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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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Norris E, Zhang L, Wuerstl K, Froome H, Michie S. A data extraction template for the behaviour change intervention ontology. Wellcome Open Res 2024; 9:168. [PMID: 38873399 PMCID: PMC11170071 DOI: 10.12688/wellcomeopenres.20872.1] [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] [Accepted: 02/13/2024] [Indexed: 06/15/2024] Open
Abstract
Background The Behaviour Change Intervention Ontology (BCIO) aims to improve the clarity, completeness and consistency of reporting within intervention descriptions and evidence synthesis. However, a recommended method for transparently annotating intervention evaluation reports using the BCIO does not currently exist. This study aimed to develop a data extraction template for annotating using the BCIO. Methods The BCIO data extraction template was developed in four stages: i) scoping review of papers citing component ontologies within the BCIO, ii) development of a draft template, iii) piloting and revising the template, and iv) dissemination and maintenance of the template. Results A prototype data extraction template using Microsoft Excel was developed based on BCIO annotations from 14 papers. The 'BCIO data extraction template v1' was produced following piloting and revision, incorporating a facility for user feedback. Discussion This data extraction template provides a single, accessible resource to extract all necessary characteristics of behaviour change intervention scenarios. It can be used to annotate the presence of BCIO entities for evidence synthesis, including systematic reviews. In the future, we will update this template based on feedback from the community, additions of newly published ontologies within the BCIO, and revisions to existing ontologies.
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Affiliation(s)
- Emma Norris
- Department of Health Sciences, Brunel University London, London, England, UK
| | - Lisa Zhang
- Centre for Behaviour Change, University College London, London, England, UK
| | - Kelsey Wuerstl
- School of Health & Exercise Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Hannah Froome
- Department of Health Sciences, Brunel University London, London, England, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, England, UK
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Tate DG, Forchheimer M, Reber L, Meade M, Tan N, Clarke P. Factors enabling comorbidities and secondary conditions in older adults with spinal cord injury. J Spinal Cord Med 2023; 46:929-940. [PMID: 35993788 PMCID: PMC10653777 DOI: 10.1080/10790268.2022.2108662] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE To examine the role of personal, social, and environmental factors predicting comorbidities and secondary conditions among older adults with spinal cord injury (SCI). DESIGN Cross-sectional study utilizing survey methods were used to collect the data analyzed with two distinct general linear models. SETTING Community-dwelling participants who resided in rural and urban areas. PARTICIPANTS One hundred and eighty-three (183) participants with SCI ages 45 and over at least five years post injury. INTERVENTIONS Not applicable. MEASURES Spinal Cord Injury Secondary Conditions Scale (SCI-SCS); Comorbidities Questionnaire; Spinal Cord Injury Functional Index Assistive Technology (SCI-FI/AT) Basic - Mobility; Spinal Cord Injury Quality of Life (SCI-QOL) Satisfaction with Social Roles and Activities Scale (SSRA); Cohen's Social Network-Social Integration Index, the Medical Outcomes Study (MOS) Social Support Emotional/Informational Support Scale, and the Facilitators and Barriers Survey for Mobility (FABS-Mv2). Questions were also asked from the Behavioral Risk Factor Surveillance System (BRFSS). RESULTS Common predictors of comorbidities and secondary conditions included age, basic mobility, primary health care payer and parking limitations. An interaction between parking and neurological classification was observed for comorbidities. Neurological classification and employment were significantly associated with comorbidities while for secondary conditions, sex, years since injury, education, satisfaction with social roles and the home environment were critical factors. CONCLUSIONS Our study shows the effects of demographic and injury factors, physical functioning, satisfaction with social roles, access to home environment adaptations and health resources in predicting comorbidities and secondary conditions among older adults with SCI.
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Affiliation(s)
- Denise G Tate
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Martin Forchheimer
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Lisa Reber
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Michelle Meade
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Nasya Tan
- Department of Epidemiology, School of Public Health, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Philippa Clarke
- Department of Epidemiology, School of Public Health, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Abou L, Rice LA. Predictors of participation enfranchisement of wheelchair users with spinal cord injury in the United States. J Spinal Cord Med 2023; 46:789-797. [PMID: 35749681 PMCID: PMC10446797 DOI: 10.1080/10790268.2022.2087336] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
CONTEXT/OBJECTIVE To investigate predictors of participation enfranchisement of individuals living with spinal cord injury (SCI) who use a wheelchair full-time. DESIGN Secondary data analysis of a cross-sectional study. SETTING Community, United States. PARTICIPANTS Participants were 59 wheelchair users (median age of 52.5 years, IQR = 21) with chronic SCI (>1 year after injury). INTERVENTIONS No intervention. MAIN OUTCOME MEASURES Participation enfranchisement was measured using the enfranchisement scale of the Community Participation Indicators (CPI). Dependent variables included importance of participation (CPI-Importance) and control over participation (CPI-Control) subscales of the CPI. Independent variables included demographics and clinical characteristics (age, sex, time since injury, level of injury), wheelchair skills, mobility level, symptoms of depression, and environmental barriers. Backward multivariable linear regression analyses were carried-out to identify predictors of CPI-Importance and CPI-Control. RESULTS Five predictors including mobility level, wheelchair skills, sex, level of injury, and symptoms of depression explained 57% (F = 14; P < 0.01) of the variance in CPI-Importance. Three predictors including mobility level, symptoms of depression, and environmental barriers explained 60% (F = 27; P < 0.01) of the variance in CPI-Control. CONCLUSION This study provides evidence of potential modifiable factors such as mobility, wheelchair skills, environmental barriers, and symptoms of depression that can influence importance of participation and control over participation of wheelchair users with SCI. The models presented in this study can serve as a conceptual framework to design effective interventions to improve participation enfranchisement of wheelchair users with SCI.
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Affiliation(s)
- Libak Abou
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Laura A. Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Divecha AA, Bialek A, Kumar DS, Garn RM, Currie LEJ, Campos T, Friel KM. Effects of a 12-week, seated, virtual, home-based tele-exercise programme compared with a prerecorded video-based exercise programme in people with chronic neurological impairments: protocol for a randomised controlled trial. BMJ Open 2023; 13:e065032. [PMID: 36693691 PMCID: PMC9884574 DOI: 10.1136/bmjopen-2022-065032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/10/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Exercise is vital to staying well and preventing secondary complications in people with chronic neurological impairments (CNI). Appropriate exercise is often inaccessible to this population. The purpose of the study is to investigate the effects of a seated, virtual exercise programme on heart rate, recovery, fatigue, pain, motivation, enjoyment and quality of life in people with CNI. METHODS AND ANALYSIS Individuals with CNI will be screened for eligibility, and 60 participants will be randomised 1:1 into either a live or prerecorded group. There is no geographical limitation to where participants reside, since participation is virtual. The study will be coordinated by one site in White Plains, New York, USA. The live group will exercise with an instructor via Zoom while the prerecorded group will exercise at their chosen time using prerecorded videos, 3×/week for 12 weeks. PRIMARY OUTCOME MEASURES change in heart rate during exercise/recovery. SECONDARY OUTCOME MEASURES fatigue, motivation, level of pain and exertion, physical well-being, enjoyment of physical activity, motivation and quality of life. Outcomes will be assessed at baseline, midpoint, end of study and 1-month poststudy. Adverse events, medication changes and physical activity will be tracked throughout. Within-group and between-group comparisons will be performed by using analysis of covariance and regression. ETHICS AND DISSEMINATION BRANY IRB approval: 22 September 2020, protocol #20-08-388-512. All participants will provide written informed consent. Results will be disseminated through presentations, publications and ClinicalTrials.gov. TRIAL REGISTRATION NUMBER NCT04564495.
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Affiliation(s)
| | - Amy Bialek
- Burke Neurological Institute, White Plains, New York, USA
| | - Devina S Kumar
- Burke Neurological Institute, White Plains, New York, USA
| | - Rachel M Garn
- Burke Neurological Institute, White Plains, New York, USA
- School of Medicine, State of New York Upstate Medical University, Syracuse, NY, USA
| | | | - Talita Campos
- Burke Neurological Institute, White Plains, New York, USA
- School of Nursing, Columbia University Irving Medical Center, New York, NY, USA
| | - Kathleen M Friel
- Burke Neurological Institute, White Plains, New York, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
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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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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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