Empowering Adults With Chronic Spinal Cord Injury to Prevent Secondary Conditions

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• 作者：Bethlyn Vergo Houlihan ; MSW ; MPH^a ; ^b ; ^{bvergo@bu.edu" class="auth_mail" title="E-mail the corresponding author} ; Sarah Everhart-Skeels ; MPH^a ; ^b ; Damara Gutnick ; MD^c ; Diana Pernigotti ; MSG^a ; ^d ; Judi Zazula ; MS ; OTR/L^a ; ^b ; Miriam Brody ; MPH^a ; ^b ; Sam Burnett ; MA^c ; Hannah Mercier ; PhD ; MS ; OTR/L^a ; ^b ; Stathis Hasiotis^a ; ^d ; Christa Green ; BA^a ; ^e ; Subramani Seetharama ; MD^a ; ^f ; Timothy Belliveau ; PhD ; ABPP^a ; ^e ; David Rosenblum ; MD^a ; ^d ; Alan Jette ; PhD ; PT^a ; ^b
• 关键词：Community-based participatory research ; Feasibility studies ; Rehabilitation ; Spinal Cord Injuries ; Telemedicine
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：97
• 期：10
• 页码：1687-1695.e5
• 全文大小：1492 K

文摘

To develop and assess the feasibility of My Care My Call, an innovative peer-led, community-based telephone intervention for individuals with chronic spinal cord injury (SCI) using peer health coaches.

Design

Qualitative pilot study.

Setting

General community.

Participants

Convenience sample of consumer advocates with traumatic SCI ≥1 year postinjury (N=7).

Interventions

My Care My Call applies a health empowerment approach for goal-setting support, education, and referral to empower consumers in managing their preventive health needs. For feasibility testing, peer health coaches, trained in brief action planning, called participants 6 times over 3 weeks.

Main Outcome Measures

Identified focus areas were acceptability, demand, implementation, and practicality. Participant outcome data were collected through brief after-call surveys and qualitative exit interviews. Through a custom website, peer health coaches documented call attempts, content, and feedback. Analysis applied the constant comparative method.

Results

My Care My Call was highly feasible in each focus area for participants. Concerning acceptability, participants were highly satisfied, rating peer health coaches as very good or excellent in 80% of calls; felt My Care My Call was appropriate; and would continue use. Regarding demand, participants completed 88% of scheduled calls; reported that My Care My Call fills a real need; and would recommend it. Considering implementation, peer health coaches made 119% of expected calls, with a larger focus on compiling individualized resources. For practicality, call duration averaged 29 minutes, with 1 hour of additional time for peer health coaches. Participant effects included feeling supported, greater confidence toward goals, and greater connection to resources. Subsequently, several process changes enhanced peer health coach training and support through role-plays, regular support calls, and streamlined My Care My Call support materials.

Conclusions

After process changes, a randomized controlled trial to evaluate My Care My Call is underway.