals with spinal cord injury and health care professionals in co-designing a self-management app can foster knowledge cocreation at the intersection of lived experience, medical expertise, and technical solutions.

scholarly journals Opportunities and Challenges of a Self-Management App to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Julia Amann ◽  
Maddalena Fiordelli ◽  
Anke Scheel-Sailer ◽  
Mirjam Brach ◽  
Sara Rubinelli
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Focus Groups ◽  
Mobile Health ◽  
Health Care Professionals ◽  
Self Management ◽  
Motivational Support ◽  
Cord Injury ◽  
Study Participants

BACKGROUND Mobile health applications can offer tailored self-management support to individuals living with chronic health conditions. However, there are several challenges to the adoption of these technologies in practice. Co-design is a promising approach to overcoming some of these challenges by enabling the development of solutions that meet the actual needs and preferences of the relevant stakeholder groups. OBJECTIVE Taking spinal cord injury as a case in point, the overall objectives of this study were to identify the perceived benefits of a co-designed self-management app that could promote its uptake and to explore the factors that may impede adoption. METHODS We adopted a qualitative research approach guided by the Technology Acceptance Model. Data were collected through semistructured interviews with individuals with spinal cord injury (n=15) and two focus groups with health care professionals specialized in spinal cord injury (n=7, n=5). Prior to the interviews and focus groups, study participants were given time to explore the app prototype. All interviews were transcribed verbatim and analyzed using inductive thematic analysis. RESULTS Findings of our analysis indicate that study participants perceived the app prototype as potentially useful for supporting individuals with spinal cord injury in preventing pressure injuries. In particular, we identified three concrete use cases highlighting the benefits of the app for different audiences: (1) a companion for newly injured individuals, (2) an emergency kit and motivational support, and 3) a guide for informal caregivers and family members. We also uncovered several challenges that might impede the adoption of the self-management app in practice, including (1) challenges in motivating individuals to use the app, (2) concerns about the misuse and abuse of the app, and (3) organizational and maintenance challenges. CONCLUSIONS This study adds to a growing body of research that investigates individuals’ adoption and nonadoption behavior regarding mobile health solutions. Building on earlier work, we make recommendations on how to address the barriers to the adoption of mobile health solutions identified by this study. In particular, there is a need to foster trust in mobile health among prospective users, including both patients and health care professionals. Moreover, increasing personal relevance of mobile health solutions through personalization may be a promising approach to promote uptake. Last but not least, organizational support also plays an instrumental role in mobile health adoption. We conclude that even though co-design is promoted as a promising approach to develop self-management tools, co-design does not guarantee adoption. More research is needed to identify the most promising strategies to promote the adoption of evidence-based mobile health solutions in practice.

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