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Sober-Williams EK, Lee RHY, Whitehurst DGT, McBride CB, Willms R, Claydon VE. Bowel burdens: a systematic review and meta-analysis examining the relationships between bowel dysfunction and quality of life after spinal cord injury. Spinal Cord 2024:10.1038/s41393-024-01002-8. [PMID: 39014196 DOI: 10.1038/s41393-024-01002-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2024] [Accepted: 05/29/2024] [Indexed: 07/18/2024]
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVES Many individuals with spinal cord injury (SCI) experience autonomic dysfunction, including profound impairments to bowel and cardiovascular function. Neurogenic bowel dysfunction (NBD) is emerging as a potential determinant of quality of life (QoL) after SCI. For individuals with high-level lesions ( > T6), bowel care-related autonomic dysreflexia (B-AD; profound episodic hypertension) further complicates bowel care. We aimed to evaluate the extent of bowel dysfunction after SCI, and the impact of bowel dysfunction on QoL after SCI. METHODS We searched five databases to identify research assessing the influence of NBD or B-AD on QoL after SCI. Metrics of bowel dysfunction (fecal incontinence [FI], constipation, time to complete, and B-AD) and QoL data were extracted and synthesised. Where possible, meta-analyses were performed. RESULTS Our search identified 2042 titles, of which 39 met our inclusion criteria. Individuals with SCI identified problems with NBD (74.7%), FI (56.9%), and constipation (54.6%), and 49.3% of individuals with SCI > T6 experienced B-AD. Additionally, 40.3% of individuals experienced prolonged defecation ( > 30 min). Moderate/severe deterioration in QoL due to NBD was reported by 55.5% of individuals with SCI, with negative impacts on physical, emotional, and social health-related QoL associated with inflexibility of bowel routines, fear of accidents, and loss of independence. CONCLUSION Bowel dysfunction and bowel care challenges are prevalent and disabling for individuals with SCI, with a profoundly negative impact on QoL. Improving bowel management is a key target to improve QoL for those living with SCI.
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Affiliation(s)
- Elin K Sober-Williams
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Rebekah H Y Lee
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - David G T Whitehurst
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | - Rhonda Willms
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Centre, Spinal Cord Injury Program, Vancouver Coastal Health, Vancouver, BC, Canada
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Victoria E Claydon
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
- International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
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Depianti JRB, Pimentel TGP, Pessanha FB, de Moraes JRMM, Cabral IE. Guides or guidelines for interacting and playing with medical complex children: a qualitative documentary research. Rev Lat Am Enfermagem 2024; 32:e4146. [PMID: 38985041 PMCID: PMC11251688 DOI: 10.1590/1518-8345.6691.4146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 12/10/2023] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVES to identify content on play and interaction with children with special health care needs recommended in clinical guidelines; analyze play and interaction activities applicable to children with special health care needs and complex care requirements. METHOD qualitative documentary research based on guides, protocols, or guidelines on playing and interacting with children with special and living with complex care. Search terms in English (guidelines, playing OR play, complex needs, OR chronic disease) and in Portuguese ( guia, brincar ou brincadeiras, condições crônicas ) on the first ten pages of_Google Search ® . Thematic analysis was applied to the information extracted from the documents. RESULTS a total of nine documents with similar content were grouped into units of analysis, keeping only the interacting and playing activities applicable to children with special health care needs and living with complex care requirements, namely stimulation of potential, stimulation of adult-child interaction, and stimulation of the senses (touch, sight, and hearing), to be carried out by health professionals and family caregivers in the different care contexts. CONCLUSION interaction and play are potential promoters of adult-child interaction, with application in the stimulating and life-delivering complex care for children.
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Affiliation(s)
- Jéssica Renata Bastos Depianti
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Rio de Janeiro, RJ, Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Thaís Guilherme Pereira Pimentel
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Rio de Janeiro, RJ, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Fernanda Borges Pessanha
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Rio de Janeiro, RJ, Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Ivone Evangelista Cabral
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Rio de Janeiro, RJ, Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
- Universidade do Estado do Rio de Janeiro, Faculdade de Enfermagem, Rio de Janeiro, RJ, Brazil
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Hoekstra F, Gainforth HL, Broeksteeg R, Corras S, Collins D, Gaudet S, Giroux EE, McCallum S, Ma JK, Rakiecki D, Rockall S, van den Berg-Emons R, van Vilsteren A, Wilroy J, Martin Ginis KA. Theory- and evidence-based best practices for physical activity counseling for adults with spinal cord injury. J Spinal Cord Med 2024; 47:584-596. [PMID: 36988416 PMCID: PMC11218585 DOI: 10.1080/10790268.2023.2169062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES This project used a systematic and integrated knowledge translation (IKT) approach to co-create theory- and evidence-based best practices for physical activity counseling for adults with spinal cord injury (SCI). METHODS Guided by the IKT Guiding Principles, we meaningfully engaged research users throughout this project. A systematic approach was used. An international, multidisciplinary expert panel (n = 15), including SCI researchers, counselors, and people with SCI, was established. Panel members participated in two online meetings to discuss the best practices by drawing upon new knowledge regarding counselor-client interactions, current evidence, and members' own experiences. We used concepts from key literature on SCI-specific physical activity counseling and health behavior change theories. An external group of experts completed an online survey to test the clarity, usability and appropriateness of the best practices. RESULTS The best practices document includes an introduction, the best practices, things to keep in mind, and a glossary. Best practices focused on how to deliver a conversation and what to discuss during a conversation. Examples include: build rapport, use a client-centred approach following the spirit of motivational interviewing, understand your client's physical activity barriers, and share the SCI physical activity guidelines. External experts (n = 25) rated the best practices on average as clear, useful, and appropriate. CONCLUSION We present the first systematically co-developed theory- and evidence-based best practices for SCI physical activity counseling. The implementation of the best practices will be supported by developing training modules. These new best practices can contribute to optimizing SCI physical activity counseling services across settings.
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Affiliation(s)
- Femke Hoekstra
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Heather L. Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | | | - Stephanie Corras
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Canada
| | - Delaney Collins
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Sonja Gaudet
- Spinal Cord Injury British Columbia, Vancouver, Canada
- The Thompson Okanagan Tourism Association, Vernon, Canada
| | - Emily E. Giroux
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - Shannon McCallum
- Therapeutic Recreation Program, St. Lawrence College, Kingston, Canada
| | - Jasmin K. Ma
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Arthritis Research Canada, Vancouver, Canada
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Diane Rakiecki
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
- School District, Vernon, Canada
| | - Shannon Rockall
- Praxis Spinal Cord Institute, Vancouver, Canada
- Access Community Therapists, Vancouver, BC, Canada
| | - Rita van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | | | - Jereme Wilroy
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kathleen A. Martin Ginis
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
- Department of Medicine, Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, Canada
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
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Mbalilaki JA, Lilleheie I, Rimehaug SA, Tveitan SN, Linnestad AM, Krøll P, Lundberg S, Molle M, Moore JL. Facilitators and Barriers to Implementing High-Intensity Gait Training in Inpatient Stroke Rehabilitation: A Mixed-Methods Study. J Clin Med 2024; 13:3708. [PMID: 38999274 PMCID: PMC11242475 DOI: 10.3390/jcm13133708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/14/2024] Open
Abstract
(1) Background: High-intensity gait training (HIT) is a recommended intervention that improves walking function (e.g., speed and distance) in individuals who are undergoing stroke rehabilitation. This study explored clinicians' perceived barriers and facilitators to implementing HIT utilizing a mixed-methods approach comprising a survey and exploratory qualitative research. (2) Methods: Clinicians (n = 13) who were implementing HIT at three facilities participated. We collected and analyzed data using the consolidated framework for implementation research. Three focus groups were recorded and transcribed, and data were coded and thematically categorized. (3) Results: Survey results identified that the facilitators with a strong impact on implementation were access to knowledge/resources and intervention knowledge/beliefs. The only agreed-upon barrier with a strong impact was lack of tension for change. The focus groups resulted in 87 quotes that were coded into 27 constructs. Frequently cited outer setting facilitators were cosmopolitanism and peer pressure, and the only barrier was related to the patient needs. Innovation characteristics that were facilitators included relative advantage and design quality and packaging, and complexity was a barrier. Inner setting facilitators included networks and communication, learning climate, leadership engagement, and readiness for implementation. However, communication, leadership engagement, and available resources were also barriers. Regarding characteristics of individuals, knowledge and beliefs were both barriers and facilitators. In the implementation process domain, common facilitators were formally appointed implementation leaders and innovation participants. Barriers in this domain were related to the patients. (4) Conclusions: Clinicians identified many barriers and facilitators to implementing HIT that often varied between facilities. Further research is warranted to deepen our understanding of clinicians' experiences with HIT implementation.
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Affiliation(s)
- Julia Aneth Mbalilaki
- Regional Rehabilitation Knowledge Center, Sunnaas Rehabilitation Hospital, 1453 Nesodden, Norway; (J.A.M.); (I.L.); (S.A.R.); (S.N.T.); (A.-M.L.)
| | - Ingvild Lilleheie
- Regional Rehabilitation Knowledge Center, Sunnaas Rehabilitation Hospital, 1453 Nesodden, Norway; (J.A.M.); (I.L.); (S.A.R.); (S.N.T.); (A.-M.L.)
- Department of Nursing and Health Sciences, University of South-Eastern Norway, 3045 Drammen, Norway
| | - Stein A. Rimehaug
- Regional Rehabilitation Knowledge Center, Sunnaas Rehabilitation Hospital, 1453 Nesodden, Norway; (J.A.M.); (I.L.); (S.A.R.); (S.N.T.); (A.-M.L.)
| | - Siri N. Tveitan
- Regional Rehabilitation Knowledge Center, Sunnaas Rehabilitation Hospital, 1453 Nesodden, Norway; (J.A.M.); (I.L.); (S.A.R.); (S.N.T.); (A.-M.L.)
| | - Anne-Margrethe Linnestad
- Regional Rehabilitation Knowledge Center, Sunnaas Rehabilitation Hospital, 1453 Nesodden, Norway; (J.A.M.); (I.L.); (S.A.R.); (S.N.T.); (A.-M.L.)
| | - Pia Krøll
- Skogli Health and Rehabilitation Center, 2614 Lillehammer, Norway;
| | - Simen Lundberg
- Division of Physical Medicine and Rehabilitation, Vestfold Hospital, 3103 Tønsberg, Norway;
| | | | - Jennifer L. Moore
- Regional Rehabilitation Knowledge Center, Sunnaas Rehabilitation Hospital, 1453 Nesodden, Norway; (J.A.M.); (I.L.); (S.A.R.); (S.N.T.); (A.-M.L.)
- Institute for Knowledge Translation, Carmel, IN 46082, USA
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Salmiranta E, Areskoug Josefsson K, Ockander M, Augutis M, Masterson D. The voice of caregivers of children and adolescents with spinal cord injuries: A scoping review. J Spinal Cord Med 2024; 47:315-326. [PMID: 36745084 PMCID: PMC11044720 DOI: 10.1080/10790268.2022.2164455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
CONTEXT Participation in SCI research with caregivers of children and adolescents with spinal cord injury (SCI) can occur in a range of different ways. This review explores the extent to which caregivers' participation is connected to what might be called a voice. OBJECTIVES To explore the voice of caregivers by collating available research with the participation of caregivers of children and adolescents with SCI, and synthesizing how the research has been conducted. METHODS The databases CINAHL, ERIC, MEDLINE, PsycInfo, and Scopus were searched for articles published between January 2008 and March 2022. Descriptive and narrative information was extracted and factors describing how caregivers participated were identified using an inductive approach. RESULTS Twenty-nine articles were identified, of which 28 had affiliations connected to the USA, and 25 to Shriners Hospitals for Children. In most of the articles, the caregivers were invited to participate in the research to complete or develop measures. Information from the caregivers was often captured using close-structured questions and summarized quantitatively with little or no exploration of the perspectives of the caregivers. CONCLUSION The voice of caregivers of children and adolescents with SCI in research is limited by representativeness, the pre-determined emphasis, a lack of involvement in the process, and the reported narrative. By reflecting on voice, caregivers can have their experiences and perspectives acted upon to a greater extent to bring change, ultimately leading to improved care and health for children and adolescents with SCI.
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Affiliation(s)
- Elin Salmiranta
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Kristina Areskoug Josefsson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Faculty of Health Science, University West, Trollhättan, Sweden
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Marlene Ockander
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Marika Augutis
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institute, Solna, Sweden
| | - Daniel Masterson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Bourke JA, Bragge P, River J, Sinnott Jerram KA, Arora M, Middleton JW. Shining a light on the road towards conducting principle-based co-production research in rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1386746. [PMID: 38660394 PMCID: PMC11039800 DOI: 10.3389/fresc.2024.1386746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/29/2024] [Indexed: 04/26/2024]
Abstract
Moving from participatory approaches incorporating co-design to co-production in health research involves a commitment to full engagement and partnership with people with lived experience through all stages of the research process-start to finish. However, despite the increased enthusiasm and proliferation of research that involves co-production, practice remains challenging, due in part to the lack of consensus on what constitutes co-production, a lack of guidance about the practical steps of applying this approach in respect to diverse research methods from multiple paradigms, and structural barriers within academia research landscape. To navigate the challenges in conducting co-produced research, it has been recommended that attention be paid to focusing and operationalising the underpinning principles and aspirations of co-production research, to aid translation into practice. In this article, we describe some fundamental principles essential to conducting co-production research (sharing power, relational resilience, and adopting a learning mindset) and provide tangible, practical strategies, and processes to engage these values. In doing so, we hope to support rehabilitation researchers who wish to engage in co-production to foster a more equitable, ethical, and impactful collaboration with people with lived experience and those involved in their circle of care.
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Affiliation(s)
- John A. Bourke
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Faculty of Medicine and Health, The Kolling Institute, The University of Sydney, Sydney, NSW, Australia
| | - Peter Bragge
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia
| | - Jo River
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Northern Sydney Local Health District, Macquarie Hospital, Sydney, NSW, Australia
| | - K. Anne Sinnott Jerram
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Faculty of Medicine and Health, The Kolling Institute, The University of Sydney, Sydney, NSW, Australia
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Faculty of Medicine and Health, The Kolling Institute, The University of Sydney, Sydney, NSW, Australia
| | - James W. Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- Faculty of Medicine and Health, The Kolling Institute, The University of Sydney, Sydney, NSW, Australia
- Royal Rehab, Ryde, NSW, Australia
- State Spinal Cord Injury Service, NSW Agency for Clinical Innovation, St Leonards, NSW, Australia
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Bourke JA, Jerram KAS, Arora M, Craig A, Middleton JW. Using the consolidated Framework for Implementation Research to integrate innovation recipients' perspectives into the implementation of a digital version of the spinal cord injury health maintenance tool: a qualitative analysis. BMC Health Serv Res 2024; 24:390. [PMID: 38549148 PMCID: PMC10976821 DOI: 10.1186/s12913-024-10847-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/11/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Despite advances in managing secondary health complications after spinal cord injury (SCI), challenges remain in developing targeted community health strategies. In response, the SCI Health Maintenance Tool (SCI-HMT) was developed between 2018 and 2023 in NSW, Australia to support people with SCI and their general practitioners (GPs) to promote better community self-management. Successful implementation of innovations such as the SCI-HMT are determined by a range of contextual factors, including the perspectives of the innovation recipients for whom the innovation is intended to benefit, who are rarely included in the implementation process. During the digitizing of the booklet version of the SCI-HMT into a website and App, we used the Consolidated Framework for Implementation Research (CFIR) as a tool to guide collection and analysis of qualitative data from a range of innovation recipients to promote equity and to inform actionable findings designed to improve the implementation of the SCI-HMT. METHODS Data from twenty-three innovation recipients in the development phase of the SCI-HMT were coded to the five CFIR domains to inform a semi-structured interview guide. This interview guide was used to prospectively explore the barriers and facilitators to planned implementation of the digital SCI-HMT with six health professionals and four people with SCI. A team including researchers and innovation recipients then interpreted these data to produce a reflective statement matched to each domain. Each reflective statement prefaced an actionable finding, defined as alterations that can be made to a program to improve its adoption into practice. RESULTS Five reflective statements synthesizing all participant data and linked to an actionable finding to improve the implementation plan were created. Using the CFIR to guide our research emphasized how partnership is the key theme connecting all implementation facilitators, for example ensuring that the tone, scope, content and presentation of the SCI-HMT balanced the needs of innovation recipients alongside the provision of evidence-based clinical information. CONCLUSIONS Understanding recipient perspectives is an essential contextual factor to consider when developing implementation strategies for healthcare innovations. The revised CFIR provided an effective, systematic method to understand, integrate and value recipient perspectives in the development of an implementation strategy for the SCI-HMT. TRIAL REGISTRATION N/A.
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Affiliation(s)
- John A Bourke
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia.
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand.
| | - K Anne Sinnott Jerram
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW, Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Royal Rehab, Ryde, NSW, Australia
- State Spinal Cord Injury Service, NSW Agency for Clinical Innovation, St Leonards, NSW, Australia
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Hoekstra F, Gainforth HL, Broeksteeg R, Corras S, Collins D, Eleftheriadou E, Gaudet S, Giroux EE, Kuipers LS, McCallum S, Ma JK, de Passillé E, Rakiecki D, Rockall S, van den Berg-Emons R, van Vilsteren A, Williamson M, Wilroy J, Martin Ginis KA. The co-development and evaluation of an e-learning course on spinal cord injury physical activity counselling: a randomized controlled trial. BMC MEDICAL EDUCATION 2024; 24:240. [PMID: 38448881 PMCID: PMC10916033 DOI: 10.1186/s12909-024-05141-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Health, fitness and lifestyle professionals can play important roles in promoting physical activity in groups at risk of developing an inactive lifestyle, such as people with spinal cord injury (SCI). Tailored counselling is a promising tool to promote and improve physical activity levels. To support professionals to effectively have a conversation about physical activity with clients with SCI, evidence-based training and resources are needed. This project aimed to (1) co-develop an e-learning course on best practices for SCI physical activity counselling and, (2) examine the effectiveness and usability of this course. METHODS Guided by the technology-enhanced learning (TEL) evaluation framework, we used a systematic, multistep approach to co-develop and evaluate an e-learning course. The development process was informed by input and feedback from a diverse group of end-users and experts (n > 160) via online surveys and (think-aloud) interviews. A randomized controlled trial was used to compare learning outcomes (post-knowledge and self-efficacy) between participants who completed the course (intervention group) and the wait-listed control group. Usability, learning experiences, and satisfaction were assessed among all participants. RESULTS Forty-one participants (21 intervention-group; 20 control-group) with various backgrounds (e.g., lifestyle counsellors, physiotherapists, occupational therapists, recreation therapists, fitness trainers) enrolled in the randomized controlled trial. After completing the course, participants in the intervention group showed significantly improved knowledge on the best practices for SCI physical activity counselling and higher self-efficacy for using these best practices in conversations with clients with SCI compared to the control group (p <.001). Participants reported above average usability scores, positive learning experiences, and high levels of satisfaction when completing the course. CONCLUSION We used a systematic, multi-step, theory-informed approach to co-develop and evaluate an evidence-based e-learning course on SCI physical activity counselling to support professionals to promote physical activity in their daily practices. The overall positive findings demonstrate that the e-learning course is feasible and ready for further implementation in various health and community settings. Implementation of the e-learning course can help professionals improve the physical activity support they provide to their clients, and subsequently increase physical activity participation in people with SCI.
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Affiliation(s)
- Femke Hoekstra
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada.
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada.
| | - Heather L Gainforth
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada
| | | | - Stephanie Corras
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Delaney Collins
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
| | - Electra Eleftheriadou
- Centre for Teaching and Learning, The University of British Columbia, Kelowna, BC, Canada
| | - Sonja Gaudet
- Spinal Cord Injury British Columbia, Vancouver, BC, Canada
- The Thompson Okanagan Tourism Association, Vernon, BC, Canada
| | - Emily E Giroux
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada
| | | | - Shannon McCallum
- Therapeutic Recreation Program, St. Lawrence College, Kingston, ON, Canada
| | - Jasmin K Ma
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Erica de Passillé
- Horizon Health Network, Stan Cassidy Centre for Rehabilitation, Fredericton, NB, Canada
| | - Diane Rakiecki
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
| | - Shannon Rockall
- Praxis Spinal Cord Institute, Vancouver, BC, Canada
- Access Community Therapists, Vancouver, BC, Canada
| | - Rita van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | | | - Jereme Wilroy
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, BC, Canada
- Department of Medicine, Division of Physical Medicine & Rehabilitation, The University of British Columbia, Vancouver, BC, Canada
- Centre for Chronic Disease Prevention and Management, The University of British Columbia, Kelowna, BC, Canada
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9
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Latulippe K, Tessier A, Routhier F, Raymond É, Fiset D, Corcuff M, Archambault PS. Facilitators and challenges in partnership research aimed at improving social inclusion of persons with disabilities. Disabil Rehabil 2024; 46:957-968. [PMID: 36945786 DOI: 10.1080/09638288.2023.2188264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/02/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE To identify partnership research challenges and facilitators, as experienced by members of the Inclusive Society (IS) initiative. MATERIALS AND METHODS A case study was conducted on all partnership research projects conducted between 2017 and 2019 under the IS initiative through surveys, interviews with the IS community, logbooks, and focus group. Thematic analysis and descriptive analysis were undertaken. RESULTS To work effectively with a diversity of stakeholders, winning conditions must be created for the project from the outset. These include determining the team functioning, project objectives, the expectations of each party, and agreeing on a realistic action plan. Project implementation with concern for sustained stakeholder commitment, good working relationships, and achieving project objectives requires organizational planning that favours partner involvement, shared leadership, agreed methods for communicating, conflict resolution methods, recognition of each participant's expertise, and creating a climate of trust. Upon concluding a partnership research project, it is essential to devote time to implement project results in local environments and to ascertain their usefulness to partners. IS partnership research challenges and facilitators are similar to those identified in past research. Despite this knowledge, challenges persist. Future research could explore tools and practices from other domain to overcome partnership research challenges.
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Affiliation(s)
- Karine Latulippe
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
| | - Alexandra Tessier
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Émilie Raymond
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
- School of Social Work and Criminology, Université Laval, Québec, Canada
| | - David Fiset
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Maëlle Corcuff
- Department of Rehabilitation, Université Laval, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
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Giroux EE, Athanasopoulos P, Sweet SN, Gainforth HL. A case study of using community-based consensus methods to facilitate shared decision-making among a spinal cord injury network. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1335467. [PMID: 38434234 PMCID: PMC10904660 DOI: 10.3389/fresc.2024.1335467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/19/2024] [Indexed: 03/05/2024]
Abstract
Spinal cord injury (SCI) research and policy decisions are rarely made in partnership with people with SCI, making them less relevant, applicable, and used by those whom the decisions are intended to support. Across disciplines, consensus methods have been promoted as a viable solution for supporting shared research and policy-based decision-making. In this paper, we describe a partnered approach between academic researchers and the Ontario SCI Alliance, a non-profit, SCI community mobilization network to co-develop and co-disseminate a community-based consensus exercise. The community-based consensus exercise included two modified Delphi surveys and one in-person retreat. The partnership's goal with this exercise was to facilitate shared decision-making for the development of their upcoming strategic plan. We then interviewed partners and participants from the Delphi and in-person retreat to discuss successes, challenges, and lessons learned from the exercise. Survey 1 was disseminated to over 2,500 members of the Ontario SCI community and received 374 responses (276 coming from people with SCI). Survey 2 had 118 responses, with 87 coming from people with SCI. The retreat had 73 attendees, including people with SCI, family/friends of people with SCI, clinicians, researchers, and SCI community and research organization staff/volunteers. The retreat included a presentation of the survey results, a clinician/researcher panel, and externally-facilitated working groups. All survey responses and retreat materials were synthesized. Using the synthesized feedback, the Ontario SCI Alliance was able to implement several changes for the Ontario SCI community, including higher-quality primary care experiences (reduced wait times, more accessible examining rooms), the development of a wound care strategy with the Ontario government, and an advocacy campaign for public coverage for catheters and urinary care supplies. From the five interviews conducted, five themes were co-constructed regarding the successes, challenges, and lessons learned from the exercise: (1) Inclusion, Diversity, Equity, and Accessibility; (2) Partnership; (3) Design Considerations; (4) Transparency and Clarity in Communication; and (5) Sustainability. Findings from this community case study demonstrate the feasibility of conducting a community-level consensus exercise among an equity-deserving group while providing detailed guidance for how to ensure future research and policy-based decision-making is shared across diverse knowledge users.
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Affiliation(s)
- Emily E. Giroux
- Centre for Health Behaviour Change, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Peter Athanasopoulos
- Department of Public Policy and Government Relations, Spinal Cord Injury Ontario, Toronto, ON, Canada
| | - Shane N. Sweet
- Department of Kinesiology & Physical Education, McGill University, Montreal, QC, Canada
| | - Heather L. Gainforth
- Centre for Health Behaviour Change, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
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Cranston KD, Grieve NJ, Dineen TE, Jung ME. Designing and Developing Online Training for Diabetes Prevention Program Coaches Using an Integrated Knowledge Translation Approach: Development and Usability Study. JMIR Form Res 2024; 8:e50942. [PMID: 38277214 PMCID: PMC10858411 DOI: 10.2196/50942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND e-Learning has rapidly become a popular alternative to in-person learning due to its flexibility, convenience, and wide reach. Using a systematic and partnered process to transfer in-person training to an e-learning platform helps to ensure the training will be effective and acceptable to learners. OBJECTIVE This study aimed to develop an e-learning platform for Small Steps for Big Changes (SSBC) type 2 diabetes prevention program coaches to improve the viability of coach training. METHODS An integrated knowledge translation approach was used in the first 3 stages of the technology-enhanced learning (TEL) evaluation framework to address the study objective. This included three steps: (1) conducting a needs analysis based on focus groups with previously trained SSBC coaches, meetings with the SSBC research team, and a review of research results on the effectiveness of the previous in-person version of the training; (2) documenting processes and decisions in the design and development of the e-learning training platform; and (3) performing usability testing. Previously trained SSBC coaches and the SSBC research team were included in all stages of this study. RESULTS Step 1 identified components from the in-person training that should be maintained in the e-learning training (ie, a focus on motivational interviewing), additional components to be added to the e-learning training (ie, how to deliver culturally safe and inclusive care), and mode of delivery (videos and opportunities to synchronously practice skills). Step 2 documented the processes and decisions made in the design and development of the e-learning training, including the resources (ie, time and finances) used, the content of the training modules, and how coaches would flow through the training process. The design and development process consisted of creating a blueprint of the training. The training included 7 e-learning modules, the learning modalities of which included narrated demonstration videos and user-engaging activities, a mock session with feedback from the research team, and a final knowledge test. Step 3, usability testing, demonstrated high levels of learnability, efficiency, memorability, and satisfaction, with minor bugs documented and resolved. CONCLUSIONS Using an integrated knowledge translation approach to the technology-enhanced learning evaluation framework was successful in developing an e-learning training platform for SSBC coaches. Incorporating end users in this process can increase the chances that the e-learning training platform is usable, engaging, and acceptable. Future research will include examining the satisfaction of coaches using the SSBC coach e-learning training platform, assessing coach learning outcomes (ie, knowledge and behavior), and estimating the cost and viability of implementing this training.
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Affiliation(s)
- Kaela D Cranston
- Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Natalie J Grieve
- Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Tineke E Dineen
- Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Mary E Jung
- Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
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Reszel J, Daub O, Leese J, Augustsson H, Bellows DM, Cassidy CE, Crowner BE, Dunn SI, Goodwin LB, Hoens AM, Hunter SC, Lynch EA, Moore JL, Rafferty MR, Romney W, Stacey D, Graham ID. Essential content for teaching implementation practice in healthcare: a mixed-methods study of teams offering capacity-building initiatives. Implement Sci Commun 2023; 4:151. [PMID: 38012798 PMCID: PMC10680357 DOI: 10.1186/s43058-023-00525-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals' and teams' ability to apply implementation science in practice is through training and professional development opportunities (capacity-building initiatives). Although there is an increasing demand for and offerings of implementation practice capacity-building initiatives, there is no universal agreement on what content should be included. In this study we aimed to explore what capacity-building developers and deliverers identify as essential training content for teaching implementation practice. METHODS We conducted a convergent mixed-methods study with participants who had developed and/or delivered a capacity-building initiative focused on teaching implementation practice. Participants completed an online questionnaire to provide details on their capacity-building initiatives; took part in an interview or focus group to explore their questionnaire responses in depth; and offered course materials for review. We analyzed a subset of data that focused on the capacity-building initiatives' content and curriculum. We used descriptive statistics for quantitative data and conventional content analysis for qualitative data, with the data sets merged during the analytic phase. We presented frequency counts for each category to highlight commonalities and differences across capacity-building initiatives. RESULTS Thirty-three individuals representing 20 capacity-building initiatives participated. Study participants identified several core content areas included in their capacity-building initiatives: (1) taking a process approach to implementation; (2) identifying and applying implementation theories, models, frameworks, and approaches; (3) learning implementation steps and skills; (4) developing relational skills. In addition, study participants described offering applied and pragmatic content (e.g., tools and resources), and tailoring and evolving the capacity-building initiative content to address emerging trends in implementation science. Study participants highlighted some challenges learners face when acquiring and applying implementation practice knowledge and skills. CONCLUSIONS This study synthesized what experienced capacity-building initiative developers and deliverers identify as essential content for teaching implementation practice. These findings can inform the development, refinement, and delivery of capacity-building initiatives, as well as future research directions, to enhance the translation of implementation science into practice.
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Affiliation(s)
- Jessica Reszel
- School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada.
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada.
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Canada.
| | - Olivia Daub
- School of Communication Sciences and Disorders, Western University, London, Canada
| | - Jenny Leese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Hanna Augustsson
- Procome Research Group, Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine (CES), Stockholm, Sweden
| | - Danielle Moeske Bellows
- School of Physical Therapy, Massachusetts College of Pharmacy and Health Sciences, Worcester, USA
| | - Christine E Cassidy
- School of Nursing, Dalhousie University, Halifax, Canada
- IWK Health Centre, Halifax, Canada
| | | | - Sandra I Dunn
- School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
- Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Canada
| | - Lisa B Goodwin
- Inpatient Rehabilitation, University of Vermont Medical Center, Colchester, USA
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Sarah C Hunter
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, Australia
| | - Elizabeth A Lynch
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, Australia
| | - Jennifer L Moore
- Regional Rehabilitation Knowledge Center, Sunnaas Hospital, Oslo, Norway
- Institute for Knowledge Translation, Carmel, Indiana, USA
| | - Miriam R Rafferty
- Shirley Ryan AbilityLab and Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, USA
| | - Wendy Romney
- Physical Therapy, Sacred Heart University, Fairfield, USA
| | - Dawn Stacey
- School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Ian D Graham
- School of Nursing, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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13
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Wiest MJ, Gargaro J, Bayley MT. What Is the Pathway to the Best Model of Care for Traumatic Spinal Cord Injury? Evidence-Based Guidance. Top Spinal Cord Inj Rehabil 2023; 29:103-111. [PMID: 38174142 PMCID: PMC10759857 DOI: 10.46292/sci23-00059s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Introduction People with traumatic spinal cord injury (tSCI) experience lifelong physical and emotional health impacts, needing specialized care that is complex to navigate. The non-standardized care pathways used by different jurisdictions to address these needs lead to care inequities and poor health outcomes. Purpose To develop an evidence-based integrated tSCI Care Pathway, from time of injury to life in the community. Methods and Analysis Eighty key partners engaged in planning, providing, and receiving tSCI care (1) identified existing guidelines, pathways, and care models; (2) created the tSCI Care Pathway with key elements or building blocks ("the what"), not specific recommendations ("the how") for each care stage (Acute, Rehabilitation, and Community), with elements highlighting the role of primary care and equity considerations on the pathway; (3) identified regional gaps in the tSCI Pathway and prioritized them for implementation; and (4) developed quality indicators. Outcomes The tSCI Pathway was drafted in overarching and detailed formats. For Acute Care, building blocks focused on appropriate assessment, initial management, and transition planning; for Rehabilitation, building blocks focused on access to specialized rehabilitation and assessment and planning of community needs; for Community, building blocks focused on follow-up, mechanisms for re-access, and holistic support for persons and families; and for equity considerations, building blocks focused on those at-risk or requiring complex supports. Team-based primary care and navigation supports were seen as crucial to reduce inequities. Conclusion This is the first comprehensive care pathway for tSCI. The Pathway is grounded in person-centred care, integrated care and services, and up-to-date clinical practice guidelines. The tSCI Care Pathway is flexible to regional realities and individual needs to ensure equitable care for all.
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Affiliation(s)
- Matheus Joner Wiest
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Judith Gargaro
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Mark T. Bayley
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
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Shwed A, Giroux EE, Hoekstra F, McKay RC, Schaefer L, West CR, McPhail LT, Sibley KM, McBride CB, Munro B, Kaiser A, Gainforth HL. Supporting meaningful research partnerships: an interview study applying behavior change theory to develop relevant recommendations for researchers. Transl Behav Med 2023; 13:833-844. [PMID: 37481469 DOI: 10.1093/tbm/ibad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023] Open
Abstract
Research partnerships, while promising for ensuring translation of relevant and useable findings, are challenging and need support. This study aimed to apply behavior change theory to understand and support researchers' adoption of a research partnership approach and the Integrated Knowledge Translation (IKT) Guiding Principles for conducting and disseminating spinal cord injury (SCI) research in partnership. Using an IKT approach, SCI researchers across Canada and the USA completed a survey (n = 22) and were interviewed (n = 13) to discuss barriers and facilitators to deciding to partner and follow the IKT Guiding Principles. The Behaviour Change Wheel, Theoretical Domains Framework (TDF), and Mode of Delivery Ontology were used to develop the survey, interview questions, and guided analyses of interview data. COM-B and TDF factors were examined using descriptive statistics and abductive analyses of barriers and facilitators of decisions to partner and/or use the IKT Guiding Principles. TDF domains from the interview transcripts were then used to identify intervention, content, and implementation options. 142 factors (79 barriers, 63 facilitators) related to deciding to partner, and 292 factors (187 barriers, 105 facilitators) related to deciding to follow the IKT Guiding Principles were identified. Barriers to partnering or use the IKT Guiding Principles were primarily related to capability and opportunity and relevant intervention options were recommended. Interventions must support researchers in understanding how to partner and use the IKT Guiding Principles while navigating a research system, which is not always supportive of the necessary time and costs required for meaningful research partnerships.
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Affiliation(s)
- Alanna Shwed
- Faculty of Health and Social Development, School of Health and Exercise Science, University of British Columbia Okanagan, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily E Giroux
- Faculty of Health and Social Development, School of Health and Exercise Science, University of British Columbia Okanagan, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Femke Hoekstra
- Faculty of Health and Social Development, School of Health and Exercise Science, University of British Columbia Okanagan, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Rhyann C McKay
- Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Lee Schaefer
- College of Kinesiology, University of Saskatchewan, Saskatoon, British Columbia, Canada
| | - Christopher R West
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Lowell T McPhail
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathryn M Sibley
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | - Barry Munro
- North American Spinal Cord Injury Consortium, Niagara Falls, NY, USA
| | - Anita Kaiser
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Heather L Gainforth
- Faculty of Health and Social Development, School of Health and Exercise Science, University of British Columbia Okanagan, Kelowna, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
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Biller OM, Biundo J, Mitchell ESL, Richardson B, Burkhart I, Kim RY, Gerhardt NM, Mulcahey MJ. Promoting community engagement in spinal cord injury research: a case example. Spinal Cord 2023; 61:632-635. [PMID: 37591948 DOI: 10.1038/s41393-023-00926-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
Community engagement is an important method of knowledge translation in spinal cord injury (SCI) research where researchers collaborate with people with lived experience, care partners, and other research users to improve the quality of research. This perspective article aims to promote community engagement in SCI research by describing useful resources for its implementation and providing an example project using the North American Spinal Cord Injury Consortium (NASCIC) process for such partnerships. Researchers from the Jefferson College of Rehabilitation Sciences' (JCRS) Center for Outcomes and Measurement engaged NASCIC to create an advisory committee composed of four people living with SCI to make recommendations for the methods of a large-scale study to develop a clinical outcome assessment. The advisory committee made usable recommendations for enhancing recruitment methods and reducing burden and barriers to participation. The successful partnership between NASCIC and JCRS shows the feasibility and value of SCI community engagement in research.
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Affiliation(s)
- Olivia M Biller
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
- Janssen Pharmaceuticals, LLC, Raritan, NJ, USA
| | - Jason Biundo
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
| | | | | | - Ian Burkhart
- The North American Spinal Cord Injury Consortium, Buffalo, NY, USA
| | - Rachel Y Kim
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nicole M Gerhardt
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA.
| | - M J Mulcahey
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
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Tappan RS, Ettinger JR, Mahon D, Mroz SE, Hall W, Maajid E, Stratton C, Zynda DT, Conroy DE, Danilovich M. Development of a physical activity counseling intervention for people with chronic respiratory disease based on the health action process approach. Pilot Feasibility Stud 2023; 9:173. [PMID: 37828614 PMCID: PMC10568913 DOI: 10.1186/s40814-023-01397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Physical activity (PA) counseling holds promise for increasing PA levels in people with chronic respiratory disease, though little long-term change has been shown to date. Here, we describe the development of a Health Action Process Approach-based PA counseling intervention that aims to promote PA and exercise in people with chronic respiratory disease who are enrolled in pulmonary rehabilitation. METHODS To collaborate in defining and refining the intervention, we convened a varied team of authors that included a panel of five stakeholder partners: three patients, one clinician, and one health behavior change researcher. We completed three steps in the intervention development process: (1) initial intervention creation, (2) iterative intervention refinement, and (3) assessment of intervention acceptability. In step 1, we created an initial draft of the PA counseling intervention based on the HAPA theoretical framework, previous evidence in people with chronic respiratory disease, and clinical experience. In step 2, we used qualitative methods of focus groups and interviews to further develop and refine the intervention. Fifteen meetings occurred with the five-member stakeholder partner panel (six focus groups with the three patient partners, four interviews with the clinician partner, and five interviews with the researcher partner) over 5 months to systematically elicit input and incorporate it into the intervention. In step 3, we measured the intervention acceptability using five-point Likert scale ratings. RESULTS Intervention materials included the eligibility screen, participant workbook, and leader guide. We identified key themes in the input from the stakeholder partners and incorporated this input into the intervention content and methods. Ratings of the intervention by the stakeholder partners (n=5) were high with mean ratings ranging 4.0-5.0 on a five-point scale. CONCLUSIONS This development process successfully engaged an intervention development team with diverse perspectives and resulted in a PA counseling intervention for people with chronic respiratory disease. The intervention's strong theoretical underpinning, person-centeredness, and the contributions from varied perspectives during intervention development position it well for future evaluations of feasibility, efficacy, and effectiveness.
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Affiliation(s)
- Rachel S Tappan
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
- Department of Medicine (Pulmonary and Critical Care), Feinberg School of Medicine, Northwestern University, 645 N. Michigan Avenue, Suite 1100, Chicago, Illinois, 60611, USA.
| | - Jennifer R Ettinger
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Delaney Mahon
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Sarah E Mroz
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Walter Hall
- , 933 Garden Lane, Homewood, Illinois, 60430, USA
| | - Estelle Maajid
- , 536 East 32nd Street Unit E, Chicago, Illinois, 60616, USA
| | - Chelsea Stratton
- Department of Physical Therapy, Marquette University, Schroeder Complex, Room 346, P.O. Box 1881, Milwaukee, Wisconsin, 53210, USA
| | | | - David E Conroy
- Department of Kinesiology, Human Development & Family Studies and Public Health Sciences, The Pennsylvania State University, 268U Recreation Building, University Park, Pennsylvania, 16802, USA
| | - Margaret Danilovich
- Leonard Schanfield Research Institute, CJE SeniorLife, 3003 W. Touhy Avenue, Chicago, Illinois, 60645, USA
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Ibáñez-Carrasco F, Jiancaro T, Torres B, McDuff K, Da Silva G, Lindsay J, Price C, Islam S, Bradford G, O'Brien KK. HIV in MOTION: a community of practice on physical rehabilitation for and by people living with HIV and their allies. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1154692. [PMID: 37869573 PMCID: PMC10588699 DOI: 10.3389/fresc.2023.1154692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023]
Abstract
Background This paper describes the design, implementation, and evaluation of a community of practice (CoP), HIV in MOTION (HIM), to advance physical activity rehabilitation interventions with adults living with HIV, clinicians, researchers, and representatives from community-based organizations. We attracted a diverse audience of geographically dispersed people living with HIV, clinicians, exercise personnel, and trainees to eight HIM community of practice events that featured the clinical, research, and lived experience of people living with HIV. HIV in MOTION had (a) a domain related to physical rehabilitation, exercise, and social participation for people living with HIV; (b) a community of diverse individuals; and (c) a practice, that is, a series of sustained interactions online and offline, synchronous, and asynchronous. Our team included six diverse people living with HIV, two coordinators, and three academic researchers who planned, prepared, implemented, and evaluated each online session. To evaluate the HIV in MOTION CoP, we employed an evaluation framework composed of five criteria: Goals and Scope, Context and Structure, Process and Activities, Outcomes, and Impact. We collected quantitative and qualitative evaluative data using online evaluation, audiovisual archiving, and participant observations during the debriefing with all members of our team. Results We widened the Goals and Scope of the HIV in MOTION CoP to include the HIV narrative of lived experiences, including autopathography, and participant storytelling. In matters of Context and Structure, we received explicit satisfaction with our governance and leadership. Also, being flexible to fit online formats was a productive strategy that made the HIV in MOTION CoP sessions agile and amenable to audiovisual archiving. Our indicators of success in Process, Activities, and Outcomes included participant retention online, elicited verbal interventions and comments in the chat room, and a rate of three repeat visits online. The indicators of success of Impact were the presence of voluntary and unscripted autopathography, the patient storytelling and how it reportedly caused changes in the participants, and the "legitimate peripheral participation" of emerging research and clinical students. In conclusion, we recommend our form of CoP for mixing the knowledge of diverse persons in this area. However, we recommend considering budget and burnout as serious challenges to sustainability.
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Affiliation(s)
| | - Tizneem Jiancaro
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Brittany Torres
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kiera McDuff
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - George Da Silva
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Joanne Lindsay
- MAP Centre for Urban Health Solutions, Unity Health, St. Michael's Hospital, Toronto, ON, Canada
| | - Colleen Price
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shaz Islam
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Kelly K. O'Brien
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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18
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Anderson KD. Including People with Spinal Cord Injury in Research as Participants, Partners, and Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6466. [PMID: 37569008 PMCID: PMC10418427 DOI: 10.3390/ijerph20156466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
Individuals with disabilities are significantly underrepresented in research and are often not included in discussions on diversity, equity, inclusion, and accessibility. The Advisory Committee to the National Institutes of Health Director Working Group on Diversity formed an ad hoc Subgroup on Individuals with Disabilities to develop recommendations on how to enhance the inclusion of people with disabilities in the scientific workforce as well as throughout the research ecosystem. The article summarizes those recommendations and how they came about, then contextualizes them for the spinal cord injury (SCI) research field. Other fields that do not typically include individuals with disabilities in research can learn from the strong history of including people with SCI as research participants. There has been a growing drive within our field to enhance the inclusion of people living with SCI as research partners, but how are we doing with promoting their inclusion in the scientific workforce?
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Affiliation(s)
- Kim D Anderson
- Department of Physical Medicine and Rehabilitation, MetroHealth System, School of Medicine, Case Western Reserve University, Cleveland, OH 44109, USA
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Shwed A, Hoekstra F, Bhati D, Athanasopoulos P, Chernesky J, Martin Ginis K, McBride CB, Mortenson WB, Sibley KM, Sweet SN, Gainforth HL. IKT Guiding Principles: demonstration of diffusion and dissemination in partnership. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:53. [PMID: 37438787 DOI: 10.1186/s40900-023-00462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Integrated knowledge translation (IKT) is a partnered approach to research that aims to ensure research findings are applied in practice and policy. IKT can be used during diffusion and dissemination of research findings. However, there is a lack of understanding how an IKT approach can support the diffusion and dissemination of research findings. In this study, we documented and described the processes and outcomes of an IKT approach to diffusing and disseminating the findings of consensus recommendations for conducting spinal cord injury research. METHODS Communication of the IKT Guiding Principles in two phases: a diffusion phase during the first 102 days from the manuscript's publication, followed by a 1147 day active dissemination phase. A record of all inputs was kept and all activities were tracked by monitoring partnership communication, a partnership tracking survey, a project curriculum vitae, and team emails. Awareness outcomes were tracked through Google Analytics and a citation-forward search. Awareness includes the website accesses, the number of downloads, and the number of citations in the 29 month period following publication. RESULTS In the diffusion period, the recommendations were viewed 60 times from 4 different countries, and 4 new downloads. In the dissemination period, the recommendations were viewed 1109 times from 39 different countries, 386 new downloads, and 54 citations. Overall, during dissemination there was a 17.5% increase in new visitors to the website a month and a 95.5% increase in downloads compared to diffusion. CONCLUSION This project provides an overview of an IKT approach to diffusion and dissemination. Overall, IKT may be helpful for increasing awareness of research findings faster; however, more research is needed to understand best practices and the the impact of an IKT approach on the diffusion and dissemination versus a non-partnered approach.
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Affiliation(s)
- Alanna Shwed
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada.
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
| | - Femke Hoekstra
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - DivyaKanwar Bhati
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | | | | | - Kathleen Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | | | - W Ben Mortenson
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Kathryn M Sibley
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
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20
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Herbison JD, Osborne M, Andersen J, Lepage P, Pagé V, Levasseur C, Beckers M, Gainforth HL, Lamontagne ME, Sweet SN. Strategies to improve access to physical activity opportunities for people with physical disabilities. Transl Behav Med 2023; 13:486-500. [PMID: 36999796 DOI: 10.1093/tbm/ibac119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Community-based physical activity opportunities have been shown to help adults with physical disabilities improve their participation in daily activities and reduce social isolation. Despite the known benefits, substantial barriers and challenges inhibit accessibility to these physical activity opportunities. To facilitate the co-construction of strategies to overcome accessibility issues pertaining to community-based physical activity opportunities. In total, 45 individuals with physical disabilities, patients at a rehabilitation hospital, staff members of disability organizations, staff of local or provincial government agencies/departments, kinesiologists, occupational therapists, graduate students, and peer mentors participated in one of four World Cafés held in their respective cities. World Café is a methodology for fostering collaborative, solution-focused conversation that aims to solve problems through collective intelligence. Participants were divided into groups of three to four people and invited to engage in evolving rounds of discussions responding to prompts about accessibility to physical activity in their communities. Transcripts were analyzed using content analysis. In total, 17 strategies were identified, addressing 5 areas: representation and visibility (e.g., prioritize hiring people with a disability), finances (e.g., reduce direct costs for participants), connection and social support (e.g., foster social networks that provide informational support), education and programming (e.g., enhance awareness of existing services and resources), and government programs and policies (e.g., enforce accessibility standards for indoor and outdoor spaces). The findings of this study provide strategies and practical applications for community programs and governments to consider for increasing access to physical activity opportunities for people with physical disabilities.
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Affiliation(s)
- Jordan D Herbison
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec H2W 1S4, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec H3S 1M9, Canada
| | - Meaghan Osborne
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec H2W 1S4, Canada
| | - Jessica Andersen
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec H2W 1S4, Canada
| | - Pierre Lepage
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec H2W 1S4, Canada
| | - Véronique Pagé
- Viomax Adapted Fitness Center, Montreal, Quebec H2H 1L6, Canada
| | | | - Mélissa Beckers
- Viomax Adapted Fitness Center, Montreal, Quebec H2H 1L6, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, The University of British Columbia - Okanagan, Kelowna V1V 1V7, British Columbia, Canada
- International Collaboration on Repair Discoveries, Faculty of Medicine, The University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, British Columbia V6T 2B5, Canada
| | - Marie-Eve Lamontagne
- Département de Réadaptation, Université Laval, Quebec, Quebec G1V 0A6, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec, Quebec G1M 2S8, Canada
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec H2W 1S4, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec H3S 1M9, Canada
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21
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Thorogood NP, Waheed Z, Chernesky J, Burkhart I, Smith J, Sweeney S, Wudlick R, Douglas S, Wang D, Noonan VK. Spinal Cord Injury Community Personal Opinions and Perspectives on Spinal Cord Stimulation. Top Spinal Cord Inj Rehabil 2023; 29:1-11. [PMID: 37235197 PMCID: PMC10208255 DOI: 10.46292/sci22-00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Background Spinal cord stimulation (SCS) clinical trials are evaluating its efficacy and safety for motor, sensory, and autonomic recovery following spinal cord injury (SCI). The perspectives of people living with SCI are not well known and can inform the planning, delivery, and translation of SCS. Objectives To obtain input from people living with SCI on the top priorities for recovery, expected meaningful benefits, risk tolerance, clinical trial design, and overall interest in SCS. Methods Data were collected anonymously from an online survey between February and May 2020. Results A total of 223 respondents living with SCI completed the survey. The majority of respondents identified their gender as male (64%), were 10+ years post SCI (63%), and had a mean age of 50.8 years. Most individuals had a traumatic SCI (81%), and 45% classified themselves as having tetraplegia. Priorities for improved outcome for those with complete or incomplete tetraplegia included fine motor skills and upper body function, whereas priorities for complete or incomplete paraplegia included standing and walking, and bowel function. The meaningful benefits that are important to achieve are bowel and bladder care, less reliance on caregivers, and maintaining physical health. Perceived potential risks include further loss of function, neuropathic pain, and complications. Barriers to participation in clinical trials include inability to relocate, out-of-pocket expenses, and awareness of therapy. Respondents were more interested in transcutaneous SCS than epidural SCS (80% and 61%, respectively). Conclusion SCS clinical trial design, participant recruitment, and translation of the technology can be improved by better reflecting the priorities and preferences of those living with SCI identified from this study.
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Affiliation(s)
| | - Zeina Waheed
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - John Chernesky
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Ian Burkhart
- North American Spinal Cord Injury Consortium, Niagara Falls, New York
| | - Judith Smith
- North American Spinal Cord Injury Consortium, Niagara Falls, New York
| | - Shannon Sweeney
- North American Spinal Cord Injury Consortium, Niagara Falls, New York
| | - Rob Wudlick
- North American Spinal Cord Injury Consortium, Niagara Falls, New York
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Sam Douglas
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Di Wang
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
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22
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Hendry KL, Vecchio A. Involving people with lived experience of spinal cord injury in research: a policy for consumer remuneration. Spinal Cord 2023; 61:285-287. [PMID: 36899098 DOI: 10.1038/s41393-023-00888-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/12/2023]
Abstract
To ensure that research outcomes are relevant and meet the needs of the spinal cord jury (SCI) community, it is essential that people with lived experience of SCI ('consumers') are actively involved in all stages of the research process. One of the goals of the Spinal Research Institute (SRI) ( www.thesri.org ) is to facilitate this active engagement of consumers in research. In order to support consumer involvement, appropriate resources, including remuneration, need to be in place. This paper sets out the process undertaken by the SRI to develop a Policy for Consumer Remuneration. It addresses the rationale for creating a policy, the resources used and shares the model that defines the levels of consumer engagement and associated remuneration. The SRI Policy for Consumer Remuneration sets a standard for the SCI research field, which can serve as a model for Australia and as a template for other countries.
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23
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Hoekstra F, Martin Ginis KA, Collins D, Dinwoodie M, Ma JK, Gaudet S, Rakiecki D, Gainforth HL. Applying state space grids methods to characterize counsellor-client interactions in a physical activity behavioural intervention for adults with disabilities. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 65:102350. [PMID: 37665832 DOI: 10.1016/j.psychsport.2022.102350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 09/06/2023]
Abstract
BACKGROUND Physical activity (PA) counselling research has mainly focused on identifying which behaviour change techniques (BCTs) are delivered by a counsellor. Less is known about how BCTs are received by clients. State Space Grids (SSGs) is a dynamic system method that can be used to study counsellor-client interactions by examining frequencies, durations and sequences of BCT delivery and receipt. In this methods paper, we show how SSG methods can be pragmatically used to characterize counsellor-client interactions during a PA behavioural support intervention for adults with disabilities. METHODS Methods were demonstrated through a secondary analysis of data from adults with spinal cord injury (age: 45.79 ± 13.63; females: n = 5; males: n = 9) who received PA counselling. Transcripts of 30 audio-recorded counselling sessions (total duration: ∼8.3 h) were double-coded for BCT delivery and receipt statements using a reliable coding method (>84% agreement) and analyzed in two different ways using SSGs methods. RESULTS Applying the SSG analyses to our data demonstrated that frequencies, durations, and sequences of BCT delivery and receipt varied largely within and between dyads. Across all sessions, the counsellor and client spent on average 32-34% of their time on talking about BCTs related to goals and planning, ∼29% of their time talking about other BCTs (e.g., self-belief, support strategies), and the remaining 27-29% of their time talking about other topics (not BCT-specific). CONCLUSION This paper showed how dynamic system methods can be pragmatically used to characterize counsellor-client interactions and illustrate the variability of how BCTs are delivered by a counsellor and received by clients in a PA behavioural support intervention. We demonstrated that SSGs methods can facilitate the examination of frequencies, durations and sequences of BCT delivery and receipt can help advance our understanding of PA behavioural support for adults with and without disabilities.
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Affiliation(s)
- Femke Hoekstra
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, BC, Canada; Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, BC, Canada
| | - Delaney Collins
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Miranda Dinwoodie
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Jasmin K Ma
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada; Arthritis Research Canada, Vancouver, BC, Canada; School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Sonja Gaudet
- Spinal Cord Injury British Columbia, Vancouver, BC, Canada; The Thompson Okanagan Tourism Association, Vernon, BC, Canada
| | - Diane Rakiecki
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; School District, Vernon, BC, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
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Consumer engagement in doctoral research - what difference does it make? Spinal Cord 2023; 61:175-183. [PMID: 36585485 PMCID: PMC9802020 DOI: 10.1038/s41393-022-00871-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022]
Abstract
STUDY DESIGN Qualitative reflective descriptive study. OBJECTIVE To evaluate a consumer engagement experience in the context of doctoral research. SETTING Full time doctoral research at an Australian university. METHOD A reflective evaluation of consumer engagement was completed, presented using the Guidance for Reporting Involvement of Patients and the Public, and frameworks of the research cycle, levels of consumer participation and integrated knowledge translation guiding principles providing theoretical background. Seven people with SCI (n = 6 men, n = 1 woman) replied to an expression of interest to join a Consumer Advisory Group for a doctoral researcher. Activities included: four 90-minute meetings, formal and ad-hoc email exchanges, and one-to-one conversations as required. Data sources included meeting transcripts, email correspondence, researcher's notes, and a short consumer survey. RESULTS Consumer engagement occurred at each stage of the research cycle and met all guiding principles. Consumers participated at consultation and involving levels, however, collaboration evolved. Enablers included a common interest for the research topic, rapport with the researcher, using a virtual platform to disseminate research findings, supervisory support, and availability of funding. Challenges included complexity in harnessing different perspectives, using a virtual platform for group meetings, time, and consumers' negative experiences of media. CONCLUSION Consumer engagement informed doctoral research by promoting nuanced perspectives on the unique experiences of living with SCI, providing unanticipated richness to data analysis. Building trust, and being responsive, led to in-depth consumer participation.
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Shi Z, Michalovic E, McKay R, Gainforth HL, McBride CB, Clarke T, Casemore S, Sweet SN. Outcomes of spinal cord injury peer mentorship: A community-based Delphi consensus approach. Ann Phys Rehabil Med 2023; 66:101678. [PMID: 35659583 DOI: 10.1016/j.rehab.2022.101678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/28/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Zhiyang Shi
- McGill University, Department of Kinesiology and Physical Education, Montreal, QC, Canada; Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, QC, Canada.
| | - Emilie Michalovic
- McGill University, Department of Kinesiology and Physical Education, Montreal, QC, Canada; Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, QC, Canada
| | - Rhyann McKay
- University of British Columbia Okanagan, School of Health and Exercise Sciences, Kelowna, BC, Canada; International Collaboration on Repair Discoveries, Canada
| | - Heather L Gainforth
- University of British Columbia Okanagan, School of Health and Exercise Sciences, Kelowna, BC, Canada; International Collaboration on Repair Discoveries, Canada
| | | | | | | | - Shane N Sweet
- McGill University, Department of Kinesiology and Physical Education, Montreal, QC, Canada; Centre for Interdisciplinary Rehabilitation Research in Metropolitan Montreal, Montreal, QC, Canada
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McInroy LB, Hawkins BW, Zapcic I, Fregoli C. Design Thinking for Health Disparities and Interdisciplinary Knowledge Translation: An LGBTQ+ Youth Health Literacy Project. HEALTH & SOCIAL WORK 2023; 48:21-32. [PMID: 36453891 PMCID: PMC9844035 DOI: 10.1093/hsw/hlac035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/12/2021] [Accepted: 01/05/2022] [Indexed: 06/17/2023]
Abstract
This article discusses the use of codesign, design thinking (DT), and design jams in collaboration with interdisciplinary scholars, service providers, and community-based stakeholders as an approach to social work intervention development-specifically, to tackle health inequities and timely knowledge translation (KT). An application of these methods to the problem of sexual health disparities and lack of access to inclusive sexual health education in school-based settings for LGBTQ+ youth is discussed. LGBTQ+ Youth HeLP (Health Literacy Project) is a holistic online sexual health resource providing evidence-based information to LGBTQ+ youth in an accessible and age-appropriate format. This article considers potential opportunities and obstacles for utilizing DT to develop responsive solutions to health inequities and health-related KT learned from the project. Codesign offers effective options for generating collaborations that may increase cross-stakeholder perspective taking in group settings and produce high-quality outputs with increased likelihood of uptake.
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Affiliation(s)
- Lauren B McInroy
- is assistant professor, College of Social Work, The Ohio State University, Stillman Hall, 1947 College Road, Columbus, OH 43210, USA
| | - Blake W Hawkins
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Ian Zapcic
- is a doctoral candidate, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Clio Fregoli
- is program manager, ESSEC Business School, University of Toronto, Toronto, Ontario, Canada
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Exploring smoking cessation experiences among persons with spinal cord injury: Informing theory-based recommendations for interventions. Spinal Cord 2023; 61:27-36. [PMID: 36138096 DOI: 10.1038/s41393-022-00856-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 01/17/2023]
Abstract
STUDY DESIGN Qualitative study. OBJECTIVE Use an integrated knowledge translation (IKT) and theory-based approach, to (1) explore factors influencing smoking cessation behaviour among people with SCI, and (2) explore the preferred intervention and implementation options for smoking cessation interventions for persons with SCI. SETTING Community. METHODS Aligned with an IKT approach, an SCI organization was meaningfully engaged throughout the research process. Semi-structured interviews were conducted with people with SCI who have quit or tried to quit smoking. Barriers and facilitators to smoking cessation were extracted and deductively coded using the Theoretical Domains Framework (TDF) and inductively analysed. To identify intervention options, a behavioural analysis was conducted using the Behaviour Change Wheel. To identify implementation options, modes of delivery and intervention messengers were extracted. Modes of delivery were deductively coded, and themes relating to intervention messengers were constructed. RESULTS Among the 12 participants (7 males; 6 with tetraplegia), seven had quit and five had relapsed. Across the 12 interviews, 130 barriers and 218 facilitators were coded to the TDF. The prominent TDF domains were beliefs about consequences, social influences, environmental context and resources, and behavioural regulation, and served as themes in the inductive analysis. Multiple modes of delivery and intervention messengers were considered important for the delivery of smoking cessation interventions. CONCLUSION This study is the first to use IKT and theory-based approaches to explore factors influencing smoking cessation among persons with SCI. Findings from this study resulted in the co-development of practical recommendations for future SCI-specific smoking cessation interventions.
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Williams G, Pirret A, Credland N, Odell M, Raftery C, Smith D, Winterbottom F, Massey D. A practical approach to establishing a critical care outreach service: An expert panel research design. Aust Crit Care 2023; 36:151-158. [PMID: 35341667 DOI: 10.1016/j.aucc.2022.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 12/18/2021] [Accepted: 01/18/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND For over two decades, nurse-led critical care outreach services have improved the recognition, response, and management of deteriorating patients in general hospital wards, yet variation in terms, design, implementation, and evaluation of such services continue. For those establishing a critical care outreach service, these factors make the literature difficult to interpret and translate to the real-world setting. AIM The aim of this study was to provide a practical approach to establishing a critical care outreach service in the hospital setting. METHOD An international expert panel of clinicians, managers, and academics with experience in implementing, developing, operationalising, educating, and evaluating critical care outreach services collaborated to synthesise evidence, experience, and clinical judgment to develop a practical approach for those establishing a critical care outreach service. A rapid review of the literature identified publications relevant to the study. A modified Delphi technique was used to achieve expert panel consensus particularly in areas where insufficient published literature or ambiguities existed. FINDINGS There were 502 publications sourced from the rapid review, of which 104 were relevant and reviewed. Using the modified Delphi technique, the expert panel identified five key components needed to establish a critical care outreach service: (i) approaches to service delivery, (ii) education and training, (iii) organisational engagement, (iv) clinical governance, and (v) monitoring and evaluation. CONCLUSION An expert panel research design successfully synthesised evidence, experience, and clinical judgement to provide a practical approach for those establishing a critical care outreach service. This method of research will likely be valuable in other areas of practice where terms are used interchangeably, and the literature is diverse and lacking a single approach to practice.
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Affiliation(s)
- Ged Williams
- School of Nursing & Midwifery, Griffith University, Australia; South Metropolitan Health Service, Perth, Australia.
| | - Alison Pirret
- Critical Care Complex, Middlemore Hospital, Auckland, New Zealand; Massey University, Auckland, New Zealand
| | - Nicki Credland
- Reader in Critical Care Education, University of Hull, United Kingdom; Chair British Association of Critical Care Nurses (BACCN), United Kingdom
| | - Mandy Odell
- Critical Care, Royal Berkshire Hospital, NHS FT, Reading, United Kingdom
| | - Chris Raftery
- School of Nursing, Queensland University of Technology, Australia; Gold Coast Health, Queensland, Australia
| | - Duncan Smith
- City, University of London, Northampton Square, London, UK; Honorary Charge Nurse - Patient Emergency Response & Resuscitation Team, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Debbie Massey
- Southern Cross University, Australia; Intensive Care Unit John Flynn Hospital, Tugun, Australia
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Pellichero A, Routhier F, Sorita É, Archambault PS, Demers L, Best KL. Consensus for a power wheelchair training approach for people with cognitive impairments. Disabil Rehabil Assist Technol 2023; 18:109-117. [PMID: 36264670 DOI: 10.1080/17483107.2022.2120100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Power wheelchairs (PWCs) can enhance independent mobility. The World Health Organization recommends training PWC users. However, current PWC training approaches do not always meet the needs of PWC users with complex mobility and cognitive impairment. The aim was to co-develop an innovative approach to PWC training for individuals with complex mobility and cognitive impairments. MATERIALS AND METHODS A two-phase mixed method research, involving PWC users, clinicians and researchers throughout all aspects of the research, was realized. (1) Interviews and focus groups were used. (2) The Delphi method was followed to refine the PWC training approach. RESULTS Phase 1: Twenty-six stakeholders indicated that PWC training should consider the client as a partner, the learning environment, the proposed activities, interactions with the trainer and intervention format. Phase 2: two hundred and seven participants agreed that the PWC training should be goal directed, should be client-centred and occupation-based, should enhance client-therapist relationships and should be realized in a safe and adapted environment. CONCLUSIONS Stakeholders on PWC use came to agreement on key components that should be applied when training people with cognitive impairments.
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Affiliation(s)
- Alice Pellichero
- Department of Rehabilitation, Université Laval, Québec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Québec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Éric Sorita
- Université de Bordeaux - Handicap Activité Cognition Santé (EA 4136 HACS), Bordeaux, France
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
| | - Louise Demers
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Canada
| | - Krista L Best
- Department of Rehabilitation, Université Laval, Québec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
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Rivera JMB, Yousefi C, Cheng CL, Norman CD, Legare J, McFarlane A, Noonan VK. Optimizing spinal cord injury care in Canada: Development of a framework for strategy and action. Front Public Health 2022; 10:921926. [PMID: 36420007 PMCID: PMC9678047 DOI: 10.3389/fpubh.2022.921926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022] Open
Abstract
National health strategies are integral in defining the vision and strategic direction for ensuring the health of a population or for a specific health area. To facilitate a national coordinated approach in spinal cord injury (SCI) research and care in Canada, Praxis Spinal Cord Institute, with support from national experts and funding from the Government of Canada, developed a national strategy to advance SCI care, health, and wellness based on previous SCI strategic documents. This paper describes the development process of the SCI Care for Canada: A Framework for Strategy and Action. Specifically, it covers the process of building on historical and existing work of SCI in Canada through a thorough review of literature to inform community consultations and co-creation design. Furthermore, this paper describes planning for communication, dissemination, and evaluation. The SCI Care Strategic Framework promotes an updated common understanding of the goals and vision of the SCI community, as well as strengths and priorities within the SCI system regarding care, health, and wellness. Additionally, it supports the coordination and scaling up of SCI advancements to make a sustainable impact nationwide focusing on the needs of people living with SCI.
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Affiliation(s)
| | | | | | | | | | | | - Vanessa K. Noonan
- Praxis Spinal Cord Institute, Vancouver, BC, Canada,*Correspondence: Vanessa K. Noonan
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Gainforth HL, McKay RC, Hoekstra F, Maffin J, Sibley KM, Jung ME. Principles to guide spinal cord injury research partnerships: a Delphi consensus study. Disabil Rehabil 2022; 44:7269-7276. [PMID: 34663158 DOI: 10.1080/09638288.2021.1985635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To establish consensus regarding principles that should be used to guide spinal cord injury (SCI) research partnerships between researchers and research users. MATERIALS AND METHODS A three-round Delphi consensus exercise was carried out with researchers and/or research users involved in one or more SCI research partnerships. Participants considered a list of 125 partnership principles. In rounds 1 and 2, participants rated their agreement that a principle should guide SCI research partnerships on an 11-point Likert scale. After each round, principles that received a mean score of ≥8.0 or 70% of participants rated the principle ≥8.0 were retained. In round 3, participants categorized principles as essential, desirable, irrelevant, or unsure. RESULTS At least 20 individuals participated in each round. In round 1, 103 principles met consensus criteria and eight principles were added. In round 2, 93 principles met the criteria. In round 3, 29 principles were categorized as essential and eight as desirable. Recommended principles focused on the interpersonal, relational, and logistical aspects of partnerships. Principles that did not reach consensus related to social justice and actionable impact. CONCLUSIONS Findings provide insight into 37 principles that could be used to combat tokenism and inform future guidance to meaningfully engage partners in SCI research.Implications for RehabilitationConsensus-based research partnership principles (i.e., norms or beliefs) were identified and could be prioritized to help support spinal cord injury (SCI) researchers and research users combat tokenism and meaningfully engage research users as partners in the co-creation of knowledge.The resulting list of recommended research partnership principles was used to inform the development of guidance to support quality partnerships between SCI researchers and research users within and outside the rehabilitation context (www.IKTprinciples.com).Guidance supporting meaningful research partnerships may accelerate the time between discovery and use of research in practice.
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Affiliation(s)
- Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada.,International Collaboration on Repair Discoveries, Vancouver, Canada
| | - Rhyann C McKay
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada.,International Collaboration on Repair Discoveries, Vancouver, Canada
| | - Femke Hoekstra
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada.,International Collaboration on Repair Discoveries, Vancouver, Canada
| | | | - Kathryn M Sibley
- Department of Community Health Sciences and Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
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Heath GW, Levine D. Physical Activity and Public Health among People with Disabilities: Research Gaps and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10436. [PMID: 36012074 PMCID: PMC9408065 DOI: 10.3390/ijerph191610436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Physical activity has become an integral component of public health systems modeling the public health core functions of assessment, policy development, and assurance. However, people with disabilities have often not been included in public health efforts to assess, develop policies, or evaluate the impact of physical activity interventions to promote health and prevent disease among people with disabilities. Addressing the core function of assessment, current physical activity epidemiology, and surveillance among people with disabilities across the globe highlights the paucity of surveillance systems that include physical activity estimates among people with disabilities. The status of valid and reliable physical activity measures among people with condition-specific disabilities is explored, including self-report measures along with wearable devices, and deficiencies in measurement of physical activity. The core functions of policy development and assurance are described in the context of community-based intervention strategies to promote physical activity among people with disabilities. The identification of research gaps in health behavior change, policy, and environmental approaches to promoting physical activity among people with disabilities is explored, along with recommendations based on the principles of inclusive and engaged research partnerships between investigators and the members of the disability community.
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Affiliation(s)
- Gregory W. Heath
- Public Health Program, Department of Health and Human Performance, University of Tennessee, Chattanooga, TN 37403, USA
- University of Tennessee Health Science Center College of Medicine Chattanooga, Chattanooga, TN 37403, USA
| | - David Levine
- Department of Physical Therapy, The University of Tennessee, Chattanooga, TN 37403, USA
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Lawrason SVC, Brown-Ganzert L, Campeau L, MacInnes M, Wilkins CJ, Martin Ginis KA. mHealth Physical Activity Intervention for Individuals With Spinal Cord Injury: Planning and Development Processes. JMIR Form Res 2022; 6:e34303. [PMID: 35984695 PMCID: PMC9440410 DOI: 10.2196/34303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 06/27/2022] [Accepted: 07/18/2022] [Indexed: 02/06/2023] Open
Abstract
Background Interventions to support physical activity participation among individuals with spinal cord injury (SCI) are required given this population’s low levels of physical activity and extensive barriers to quality physical activity experiences. Objective This study aimed to develop a mobile health intervention, called SCI Step Together, to improve the quantity and quality of physical activity among individuals with SCI who walk. Methods Our overarching methodological framework was the Person-Based approach. This included the following 4 steps: conduct primary and secondary research (step 1); design intervention objectives and features (step 2a); conduct behavioral analysis and theory (step 2b); create a logic model (step 3); and complete the SCI Step Together program content and integrated knowledge translation (IKT; step 4), which occurred throughout development. The partnership approach was informed by the SCI IKT Guiding Principles. Three end users pilot-tested the app and participated in the interviews. Results Step 1 identified issues to be addressed when designing intervention objectives and features (step 2a) and features were mapped onto the Behavior Change Wheel (step 2b) to determine the behavior change techniques (eg, action planning) to be included in the app. The logic model linked the mechanisms of action to self-determination theory (steps 2/3). Interviews with end users generated recommendations for the technology (eg, comparing physical activity levels with guidelines), trial (eg, emailing participants’ worksheets), and intervention content (eg, removing graded tasks; step 4). Conclusions Using the SCI IKT Guiding Principles to guide partner engagement and involvement ensured that design partners had shared decision-making power in intervention development. Equal decision-making power maximizes the meaningfulness of the app for end users. Future research will include testing the acceptability, feasibility, and engagement of the program. Partners will be involved throughout the research process. Trial Registration ClinicalTrials.gov: NCT05063617; https://clinicaltrials.gov/ct2/show/NCT05063617
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Affiliation(s)
- Sarah Victoria Clewes Lawrason
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada.,Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada
| | | | | | | | - C J Wilkins
- Community Research Partner, Kelowna, BC, Canada
| | - Kathleen Anne Martin Ginis
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada.,Centre for Chronic Disease Prevention and Management, Faculty of Medicine, University of British Columbia, Kelowna, BC, Canada.,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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MacLeod MLP, Leese J, Garraway L, Oelke ND, Munro S, Bailey S, Hoens AM, Loo S, Valdovinos A, Wick U, Zimmer P, Li LC. Engaging with patients in research on knowledge translation/implementation science methods: a self study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:41. [PMID: 35941661 PMCID: PMC9358643 DOI: 10.1186/s40900-022-00375-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In 2017, the British Columbia (Canada) SUPPORT (SUpport for People and Patient-Oriented Research) Unit created six methods clusters to advance methodologies in patient and public oriented research (POR). The knowledge translation (KT)/implementation science methods cluster identified that although there was guidance about how to involve patients and public members in POR research generally, little was known about how best to involve patients and public members on teams specifically exploring POR KT/implementation science methodologies. The purpose of this self-study was to explore what it means to engage patients and the public in studies of POR methods through the reflections of members of five KT/implementation science teams. METHODS Informed by a collaborative action research approach, this quality improvement self-study focused on reflection within four KT/implementation science research teams in 2020-2021. The self-study included two rounds of individual interviews with 18 members across four teams. Qualitative data were analyzed using a thematic analysis approach followed by a structured discussion of preliminary findings with the research teams. Subsequently, through two small group discussion sessions, the patients/public members from the teams refined the findings. RESULTS Undertaking research on POR KT/implementation science methodologies typically requires teams to work with the uncertainty of exploratory and processual research approaches, make good matches between patients/public members and the team, work intentionally yet flexibly, and be attuned to the external context and its influences on the team. POR methodological research teams need to consider that patients/public members bring their life experiences and world views to the research project. They become researchers in their own right. Individual and team reflection allows teams to become aware of team needs, acknowledge team members' vulnerabilities, gain greater sensitivity, and enhance communication. CONCLUSIONS The iterative self-study process provided research team members with opportunities for reflection and new understanding. Working with patients/public team members as co-researchers opens up new ways of understanding important aspects of research methodologies, which may influence future KT/implementation science research approaches.
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Affiliation(s)
- Martha L. P. MacLeod
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9 Canada
| | - Jenny Leese
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Centre for Implementation Research, The Ottawa Hospital Research Institute, Ottawa, Canada
- Arthritis Research Canada, Vancouver, BC Canada
| | - Leana Garraway
- Health Research Institute, University of Northern British Columbia, Prince George, BC Canada
| | - Nelly D. Oelke
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC Canada
- Rural Coordination Centre of BC, Vancouver, BC Canada
| | - Sarah Munro
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC Canada
| | - Sacha Bailey
- BC Centre for Ability, Vancouver, BC Canada
- Centre for Research on Children and Families, Montreal, QC Canada
| | - Alison M. Hoens
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
| | - Sunny Loo
- Patient Partner, Michael Smith Health Research BC, PaCER Certified, University of Calgary, Calgary, AB Canada
| | - Ana Valdovinos
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC Canada
| | - Ursula Wick
- University of British Columbia, Okanagan, Kelowna, BC Canada
| | - Peter Zimmer
- University of Northern British Columbia, Prince George, BC Canada
| | - Linda C. Li
- Arthritis Research Canada, Vancouver, BC Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC Canada
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Hoekstra F, Schaefer L, Athanasopoulos P, Gainforth HL. Researchers' and Research Users' Experiences With and Reasons for Working Together in Spinal Cord Injury Research Partnerships: A Qualitative Study. Int J Health Policy Manag 2022; 11:1401-1412. [PMID: 34060273 PMCID: PMC9808362 DOI: 10.34172/ijhpm.2021.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/28/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Research partnership approaches are becoming popular within spinal cord injury (SCI) health research system, providing opportunities to explore experiences of and learn from SCI research partnership champions. This study aimed to explore and describe SCI researchers' and research users' (RU') experiences with and reasons for conducting and/or disseminating (health) research in partnership in order to gain more insight into potentially ways to build capacity for and foster change to support research partnerships within a health research system. METHODS Underpinned by a pragmatic perspective, ten semi-structured timeline interviews were conducted with researchers and RU who have experiences with SCI research partnerships. Interviews focused on experiences in participants' lives that have led them to become a person who conducts and/or disseminates research in partnership. Data were analysed using narrative thematic analysis. RESULTS We identified three threads from participants' stories: (1) seeing and valuing different perspectives, (2) inspirational role models, and (3) relational and personal aspect of research partnerships. We identified sub-threads related to experiences that participants draw on how they came to be a person who engage in (health) research partnerships, and sub-threads related to participants' reasons for engaging in research partnerships. While most sub-threads were identified from both researchers' and RU' perspectives (eg, partnership successes and failures), some were unique for researchers (morally the right thing to do) or RU (advocating). CONCLUSION Using a narrative and pragmatic approach, this study provided a new understanding of SCI researchers' and RU' partnership experiences over time. We found that participants' research partnership experiences and motivations align with components of leadership theories. The findings from this study may be used to inform strategies and policy programs to build capacity for conducting and disseminating (health) research in partnership, within and beyond SCI research.
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Affiliation(s)
- Femke Hoekstra
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Lee Schaefer
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | | | | | - Heather L. Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
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Walsh RJ, McKay VR, Hansen PE, Barco PP, Jones K, Lee Y, Patel RD, Chen D, Heinemann AW, Lenze EJ, Wong AWK. Using Implementation Science to Guide the Process of Adapting a Patient Engagement Intervention for Inpatient Spinal Cord Injury/Disorder Rehabilitation. Arch Phys Med Rehabil 2022; 103:2180-2188. [PMID: 35588857 DOI: 10.1016/j.apmr.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 04/17/2022] [Accepted: 04/18/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVES This study aimed to describe the process of adapting an evidence-based patient engagement intervention, Enhanced Medical Rehabilitation (E-MR), for inpatient spinal cord injury/disease (SCI/D) rehabilitation using an implementation science framework. DESIGN We applied the Collaborative Intervention Planning Framework (CIPF) and included a community advisory board (CAB) in an intervention mapping process. SETTING A rehabilitation hospital. PARTICIPANTS Stakeholders from inpatient SCI/D rehabilitation (N=7) serving as a CAB and working with the research team (N=7) to co-adapt E-MR. INTERVENTIONS E-MR MAIN OUTCOME MEASURES: Logic model and matrices of change used in CAB meetings to identify areas of intervention adaptation. RESULTS The CAB and research team implemented adaptations to E-MR, including (1) identifying factors influencing patient engagement in SCI/D rehabilitation (e.g., therapist training); (2) revising intervention materials to meet SCI/D rehabilitation needs (e.g., modified personal goals interview and therapy trackers to match SCI needs); (3) incorporating E-MR into the rehabilitation hospital's operations (e.g., research team coordinated with CAB to store therapy trackers in the hospital system); and (4) retaining fidelity to the original intervention while best meeting the needs of SCI/D rehabilitation (e.g., maintained core E-MR principles while adapting). CONCLUSIONS This study demonstrated that structured processes guided by an implementation science framework can help researchers and clinicians identify adaptation targets and modify the E-MR program for inpatient SCI/D rehabilitation.
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Affiliation(s)
- Ryan J Walsh
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO 63108.
| | - Virginia R McKay
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130, and Dissemination and Implementation Research Core, Washington University Institute of Clinical and Translational Sciences, St. Louis, MO 63110.
| | - Piper E Hansen
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL 0661.
| | - Peggy P Barco
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO 63108.
| | - Kayla Jones
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL 60611.
| | - Yejin Lee
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO 63108.
| | - Riddhi D Patel
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL 60611.
| | - David Chen
- Spinal Cord Injury Section, Shirley Ryan AbilityLab, Chicago, IL 60611, and Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL 60611.
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL 60611, USA, and Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL 60611.
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.
| | - Alex W K Wong
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL 60611, USA, and Departments of Physical Medicine & Rehabilitation and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Shaw RB, Giroux EE, Gainforth HL, McBride CB, Vierimaa M, Martin Ginis KA. Investigating the influence of interaction modality on the communication patterns of spinal cord injury peer mentors. PATIENT EDUCATION AND COUNSELING 2022; 105:1229-1236. [PMID: 34579997 DOI: 10.1016/j.pec.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/23/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To examine how the quality of spinal cord injury peer mentorship relationships and mentor-mentee behaviors are impacted by interaction modality. METHODS Using a within-subjects, repeated measures, experimental design, peer mentors (n = 8) completed two mentoring sessions with a standardized mentee in a telephone and a video chat condition. Measures of therapeutic alliance and autonomy supportiveness were administered following each session. Mentors' leadership behaviors, motivational interviewing skills, and behavior change techniques were compared across conditions. Mentors' and mentees' use of motivational interviewing skills and behavior change techniques were further analyzed using state space grids. RESULTS Mentors' therapeutic alliance, autonomy supportiveness, use of leadership behaviors, motivational interviewing skills, and behavior change techniques did not significantly differ across the two conditions (ps > 0.123; Cohen's d range = 0.218-0.619). State space grids analyses revealed that the dynamic structure of mentoring conversations was similar when interactions occurred through the telephone versus video chat. CONCLUSIONS Mentors were effective at forming positive, autonomy supportive relationships with mentees in telephone and video chat interaction conditions. Mentors also used leadership/counselling behaviors to a similar extent when interacting through these two modalities. PRACTICE IMPLICATIONS Organizations that provide peer mentorship can have confidence in using both telephone and video chat modalitites.
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Affiliation(s)
- Robert B Shaw
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
| | - Emily E Giroux
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - Heather L Gainforth
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | | | | | - Kathleen A Martin Ginis
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver, Canada; University of British Columbia, Faculty of Medicine, Centre for Chronic Disease Prevention and Management, Kelowna, Canada
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Hoekstra F, Trigo F, Sibley KM, Graham ID, Kennefick M, Mrklas KJ, Nguyen T, Vis-Dunbar M, Gainforth HL. Systematic overviews of partnership principles and strategies identified from health research about spinal cord injury and related health conditions: A scoping review. J Spinal Cord Med 2022:1-18. [PMID: 35262473 DOI: 10.1080/10790268.2022.2033578] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
STUDY DESIGN Scoping review. OBJECTIVE To identify and provide systematic overviews of partnership principles and strategies identified from health research about spinal cord injury (SCI) and related health conditions. METHODS Four health electronic databases (Medline, Embase, CINAHL, PsycINFO) were searched from inception to March 2019. We included articles that described, reflected, and/or evaluated one or more collaborative research activities in health research about SCI, stroke, multiple sclerosis, Parkinson's disease, amputation, cerebral palsy, spina bifida, amyotrophic lateral sclerosis, acquired brain injury, or wheelchair-users. Partnership principles (i.e. norms or values) and strategies (i.e. observable actions) were extracted and analyzed using directed qualitative content analysis. RESULTS We included 39 articles about SCI (n = 13), stroke (n = 15), multiple sclerosis (n = 5), amputation (n = 2), cerebral palsy (n = 2), Parkinson's disease (n = 1), and wheelchair users (n = 1). We extracted 110 principles and synthesized them into 13 overarching principles. Principles related to building and maintaining relationships between researchers and research users were most frequently reported. We identified 32 strategies that could be applied at various phases of the research process and 26 strategies that were specific to a research phase (planning, conduct, or dissemination). CONCLUSION We provided systematic overviews of principles and strategies for research partnerships. These could be used by researchers and research users who want to work in partnership to plan, conduct and/or disseminate their SCI research. The findings informed the development of the new SCI Integrated Knowledge Translation Guiding Principles (www.iktprinciples.com) and will support the implementation of these Principles within the SCI research system.
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Affiliation(s)
- Femke Hoekstra
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.,Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Francisca Trigo
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Kathryn M Sibley
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
| | - Ian D Graham
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Michael Kennefick
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Kelly J Mrklas
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.,Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada
| | - Tram Nguyen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Mathew Vis-Dunbar
- UBC Okanagan Library, University of British Columbia, Kelowna, BC, Canada
| | | | - Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
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A scoping review of interventions to improve strength training participation. PLoS One 2022; 17:e0263218. [PMID: 35113954 PMCID: PMC8812857 DOI: 10.1371/journal.pone.0263218] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/17/2022] [Indexed: 11/27/2022] Open
Abstract
Background Low participation rates (1–31%) and unique barriers to strength training (e.g., specialized knowledge, equipment, perceived complexity) suggest effective strength training interventions may differ from effective aerobic or general physical activity interventions. The purpose of this scoping review was to examine interventions used to improve strength training participation through mapping theory, intervention characteristics, prescription parameters, and behaviour change techniques. Methods Recommendations by Levac et al. (2010) and PRISMA-ScR were followed in the conduct and reporting of this review, respectively. Patients and exercise professionals participated in developing the research question and data extraction form, interpreting the findings, and drafting the manuscript. Medline, Embase, PsycINFO, CINAHL, SPORTDiscus, and PubMed databases (inception–December 2020) were searched. The inclusion criteria were (a) original peer-reviewed articles and grey literature, (b) intervention study design, and (c) behavioural interventions targeted towards improving strength training participation. Two reviewers performed data screening, extraction, and coding. The interventions were coded using the Behaviour Change Technique Taxonomy version 1. Data were synthesized using descriptive and frequency reporting. Results Twenty-seven unique interventions met the inclusion criteria. Social cognitive theory (n = 9), the transtheoretical model (n = 4), and self-determination theory (n = 2) were the only behaviour change theories used. Almost all the interventions were delivered face-to-face (n = 25), with the majority delivered by an exercise specialist (n = 23) in community or home settings (n = 24), with high variability in exercise prescription parameters. Instructions on how to perform the behaviour, behavioural practice, graded tasks, goal setting, adding objects to the environment (e.g., providing equipment), and using a credible source (e.g., exercise specialist delivery) comprised the most common behaviour change techniques. Conclusions Our results highlight gaps in theory, intervention delivery, exercise prescription parameters, and behaviour change techniques for future interventions to examine and improve our understanding of how to most effectively influence strength training participation.
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Laskin JJ, Waheed Z, Thorogood NP, Nightingale TE, Noonan VK. Spinal cord stimulation research in the restoration of motor, sensory and autonomic function for individuals living with spinal cord injuries: A scoping review. Arch Phys Med Rehabil 2022; 103:1387-1397. [PMID: 35202581 DOI: 10.1016/j.apmr.2022.01.161] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe the status of spinal cord stimulation (SCS) research for the improvement of motor, sensory and autonomic function for individuals living with a spinal cord injury (SCI). DATA SOURCES This scoping review identified original research published prior to March 31, 2021, via literature searches using Medline, EMBASE, PubMed, Science Direct, CINAHL, Sport Discus, Web of Science, as well as a targeted search for well-known principal investigators. Search terms included permutations of "spinal cord stimulation", "epidural spinal cord stimulation", "transcutaneous spinal cord stimulation", "magnetic spinal cord stimulation" and "neuromodulation". STUDY SELECTION Studies were included if they: 1) were in English, 2) presented original research on humans living with a SCI, and 3) investigated at least one of the three forms of SCS. DATA EXTRACTION Extracted data included: authors, publication year, participant characteristics, purpose, study design, stimulation (device, location, parameters,) primary outcomes, and adverse events. DATA SYNTHESIS As a scoping review the extracted data was tabulated and presented descriptively. Themes and gaps in the literature were identified and reported. Of the 5,754 articles screened, 103 articles were included (55 epidural, 36 transcutaneous and 12 magnetic). The primary research design was a case study or series with only a single randomized clinical trial. Motor recovery was the most common primary outcome for epidural and transcutaneous SCS studies whereas bowel and bladder outcomes were most common for magnetic. Seventy percent of the studies included 10 or fewer participants, and 18 articles documented at least one adverse event. Incomplete stimulation parameter descriptions were noted across many studies. No articles mentioned direct engagement of consumers or advocacy groups. CONCLUSION This review identified a need for more robust study designs, larger sample sizes, comparative studies, improved reporting of stimulation parameters, adverse event data, and alignment of outcomes with the priorities of the SCI community.
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Affiliation(s)
- James J Laskin
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada; School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, Montana.
| | - Zeina Waheed
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | | | - Tom E Nightingale
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom; Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada
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Barriers and facilitators to changing bowel care practices after spinal cord injury: a Theoretical Domains Framework approach. Spinal Cord 2022; 60:664-673. [PMID: 34997189 PMCID: PMC9287175 DOI: 10.1038/s41393-021-00743-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Improvement to autonomic processes such as bladder, bowel and sexual function are prioritised by individuals with spinal cord injury (SCI). Bowel care is associated with high levels of dissatisfaction and decreased quality of life. Despite dissatisfaction, 71% of individuals have not changed their bowel care routine for at least 5 years, highlighting a disconnect between dissatisfaction with bowel care and changing routines to optimise bowel care. OBJECTIVE Using an integrated knowledge translation approach, we aimed to explore the barriers and facilitators to making changes to bowel care in individuals with SCI. METHODS Our approach was guided by the Behaviour Change Wheel and used the Theoretical Domains Framework (TDF). Semi-structured interviews were conducted with individuals with SCI (n = 13, mean age 48.6 ± 13.1 years) and transcribed verbatim (duration 31.9 ± 7.1 min). Barriers and facilitators were extracted, deductively coded using TDF domains and inductively analysed for themes within domains. RESULTS Changing bowel care after SCI was heavily influenced by four TDF domains: environmental context and resources (workplace flexibility, opportunity or circumstance, and access to resources); beliefs about consequences; social influences (perceived support and peer mentorship); and knowledge (knowledge of physiological processes and bowel care options). All intervention functions and policy categories were considered viable intervention options, with human (61%) and digital (33%) platforms preferred. CONCLUSIONS Modifying bowel care is a multi-factorial behaviour. These findings will support the systematic development and implementation of future interventions to both enable individuals with SCI to change their bowel care and to facilitate the optimisation of bowel care approaches.
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Bochkezanian V, Anderson KD. Comprehensive and person-centred approach in research: what is missing? Spinal Cord 2022; 60:187-189. [PMID: 34975156 DOI: 10.1038/s41393-021-00735-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/09/2022]
Abstract
The concept of a comprehensive and person-centred approach in healthcare is not new and it is the basic principle that is embedded in the International Classification of Functioning, Disability and Health (ICF) framework. However, the implementation of a comprehensive and person-centred approach has not been fully translated into research development in people living with spinal cord injuries (SCI). This approach in research is important as the perspectives of persons living with SCI should be equally valued drivers in any research intended to provide a direct or indirect outcome to people living with a SCI. This perspective paper will discuss some of the limiting factors and provide some examples of previous and current successful steps being taken towards the worldwide implementation of this approach. Finally, this paper will suggest some of the steps needed to implement this person-centred model in research in people with SCI.
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Affiliation(s)
- Vanesa Bochkezanian
- School of Health, Medical & Applied Sciences, College of Health Sciences, Central Queensland University, Rockhampton, QLD, Australia.
| | - Kim D Anderson
- Department of Physical Medicine and Rehabilitation. Metrohealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Catharine Craven B, Musselman K, Humphreys S, Walden K, Parsons J, Eapen J, Noonan VK, Cheng CL, Yousefi C, Chernesky J, Côté-Boileau É, Ibrahim N, Kalay AL, Kingston D, Clément L, Bayley M, Kua A, Patsakos E, Cheng C, Eng J, Ho C, Queree M, Farahani F, Flett H, Scovil C, Evbuomwan I, Athanasopoulos P, Wolf D, Ebsary S, McBride C, Adair B, Beaton N, Bury M, Cooper D, Dyer S, Howe S, Scott L, Stanley A. Transforming SCI rehabilitation care through innovation. J Spinal Cord Med 2021; 44:S5-S16. [PMID: 34779734 PMCID: PMC8604518 DOI: 10.1080/10790268.2021.1965449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- B. Catharine Craven
- Canadian Spinal Cord Injury – Rehabilitation Association,Correspondence to: B. Catharine Craven, Toronto Rehabilitation Institute, KITE Research Institute, University Health Network, Toronto, Ontario M4G 3V9, Canada.
| | | | - Suzanne Humphreys
- PRAXIS Spinal Cord Institute for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Kristen Walden
- PRAXIS Spinal Cord Institute for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Jessica Parsons
- PRAXIS Spinal Cord Institute for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Jessica Eapen
- PRAXIS Spinal Cord Institute for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Vanessa K Noonan
- PRAXIS Spinal Cord Institute for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Christiana L Cheng
- PRAXIS Spinal Cord Institute for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Charlene Yousefi
- PRAXIS Spinal Cord Institute and the Health Standards Organization for Canadian Spinal Cord Injury – Rehabilitation Association
| | - John Chernesky
- PRAXIS Spinal Cord Institute and the Health Standards Organization for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Élizabeth Côté-Boileau
- PRAXIS Spinal Cord Institute and the Health Standards Organization for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Nadine Ibrahim
- PRAXIS Spinal Cord Institute and the Health Standards Organization for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Anifa Luyinga Kalay
- PRAXIS Spinal Cord Institute and the Health Standards Organization for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Darryl Kingston
- PRAXIS Spinal Cord Institute and the Health Standards Organization for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Louise Clément
- PRAXIS Spinal Cord Institute and the Health Standards Organization for Canadian Spinal Cord Injury – Rehabilitation Association
| | - M. Bayley
- University Health Network Can-SCIP, Steering Committee for Canadian Spinal Cord Injury – Rehabilitation Association
| | - A. Kua
- University Health Network Can-SCIP, Steering Committee for Canadian Spinal Cord Injury – Rehabilitation Association
| | - E. Patsakos
- University Health Network Can-SCIP, Steering Committee for Canadian Spinal Cord Injury – Rehabilitation Association
| | - C. Cheng
- University Health Network Can-SCIP, Steering Committee for Canadian Spinal Cord Injury – Rehabilitation Association
| | - J. Eng
- University Health Network Can-SCIP, Steering Committee for Canadian Spinal Cord Injury – Rehabilitation Association
| | - C. Ho
- University Health Network Can-SCIP, Steering Committee for Canadian Spinal Cord Injury – Rehabilitation Association
| | - M. Queree
- University Health Network Can-SCIP, Steering Committee for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Farnoosh Farahani
- Spinal Cord Injury Implementation and Evaluation Quality Care Consortium for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Heather Flett
- Spinal Cord Injury Implementation and Evaluation Quality Care Consortium for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Carol Scovil
- Spinal Cord Injury Implementation and Evaluation Quality Care Consortium for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Ivie Evbuomwan
- Spinal Cord Injury Implementation and Evaluation Quality Care Consortium for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Peter Athanasopoulos
- Spinal Cord Injury Implementation and Evaluation Quality Care Consortium for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Dalton Wolf
- Spinal Cord Injury Implementation and Evaluation Quality Care Consortium for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Sophie Ebsary
- Canadian Activity-Based Therapy Community of Practice for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Christopher McBride
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Bill Adair
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Nancy Beaton
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Michael Bury
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Darlene Cooper
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Shaun Dyer
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Stuart Howe
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Launel Scott
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
| | - Alan Stanley
- Spinal Cord Injury Canada for Canadian Spinal Cord Injury – Rehabilitation Association
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Anderson KD. Equitable partnerships between scientists and persons living with spinal cord injury will strengthen research scope, quality, and outcomes. Curr Opin Neurol 2021; 34:783-788. [PMID: 34545013 DOI: 10.1097/wco.0000000000000989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Partnerships across all stakeholders in the research process strengthen the outcomes and ultimate usability of research. The purpose of this review is to discuss the current level of inclusion of people living with spinal cord injury (SCI) in the research process, the science of engagement and benefits of partnerships in research, and emerging resources available to help promote ethical and effective partnerships in SCI research. RECENT FINDINGS Significant strides have been made in interacting with people living with SCI to help identify the problem(s) that are important to study (i.e. the first step in the research process). The SCI research field is lagging in partnering with people living with SCI throughout the rest of the research process despite a plethora of evidence-based principles and strategies for effective partnerships in the broader context of research. There are several emerging resources specific to SCI to help researchers and the community begin to build meaningful partnerships throughout the entire cycle of research. SUMMARY The SCI research field already values partnerships with clinicians and promotes the concept of 'bench-to-bedside and back again'. Now is the time to take it a step further to 'bench-to-bedside-to-community and back again'.
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Affiliation(s)
- Kim D Anderson
- Department of Physical Medicine and Rehabilitation, MetroHealth System, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury. J Clin Med 2021; 10:jcm10225356. [PMID: 34830637 PMCID: PMC8625266 DOI: 10.3390/jcm10225356] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 12/13/2022] Open
Abstract
This review of literature provides the latest evidence involving invasive and non-invasive uses of electrical stimulation therapies that assist in restoring functional abilities and the enhancement of quality of life in those with spinal cord injuries. The review includes neuromuscular electrical stimulation and functional electrical stimulation activities that promote improved body composition changes and increased muscular strength, which have been shown to improve abilities in activities of daily living. Recommendations for optimizing electrical stimulation parameters are also reported. Electrical stimulation is also used to enhance the skills of reaching, grasping, standing, and walking, among other activities of daily living. Additionally, we report on the use of invasive and non-invasive neuromodulation techniques targeting improved mobility, including standing, postural control, and assisted walking. We attempt to summarize the effects of epidural stimulation on cardiovascular performance and provide a mechanistic explanation to the current research findings. Future trends such as the combination of epidural stimulation and exoskeletal-assisted walking are also discussed.
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Sweet SN, Hennig L, Shi Z, Clarke T, Flaro H, Hawley S, Schaefer L, Gainforth HL. Outcomes of peer mentorship for people living with spinal cord injury: perspectives from members of Canadian community-based SCI organizations. Spinal Cord 2021; 59:1301-1308. [PMID: 34732859 PMCID: PMC8565648 DOI: 10.1038/s41393-021-00725-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A generic qualitative design. OBJECTIVES To obtain a deeper understanding of the outcomes of spinal cord injury (SCI) peer mentorship programs delivered by community-based organizations. SETTING Peer mentorship programs of community-based SCI organizations METHODS: We interviewed 36 individuals who shared their experiences of SCI peer mentorship from the perspective of a peer mentee, peer mentor, or family member of a peer mentee/mentor, or staff of SCI community-based organizations. Interview data were analyzed using an inductive thematic analysis approach. RESULTS Four overarching themes with sub-themes were identified. (1) Positive outcomes for mentees such as understanding, emotional outlet/psychological support, inspiration/hope, and belonging. (2) Positive outcomes for mentors such as gaining gratitude, confidence, pride, and personal growth. (3) Reciprocity in positive/negative outcomes for mentors and mentees, such as shared learning and a lack of connection. (4) Negative outcomes for mentors such as impact of negativity, emotional toll, and time/energy demands. CONCLUSIONS Peer mentorship programs delivered by community-based SCI organizations are important, impactful resources for individuals with SCI who engage in these programs. These results provide insights into the variety of positive and negative outcomes linked with these programs.
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Affiliation(s)
- Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada. .,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
| | - Lauren Hennig
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Zhiyang Shi
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Teren Clarke
- Spinal Cord Injury Alberta, Edmonton, AB, Canada
| | - Haley Flaro
- Ability New Brunswick, Fredericton, NB, Canada
| | - Stephanie Hawley
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Lee Schaefer
- College of Kinesiology, University of Saskatchewan, Saskatchewan, SK, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, BC, Canada.,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
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Understanding peer mentorship programs delivered by Canadian SCI community-based organizations: perspectives on mentors and organizational considerations. Spinal Cord 2021; 59:1285-1293. [PMID: 34645921 DOI: 10.1038/s41393-021-00721-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN The study used a generic qualitative design. OBJECTIVES This article set out to garner knowledge of peer mentorship programs delivered by SCI community-based organizations by interviewing people who are directly and in-directly involved with these programs. SETTING Four provincial community-based SCI organizations across Canada. An integrated knowledge translation approach was applied in which researchers and SCI organization members co-constructed, co-conducted, and co-interpreted the study. METHODS Thirty-six individuals (N = 36, including peer mentees, mentors, family members of mentees, and organizational staff) from four provincial SCI community-based organizations were interviewed. The participants' perspectives were combined and analyzed using a thematic analysis. RESULTS Two overarching themes with respective subthemes were identified. Mentorship Mechanics describes the characteristics of mentors and mentees and components of the mentor-mentee relationship (e.g., establish a common ground). Under the theme Peer Mentorship Program Structures, participants described the organizational considerations for peer mentorship programs (e.g., format), and organizational responsibilities (e.g., funding; creating a peer mentorship team). CONCLUSION This study provides an in-depth look at the characteristics of peer mentorship programs that are delivered by community-based organizations in Canada and highlights the complexity of delivering such programs.
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Martin Ginis KA, van der Ploeg HP, Foster C, Lai B, McBride CB, Ng K, Pratt M, Shirazipour CH, Smith B, Vásquez PM, Heath GW. Participation of people living with disabilities in physical activity: a global perspective. Lancet 2021; 398:443-455. [PMID: 34302764 DOI: 10.1016/s0140-6736(21)01164-8] [Citation(s) in RCA: 146] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/13/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
Approximately 1·5 billion people worldwide live with a physical, mental, sensory, or intellectual disability, about 80% of which are in low-income and middle-income countries. This Series paper provides a global overview of the prevalence, benefits, and promotion policies for physical activity for people living with disabilities (PLWD). PLWD are 16-62% less likely to meet physical activity guidelines and are at higher risk of serious health problems related to inactivity than people without disabilities. Meta-analyses have shown that physical activity has beneficial effects on cardiovascular fitness (average standardised mean difference [SMD] 0·69 [95% CI 0·31-1·01]), musculoskeletal fitness (0·59 [0·31-0·87]), cardiometabolic risk factors (0·39 [0·04-0·75]), and brain and mental health outcomes (0·47 [0·21-0·73]). These meta-analyses also show that health benefits can be achieved even with less than 150 min of physical activity per week, and suggest that some physical activity is better than none. Meta-analyses of interventions to increase physical activity for PLWD have reported effect sizes ranging from SMD 0·29 (95% CI 0·17-0·41, k=10) to 1·00 (0·46-1·53, k=10). There is increasing awareness among policy makers of the needs of PLWD for full participation in physical activity. Physical activity action plans worldwide must be adequately resourced, monitored, and enforced to truly advance the fundamental rights of PLWD to fully participate in physical activity.
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Affiliation(s)
- Kathleen A Martin Ginis
- Department of Medicine and Centre for Chronic Disease Prevention and Management and International Collaboration on Repair Discoveries, Faculty of Medicine, School of Health and Exercise Sciences, Faculty of Health and Social Development, and Reichwald Health Sciences Centre, University of British Columbia, Kelowna, BC, Canada.
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Byron Lai
- Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland; Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Michael Pratt
- Institute for Public Health and Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Celina H Shirazipour
- Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Brett Smith
- School of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Priscilla M Vásquez
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
| | - Gregory W Heath
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, USA
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Assessment of body composition in spinal cord injury: A scoping review. PLoS One 2021; 16:e0251142. [PMID: 33961647 PMCID: PMC8104368 DOI: 10.1371/journal.pone.0251142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 04/21/2021] [Indexed: 11/19/2022] Open
Abstract
The objective of this scoping review was to map the evidence on measurement properties of body composition tools to assess whole-body and regional fat and fat-free mass in adults with SCI, and to identify research gaps in order to set future research priorities. Electronic databases of PubMed, EMBASE and the Cochrane library were searched up to April 2020. Included studies employed assessments related to whole-body or regional fat and/or fat-free mass and provided data to quantify measurement properties that involved adults with SCI. All searches and data extractions were conducted by two independent reviewers. The scoping review was designed and conducted together with an expert panel (n = 8) that represented research, clinical, nutritional and lived SCI experience. The panel collaboratively determined the scope and design of the review and interpreted its findings. Additionally, the expert panel reached out to their professional networks to gain further stakeholder feedback via interactive practitioner surveys and workshops with people with SCI. The research gaps identified by the review, together with discussions among the expert panel including consideration of the survey and workshop feedback, informed the formulation of future research priorities. A total of 42 eligible articles were identified (1,011 males and 143 females). The only tool supported by studies showing both acceptable test-retest reliability and convergent validity was whole-body dual-energy x-ray absorptiometry (DXA). The survey/workshop participants considered the measurement burden of DXA acceptable as long as it was reliable, valid and would do no harm (e.g. radiation, skin damage). Practitioners considered cost and accessibility of DXA major barriers in applied settings. The survey/workshop participants expressed a preference towards simple tools if they could be confident in their reliability and validity. This review suggests that future research should prioritize reliability and validity studies on: (1) DXA as a surrogate 'gold standard' tool to assess whole-body composition, regional fat and fat-free mass; and (2) skinfold thickness and waist circumference as practical low-cost tools to assess regional fat mass in persons with SCI, and (3) females to explore potential sex differences of body composition assessment tools. Registration review protocol: CRD42018090187 (PROSPERO).
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Patsakos EM, Bayley MT, Kua A, Cheng C, Eng J, Ho C, Noonan VK, Querée M, Craven BC. Development of the Canadian Spinal Cord Injury Best Practice (Can-SCIP) Guideline: Methods and overview. J Spinal Cord Med 2021; 44:S52-S68. [PMID: 34779719 PMCID: PMC8604491 DOI: 10.1080/10790268.2021.1953312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Spinal cord injury (SCI) is a life-altering injury that leads to a complex constellation of changes in an individual's sensory, motor, and autonomic function which is largely determined by the level and severity of cord impairment. Available SCI-specific clinical practice guidelines (CPG) address specific impairments, health conditions or a segment of the care continuum, however, fail to address all the important clinical questions arising throughout an individual's care journey. To address this gap, an interprofessional panel of experts in SCI convened to develop the Canadian Spinal Cord Injury Best Practice (Can-SCIP) Guideline. This article provides an overview of the methods underpinning the Can-SCIP Guideline process. METHODS The Can-SCIP Guideline was developed using the Guidelines Adaptation Cycle. A comprehensive search for existing SCI-specific CPGs was conducted. The quality of eligible CPGs was evaluated using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. An expert panel (n = 52) convened, and groups of relevant experts met to review and recommend adoption or refinement of existing recommendations or develop new recommendations based on evidence from systematic reviews conducted by the Spinal Cord Injury Research Evidence (SCIRE) team. The expert panel voted to approve selected recommendations using an online survey tool. RESULTS The Can-SCIP Guideline includes 585 total recommendations from 41 guidelines, 96 recommendations that pertain to the Components of the Ideal SCI Care System section, and 489 recommendations that pertain to the Management of Secondary Health Conditions section. Most recommendations (n = 281, 48%) were adopted from existing guidelines without revision, 215 (36.8%) recommendations were revised for application in a Canadian context, and 89 recommendations (15.2%) were created de novo. CONCLUSION The Can-SCIP Guideline is the first living comprehensive guideline for adults with SCI in Canada across the care continuum.
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Affiliation(s)
- Eleni M. Patsakos
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Mark T. Bayley
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ailene Kua
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Christiana Cheng
- Praxis Spinal Cord Institute, International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Janice Eng
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physiotherapy, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
| | - Chester Ho
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Vanessa K. Noonan
- Praxis Spinal Cord Institute, International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew Querée
- GF Strong Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - B. Catharine Craven
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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