Background: Individuals with spinal cord injury (SCI) in less-resourced settings reported barriers to community integration, including inaccessible rehabilitation services, restricted environments and limited social integration. Peer training and entrepreneurial skills training are provided by Motivation, a nonprofit organisation, and Moshi Cooperative University to enhance occupational engagement of individuals with SCI in less-resourced settings.Objective: This study aimed to explore the impact of peer training and entrepreneurial skills training on the social participation of individuals with SCI living in Tanzania.Method: Using a qualitative photovoice approach, 10 participants captured meaningful photos and provided captions according to five standardised questions (PHOTO technique) to convey their messages. Participants selected up to 34 photos that best illustrated their experiences in the community. A mixed inductive–deductive thematic analysis was guided by the International Classification of Functioning, Disability and Health.Results: Two interrelated themes emerged: (1) ‘influencing factors’, which revealed how participants’ inclusion in the community was influenced by their activities and personal and environmental factors and (2) ‘empowerment’, which highlighted participants’ desire to advocate and promote awareness of needs and hopes.Conclusion: Participants emphasised the importance of accessibility and equal opportunities. Whilst some were able to overcome obstacles, others experienced continued inaccessibility that inhibited meaningful occupations. Daily participation challenges of individuals with SCI in rural Tanzania were highlighted. Although the Motivation programmes were perceived to have powerful impacts on social participation, continued efforts and advocacy are needed to overcome accessibility issues and to meet the physical, psychological and social needs of Tanzanians living with SCI.Contribution: This article highlights the importance of accessibility and equal opportunities for individuals with disability living in rural Tanzania. Peer-training and entrepreneurial programs offer community-based rehabilitation services that were perceived by people with disabilities to have a powerful impact on social participation and vocation. However, continued efforts and advocacy are needed to meet the needs of Tanzanians living with spinal cord injury.
Background: Limited knowledge and skills of health professionals is a common barrier when adapting physical activity for people with disabilities. A community organization (Adaptavie) identified the need for improved training and resources to facilitate APA prescription by their employees. The objectives of this research were to co-create an APA toolkit and evaluate implementation.Methods: A multi-method participatory research approach was used with kinesiologists who worked at Adaptavie. The project consisted of two phases: P1) co-creation of the toolkit; P2) implementation evaluation. Sociodemographic information (P1; P2), the Work self-efficacy Inventory Survey (P1; P2), the Indicators of Success Questionnaire (P2) and focus groups (P1 n = 3; P2 n = 1) were conducted with kinesiologists. Summary statistics were described (sociodemographic and questionnaires) and analysed thematically (focus groups). Results:The co-creation of an evidence-based training toolkit contained information about 45 types of disabilities. Five to eight kinesiologists (depending on the phase) reported improvements in workplace self-efficacy, skills and knowledge after using the APA toolkit for one year. Following implementation, the APA toolkit was reported to have a high level of usability and fidelity. Conclusion:A co-created APA toolkit supported kinesiologists to prescribe evidencebased APA programs by increasing their knowledge, skills and self-efficacy.
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