Evaluating the Feasibility, Acceptability, and Engagement of an mHealth Physical Activity Intervention for Adults With Spinal Cord Injury Who Walk: A Randomized Controlled Trial.

The purpose of this study was to test a partnered, self-determination theory-informed mobile health intervention called SCI Step Together, using an 8-week randomized controlled trial design. The aim of SCI Step Together is to increase the quantity and quality of physical activity (PA) among adults with spinal cord injury (SCI) who walk. The SCI Step Together program provides PA modules and PA self-monitoring tools and facilitates peer and health coach support. Process, resource, management, and scientific feasibility were assessed, and participants completed questionnaires at baseline, mid-, and postintervention to assess determinants and outcomes of PA. Interviews were conducted to evaluate acceptability. Results suggest that the program demonstrated good feasibility, acceptability, and engagement. The intervention group (n = 11) had greater fulfillment of basic psychological needs and knowledge (p = .05) than the control group (n = 9). There were no significant interaction effects for other outcomes. The SCI Step Together program is feasible and acceptable and efficacious for improving some psychosocial variables. Results may inform SCI mobile health programs.

Physical activity interventions, chronic pain, and subjective well-being among persons with spinal cord injury: a systematic scoping review.

STUDY DESIGN: Scoping review of experimental and quasi-experimental studies. OBJECTIVE: To systematically synthesize research testing the effects of leisure time physical activity (LTPA) interventions on chronic pain and subjective well-being (SWB) among adults with spinal cord injury (SCI). METHODS: Literature searches were conducted using multiple databases (Web of Science, Embase, CINAHL, Medline, PsychINFO and SPORTDiscus) to identify studies involving persons with SCI that measured and reported the effects of LTPA interventions on both chronic pain and at least one measure of SWB (e.g., affect, life satisfaction, satisfaction with various life domains). Relevant data were extracted from the studies and synthesized. RESULTS: A total of 3494 articles were screened. Fifteen published articles, consisting of 12 different studies met the review inclusion criteria. Four different patterns of findings were observed regarding the effect of LTPA on chronic pain and SWB outcomes: (1) increased chronic pain, decreased SWB (1 article); (2) decreased chronic pain, improved SWB (12 articles); (3) increased chronic pain, improved SWB (1 article); and (4) unchanged levels of pain, improved SWB (1 article). CONCLUSIONS: Results of most articles included in this scoping review suggest that LTPA interventions can reduce chronic pain and improve SWB for persons with SCI. Further research is needed to identify the mechanisms by which LTPA affects pain and SWB, in order to formulate LTPA prescriptions that maximize improvements in these outcomes.

A Scoping Review of Peer Mentorship Studies for People with Disabilities: Exploring Interaction Modality and Frequency of Interaction.

Given our understanding of the importance of peer mentorship for people with disabilities, research needs to begin exploring characteristics of the mentor-mentee relationship that could contribute to the observed positive outcomes. To date, no review has examined characteristics of peer mentorship (i.e. interaction modality, interaction frequency) that could impact the quality and effectiveness of this service. The primary purpose was to synthesize the peer-reviewed peer mentorship literature for people with disabilities and report on the interaction modality and frequency employed in each study. A secondary purpose was to document the results of studies that have tested relationships between the outcomes of peer mentorship and interaction modality or frequency. A scoping review was performed that involved a systematic search of MEDLINE, EMBASE, PsychINFO, CINAHL, Web of Science, and SPORTDiscus. Thirteen studies met the inclusion criteria. Articles reported five different interaction modalities; the telephone (n = 12) was the most common. Frequency of interactions was reported in nine studies with mentees reporting between 3 and 77 interactions with their mentor. Only one study attempted to analyze the mediating or moderating effects of modality and frequency on the reported outcomes. In conclusion, peer mentorship is occurring through various interaction modalities and at varying frequencies. Future research should focus on examining the impact that modality and frequency of interaction have on outcomes of peer mentorship.

Physical activity among individuals with spinal cord injury who ambulate: a systematic scoping review.

STUDY DESIGN: Systematic scoping review. OBJECTIVES: The purpose of this project was to conduct a scoping review to understand the amounts, types, correlates, and outcomes of physical activity (PA) participation for ambulators with SCI. METHODS: A systematic search was employed among five large databases and two theses/dissertation databases, yielding 3257 articles. Following a two-phase screening process by independent coders, 17 articles were included in the review. Data were charted and summarized, and correlates were coded using the COM-B model. RESULTS: 11 studies were cross-sectional, 5 studies involved an exercise intervention, and 1 study used mixed methods. Overall, ambulators with SCI participated in low levels of PA. The type of PA investigated across all studies was leisure-time PA (e.g., sports, exercise). Psychological and physical capability (e.g., perceived behavioral control, fatigue), social and environmental opportunity (e.g., perceptions of disability, cost), and automatic and reflective motivation (e.g., boredom, intentions) were correlates of PA measured within studies. Exercise intervention studies measured physical (e.g., strength, fitness) and one psychological outcome (i.e., depression). No studies examined the quality of PA experiences. CONCLUSIONS: Only leisure-time PA has been investigated among ambulators with SCI, and low levels of leisure-time PA have been reported. Correlates of leisure-time PA can be mapped onto all COM-B model constructs and are potential targets for PA-enhancing interventions. Further investigation is warranted into the physical and psychosocial outcomes across all types of LTPA in addition to understanding the quality of LTPA experiences.

Characteristics of transformational leadership development programs: A scoping review.

The effectiveness of transformational leadership (TFL) on various outcomes is well known. Accordingly, researchers have developed training programs to enhance TFL behaviours of leaders. Yet, no reviews summarizing the characteristics of TFL training programs exist. The purpose of this review was to examine the characteristics, reporting, and application of TFL-informed programs. A search of six databases yielded 4032 articles, 31 of which met the inclusion criteria. Program characteristics were analyzed using the Template for Intervention Description and Replication (TIDieR) checklist tool, while outcomes were analyzed according to the Kirkpatrick model of evaluation. The most common context for TFL program implementation was healthcare (n = 9). Programs were tailored and often delivered using group workshops and individual feedback. Studies reported variation in the dose of programs, rarely evaluated outcomes multiple times post-baseline, and typically employed Level 3a (subjective ratings of behaviour) evaluation measures. Reporting on program location, modifications, and fidelity was poor. Varying conceptualizations of TFL in different contexts lead to disparities in programs and protocols. Evaluation specialists should consider using tools like the TIDiER checklist to ensure that program characteristics are reported appropriately. Program planners should develop common approaches for planning and evaluating TFL programs to improve transparency and replicability of programs.

Factors associated with leisure-time physical activity participation among individuals with spinal cord injury who ambulate.

PURPOSE: The purpose of this study was to employ the theoretical domains framework (TDF) to identify behaviour change factors related to leisure-time physical activity (LTPA) in spinal cord injury (SCI) ambulators. METHODS: A cross-sectional design was employed. Among 43 SCI ambulators, the TDF behaviour change factors were assessed, along with the duration, types, and intensities of LTPA performed over the previous week. RESULTS: The TDF behaviour change factors identified as barriers to LTPA included: knowledge, beliefs about capabilities, coping planning, and goal conflict. Approximately 71.81 mins/day (SD = 75.41) was spent doing LTPA. Participants reported aerobic and resistance training activities, along with several other types of LTPA (e.g., rock climbing). Coping planning, action planning, goal conflict, and skills explained significant variance in time spent on LTPA (R2adjusted = 0.259, p < 0.01), but only action planning uniquely predicted LTPA. CONCLUSIONS: Greater use of coping and action planning, lower levels of goal conflict and stronger skills were associated with greater participation in LTPA. These factors will be targeted for a future LTPA-enhancing intervention for SCI ambulators, informed by behaviour change theory. SCI ambulators participate in a surprisingly wide range of LTPA. Rehabilitation specialists can use this list to suggest activities for patients with SCI who ambulate.IMPLICATIONS FOR REHABILITATIONBarriers to leisure-time physical activity for individuals with spinal cord injury (SCI) who ambulate include lack of knowledge, weak beliefs about capabilities, lack of coping planning, and high goal conflict.Physical activity interventions for individuals with SCI who ambulate should include action and coping planning, goal conflict, and skills.Physical activity interventions should be created systematically using behaviour change theory and involvement of stakeholders throughout the development process.Practitioners can promote skills training in adapted activities like gardening, cycling, and rock-climbing for ambulators with SCI.