SCI Thrive: Impact of a peer-led online self-management program

J Spinal Cord Med. 2023 Mar 31:1-10. doi: 10.1080/10790268.2023.2192852. Online ahead of print.

Abstract

Objective: To test the effectiveness of a peer-led online self-management program for individuals with spinal cord injury (SCI).

Design: Randomized waitlist control trial.

Setting: Community.

Participants: 184 adults with SCI.

Interventions: SCI Thrive is a peer-led self-management program with self-paced online content and video-sessions for live discussion.

Outcome measures: Perceived quality of life, self-efficacy for health, participation.

Results: A total of 97 individuals (86 randomized plus 9 assigned to the final group) were assigned to treatment and 86 randomized to the waitlist. Participants were 51 years old on average (SD = 14.9), with 58% male, mean of 15.5 (SD = 14.0) years injured, with 59% cervical injuries and 64% incomplete injuries. The treatment group had significantly higher scores on CHART occupational subscale (P = .022), but no other differences were found at the end of 6 weeks. Analysis of all participants who completed SCI Thrive showed significant increase in self-efficacy between baseline (6.32) and 6 weeks (6.81; P < .001) which was maintained at 3 months post treatment (6.83; P = .001). Those who were more engaged in SCI Thrive reported higher quality of life (P = .001), self-efficacy (P = .007), and increased mobility on the CHART (P = .026).

Conclusion: SCI Thrive is a highly accessible program for individuals with SCI and shows promise for improving self-efficacy. Strategies to increase engagement should be added to maximize benefits. Measurement tools may have been impacted by COVID-19 pandemic. Further research on the efficacy of SCI Thrive is needed given feedback on benefit of a group focus area, such as on physical activity.

Keywords: Self-efficacy; Self-management; Spinal cord injury.