Lifestyle intervention for adults with spinal cord injury: Results of the USC–RLANRC Pressure Ulcer Prevention Study

Carlson, Michael; Vigen, Cheryl; Rubayi, Salah; Blanche, Erna Imperatore; Blanchard, Jeanine; Atkins, Michal; Bates‐Jensen, Barbara M.; Garber, Susan L.; Pyatak, Elizabeth A.; Díaz, Jesús; Floríndez, Lucía I.; Hay, Joel W.; Mallinson, Trudy; Unger, Jennifer B.; Azen, Stanley P.; Scott, Michael D.; Cogan, Alison M.; Clark, Florence

doi:10.1080/10790268.2017.1313931

Cited by 29 publications

(33 citation statements)

References 58 publications

(68 reference statements)

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“…The methods and results of the RCT are described elsewhere. 15,16 The difference in pressure injury incidence between intervention and control groups was not statistically significant in the intent-to-treat analysis. 15 The PUPS participants were recruited from Rancho Los Amigos National Rehabilitation Center, which primarily serves a low-income, minority segment of Los Angeles County residents-one of the most medical ly underserved populations in the United States.…”

mentioning

confidence: 88%

Factors Protecting Against Pressure Injuries in Medically Underserved Adults With Spinal Cord Injury: A Qualitative Study

Sleight

Cogan

Hill

et al. 2019

Topics in Spinal Cord Injury Rehabilitation

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Background: Pressure injuries negatively impact quality of life and participation for individuals with spinal cord injury (SCI). Objective: To examine the factors that may protect against the development of medically serious pressure injuries in adults with SCI. Methods: A qualitative analysis was conducted using treatment notes regarding 50 socioeconomically disadvantaged individuals who did not develop medically serious pressure injuries during a 12-month pressure injury prevention intervention program. Results: Eight types of potentially protective factors were identified: meaningful activity, motivation to prevent negative health outcomes, stability/resources, equipment, communication and self-advocacy skills, personal traits, physical factors, and behaviors/activities. Conclusions: Some protective factors (eg, personal traits) may be inherent to certain individuals and nonmodifiable. However, future interventions for this population may benefit from a focus on acquisition of medical equipment and facilitation of sustainable, health-promoting habits and routines. Substantive policy changes may be necessary to facilitate access to adequate resources, particularly housing and equipment, for socioeconomically disadvantaged individuals with SCI. Further research is needed to understand the complex interplay of risk and protective factors for pressure injuries in adults with SCI, particularly in underserved groups.

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mentioning

confidence: 88%

Factors Protecting Against Pressure Injuries in Medically Underserved Adults With Spinal Cord Injury: A Qualitative Study

Sleight

Cogan

Hill

et al. 2019

Topics in Spinal Cord Injury Rehabilitation

Self Cite

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“…A range of trials of interventions for PUs appears in the published literature, specifically in people with SCI, some of which may not be captured in existing systematic reviews. Preventative interventions include those which involve self-efficacy enhancement [87] and lifestyle management [88,89], whilst interventions for treatment include irradiation with ultraviolet-C [90], telephone-based support [91] and negative pressure wound therapy [92]. These are clearly candidates for future consideration in systematic reviews and updates.…”

Section: Additional Pu Trials In People With Scimentioning

confidence: 99%

Interventions for pressure ulcers: a summary of evidence for prevention and treatment

Atkinson

Cullum

2018

Spinal Cord

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“…Spinal cord injury is a complex chronic health condition that also makes individuals prone to several secondary complications, including pressure injuries [ 1 - 3 ]. In fact, pressure injuries are one of the most common secondary complications affecting community-dwelling individuals with spinal cord injury [ 3 - 5 ]. In addition to having a considerable impact on a person’s health, quality of life, and well-being, there are also high economic costs associated with the treatment of pressure injuries [ 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Co-designing a Self-Management App Prototype to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Mixed Methods Study

Amann¹,

Fiordelli²,

Brach³

et al. 2020

JMIR Mhealth Uhealth

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Background Spinal cord injury is a complex chronic health condition that requires individuals to actively self-manage. Therefore, an evidence-based, self-management app would be of value to support individuals with spinal cord injury in the prevention of pressure injuries. Objective The main objectives of this study were to (1) establish a co-design approach for developing a high-fidelity prototype app for the self-management of individuals with spinal cord injury, (2) design the prototype that resulted from this process, and (3) conduct the first usability assessment of the prototype app. Methods We adopted a co-design approach to develop an evidence-based app prototype. Starting from a preliminary content model (based on clinical guidelines for the prevention of pressure injuries) and three research-based user personas, we conducted an ideation workshop involving individuals with spinal cord injury and health care professionals. The ideation workshop formed the basis for two consecutive design sprints. The result of this co-design phase was an interactive app prototype. The prototype was evaluated in two rounds of usability testing (N=4 and N=15, respectively) using a combination of qualitative and quantitative methods. Results The co-design process resulted in a high-fidelity prototype with two key components: a self-management component and a communication component. The final prototype included a combination of features to support individuals with spinal cord injury in the prevention of pressure injuries, namely a smart camera, pressure injury diary, expert consultation, reminders, and knowledge repository. Findings of the usability testing showed that most participants navigated the app fluently with little back and forth navigation and were able to successfully complete a set of assigned tasks. These positive results are supported by the average system usability score achieved (78.5/100; range 47.5-95.0) and our qualitative analysis of the semistructured interviews. Despite an overall positive evaluation of the app prototype, we identified areas for improvement (eg, inclusion of a search function). Conclusions Individuals with spinal cord injury often need to navigate competing interests and priorities, paired with uncertainty about the accuracy and relevance of clinical recommendations. Understanding what matters to individuals with spinal cord injury can help guide the design of behavioral interventions that are useful and acceptable to these individuals in their daily lives. This study shows that involving individuals with spinal cord injury and health care professionals in co-designing a self-management app can foster knowledge cocreation at the intersection of lived experience, medical expertise, and technical solutions.

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Lifestyle intervention for adults with spinal cord injury: Results of the USC–RLANRC Pressure Ulcer Prevention Study

Abstract: ClinicalTrials.gov NCT01999816.

Cited by 29 publications

References 58 publications

Factors Protecting Against Pressure Injuries in Medically Underserved Adults With Spinal Cord Injury: A Qualitative Study

Factors Protecting Against Pressure Injuries in Medically Underserved Adults With Spinal Cord Injury: A Qualitative Study

Interventions for pressure ulcers: a summary of evidence for prevention and treatment

Co-designing a Self-Management App Prototype to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Mixed Methods Study

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