Strategies used by providers to support individuals with spinal cord injury in weight management: a qualitative study of provider perspectives

Burkhart, Lisa; Pellegrini, Christine A.; Jones, Kayla; LaVela, Sherri L.

doi:10.1038/s41394-021-00426-1

Cited by 6 publications

(9 citation statements)

References 40 publications

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“…Our findings indicate that HCPs are not aware of SCI‐specific WM guidance. This suggests that health care settings need more proactive efforts to increase knowledge and awareness within interprofessional health care teams 41 …”

Section: Discussionmentioning

confidence: 99%

“…This suggests that health care settings need more proactive efforts to increase knowledge and awareness within interprofessional health care teams. 41 HCPs, internationally, have previously urged this appeal for SCI-relevant evidence-based WM guidelines. 42,43 Exercise recommendations have been made for persons with SCI 44 and Gorgey recommended that the medical community reinforce an active lifestyle.…”

Section: Discussionmentioning

confidence: 99%

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Health care provider views on the magnitude of overweight/obesity in spinal cord injury and awareness of evidence‐based guidance for weight management

LaVela

Burkhart

Jones

et al. 2021

PM&R

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Background: Literature shows that large proportions of people with a spinal cord injury (SCI) continue to experience challenges and limitations in weight management (WM) efforts in the health care setting. Despite the need, evidence-based research on effective and practical WM practices for persons with SCI is inconsistent and not widely used by health care providers (HCPs). Objective: The objectives were twofold: (1) to explore HCP perspectives of the extent of the problem of overweight/obesity in individuals with SCI and (2) HCPs awareness of and beliefs about availability of literature or evidence-based guidelines that discuss WM in SCI. Design: Qualitative study using semistructured interviews with HCPs and thematic analysis to identify themes. Participants/Setting: SCI HCPs (n = 25) from Veterans Health Administration and Midwest Regional SCI Care System. Intervention: Not applicable. Results: SCI HCPs (88%) emphasized the large scope of the problem of overweight and obesity in persons with SCI. HCPs noted the multiple associated negative consequences, specifically 84% highlighted the impact on chronic conditions (cardiometabolic, respiratory) and 48% discussed the impact on secondary/ associated conditions (skin, bowel, bladder, musculoskeletal). HCPs noted other impacts of excess weight as greater disability in later life (28%), challenges with mobility and function (60%), self-care (24%), and equipment safety (28%). This sample of HCPs (76%) indicated being unaware of published or available information about WM efforts that work in SCI populations. Conclusion: Our findings indicate that HCPs believe that overweight and obesity is a significant problem in persons with SCI but that this sample of HCPs are not aware of published work and easily accessible SCI-specific WM evidence-based guidance. This suggests the need for more education and proactive efforts to improve awareness of appropriate information within interprofessional HCPs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Health care provider views on the magnitude of overweight/obesity in spinal cord injury and awareness of evidence‐based guidance for weight management

LaVela

Burkhart

Jones

et al. 2021

PM&R

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“…One additional study 23 was found through handsearching the reference lists of relevant resources, making a total of 22 articles. 13,14,23,24,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]…”

Section: Resultsmentioning

confidence: 99%

“…Included studies (Supplementary Table S1a and S1b) were individual RCTs (n = 2) (14.37), an RCT with a case series (n = 1), 40 PP studies (n = 8), 23,24,30,38,39,[41][42][43] and qualitative studies (n = 11) 13,29,[31][32][33][34][35][36]44,45 with one combined pre/post and qualitative design, 30 making a total of 22 studies. Eight studies focused on weight gain prevention (all qualitative studies except for a combined qualitative and pre-post design), and one study focused on weight loss.…”

Section: Study Characteristicsmentioning

confidence: 99%

A systematic review and qualitative synthesis of weight management interventions for people with spinal cord injury

Madigan,

King,

Taylor

et al. 2024

Obesity Reviews

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SummaryPeople with spinal cord injury (SCI) are at greater risk of developing obesity and related co‐morbidities than those without SCI. The objectives of this systematic review were to examine the effectiveness of weight management interventions for people with SCI and to synthesize the experiences of people involved with SCI weight management (e.g., SCI healthcare professionals and caregivers). Five databases were searched (up to July 31, 2023) and 5,491 potentially eligible articles were identified. Following screening, 22 articles were included, comprising 562 adults. There was considerable heterogeneity in study design and weight loss interventions included behavioral nutritional and exercise education sessions, recalling food diaries, exercise interventions, and pharmaceuticals. The mean percentage change of the pooled body mass data equated to −4.0 ± 2.3%, with a range from −0.5 to −7.6%. In addition, 38% of the individuals with SCI who completed a weight loss intervention (N = 262) had a ≥5% reduction in body weight. Collectively, although on average the included interventions led to moderate weight loss, the finding that just over a third of individuals achieved clinically meaningful 5% weight loss suggests that available interventions for this population may need to be improved.

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“…Pellegrini et al [40] reported that common barriers to counseling for weight management amongst SCI healthcare providers included individual-level factors, such as the healthcare providers' lack of knowledge and poor dietary strategies [40]. In support of this, a study by Burkhart et al [41] indicated that provision of education and encouragement of healthy behaviors by health care providers were effective methods for weight management among persons with SCI.…”

Section: Weight/adipose Tissue Management In Scimentioning

confidence: 99%

Nutrition Education to Reduce Metabolic Dysfunction for Spinal Cord Injury: A Module-Based Nutrition Education Guide for Healthcare Providers and Consumers

Sneij

Farkas

Mason

et al. 2022

JPM

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Spinal cord injury (SCI) results in a high prevalence of neurogenic obesity and metabolic dysfunction. The increased risk for neurogenic obesity and metabolic dysfunction is mainly due to the loss of energy balance because of significantly reduced energy expenditure following SCI. Consequently, excessive energy intake (positive energy balance) leads to adipose tissue accumulation at a rapid rate, resulting in neurogenic obesity, systemic inflammation, and metabolic dysfunction. The purpose of this article is to review the existing literature on nutrition, dietary intake, and nutrition education in persons with SCI as it relates to metabolic dysfunction. The review will highlight the poor dietary intakes of persons with SCI according to authoritative guidelines and the need for nutrition education for health care professionals and consumers. Nutrition education topics are presented in a module-based format with supporting literature. The authors emphasize the role of a diet consisting of low-energy, nutrient-dense, anti-inflammatory foods consistent with the Dietary Guidelines for Americans’ MyPlate to effectively achieve energy balance and reduce the risk for neurogenic obesity and metabolic dysfunction in individuals with SCI.

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Strategies used by providers to support individuals with spinal cord injury in weight management: a qualitative study of provider perspectives

Cited by 6 publications

References 40 publications

Health care provider views on the magnitude of overweight/obesity in spinal cord injury and awareness of evidence‐based guidance for weight management

Health care provider views on the magnitude of overweight/obesity in spinal cord injury and awareness of evidence‐based guidance for weight management

A systematic review and qualitative synthesis of weight management interventions for people with spinal cord injury

Nutrition Education to Reduce Metabolic Dysfunction for Spinal Cord Injury: A Module-Based Nutrition Education Guide for Healthcare Providers and Consumers

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