Well on wheels intervention: Satisfaction with life and health for adults with spinal cord injuries

Abstract

Objective/Background: To examine how demographic and injury characteristics identify satisfaction with life (SWL), and assess the differential effects of a wellness intervention by baseline SWL groups.

Design: Baseline and longitudinal analysis of a randomized controlled pilot intervention using decision tree regression and linear mixed models.

Setting: Community based.

Participants: Seventy-two individuals with spinal cord injury (SCI) were randomized to an intervention group (n = 39) or control group (n = 33). Participants were aged 44.1 ± 13.0 years and 13.1 ± 10.6 years post-injury. Most participants were male (n = 50; 69.4%) and had paraplegia (n = 38; 52.7%). Participants were classified as high versus low SWL at baseline using a cutoff score of 20.

Interventions: The intervention aimed to increase self-efficacy, and in turn, increase engagement in health-promoting behaviors related to SWL. Six 4-hour in-person workshops were conducted over a 3-month period led by experts and peer-mentors who were available for support.

Outcome measure(s): Self-efficacy for health practices, secondary condition severity, health-promoting behaviors, perceived stress, and SWL.

Results: At baseline, participants with low SWL were recently injured (<4.5 years), while persons with high SWL were married and younger (<49 years old). Intervention participants with low SWL at baseline significantly improved SWL over time compared to those with high SWL (P = 0.02).

Conclusion: Certain injury and demographic characteristics were associated with SWL, and intervention participants with low SWL at baseline improved their SWL over 2 years. Healthcare providers should consider time post-injury, marital status, and age in identifying individuals at risk for low SWL that may benefit from wellness interventions.

Keywords:

• Spinal cord injuries
• Quality of life
• self-efficacy
• Clinical trial
• Outcomes assessment
• Rehabilitation

Acknowledgements

The published material is substantially the product of the first author's dissertation.

Disclaimer statements

Contributors None.

Funding Funding was provided by a grant from the University of Michigan Health Systems (UHMS) Venture Investment Fund; by the UHMS General Clinical Research Center (NIH grant M01-RR00042); and the University of Michigan Spinal Cord Injury Model System Program, funded by NIDLRR grant H133N000009.

Conflicts of interest Authors have no conflicts of interest to declare.

ORCID

Stephanie L. Silveira http://orcid.org/0000-0002-1973-2119

Daniel P. O'Connor http://orcid.org/0000-0001-9750-2864