Pilot Study of a Peer-Led Wheelchair Training Program to Improve Self-Efficacy Using a Manual Wheelchair: A Randomized Controlled Trial.

OBJECTIVES: To evaluate the effect of a peer-led wheelchair training program on self-efficacy of manual wheelchair (MWC) use and to explore influences of the intervention on MWC skills, life-space mobility, and satisfaction with participation. DESIGN: Pilot randomized controlled trial. SETTING: Rehabilitation center and community. PARTICIPANTS: Community-living MWC users (N=28; mean MWC experience, 13y; mean age, 49y; 6 [21%] women). INTERVENTIONS: The experimental group (n=16) received six 1.5-hour sessions of a peer-led self-efficacy-enhanced wheelchair training program (WheelSee). On the basis of individualized goals, peer trainers administered WheelSee to pairs of MWC users. The control group (n=12) received no intervention. MAIN OUTCOME MEASURES: The primary outcome--wheelchair use self-efficacy--was assessed using the Wheelchair Use Confidence Scale (WheelCon) version 3.0. Secondary outcomes included wheelchair skills capacity and performance (Wheelchair Skills Test Questionnaire version 4.1), life-space mobility (Life Space Assessment), and satisfaction with participation (Wheelchair Outcome Measure). RESULTS: Controlling for baseline scores, an analysis of covariance revealed that WheelSee had a large statistically significant effect on MWC use self-efficacy in community-living adult MWC users (Cohen d=1.4; P=.002) than in a control group. WheelSee also had a large statistically significant effect on MWC skills capacity (Cohen d=1.3; P=.003) and performance (Cohen d=1.0; P=.02). There were no statistically significant differences in life-space mobility or satisfaction with participation scores between the groups. CONCLUSIONS: A peer-led MWC training program improves wheelchair use self-efficacy in adult MWC users and had a positive influence on other wheelchair-related outcomes. WheelSee may offer a promising intervention strategy to accommodate the training needs of community-living MWC users.