Expert consensus for a digital peer-led approach to improving physical activity among individuals with spinal cord injury who use manual wheelchairs

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.1986308 · Published: January 1, 2023

Spinal Cord Injury Rehabilitation Social Support

Simple Explanation

This study explores a new program called ALLWheel, which uses digital peer support to help people with spinal cord injuries (iSCI) who use manual wheelchairs to be more physically active. The goal was to get expert opinions on the ALLWheel program to make sure it's helpful and safe. Experts included individuals with spinal cord injuries, healthcare professionals, and community partners. Experts agreed that the program is needed, should be fun and personalized, and that involving healthcare professionals would address safety concerns. They also agreed that peers can be effective coaches and that smartphones can help reach more people.

Study Duration

Not specified

Participants

Twelve experts in SCI and LTPA

Evidence Level

Not specified

Key Findings

1
Experts affirmed the need for leisure-time physical activity (LTPA) programs for individuals with spinal cord injury (iSCI).
2
Experts agreed that healthcare professional involvement would alleviate safety concerns with the ALLWheel program.
3
Experts agreed that peer-coaches have benefits for delivering the program and that it targets important psychological factors.

Research Summary

The Active Living Lifestyles for manual wheelchair users (ALLWheel) program uses a digital peer-led approach to incorporate two behavior change theories to address a critical need for leisure-time physical activity (LTPA) programs for individuals with spinal cord injury (iSCI). Two, 90-minute focus groups were conducted and transcribed verbatim, analyzed thematically, and the results were used to create a Delphi survey. Delphi surveys were completed online using consecutive rounds until ≥70% consensus per item was attained. Experts established a need for fun and personalized community-based LTPA programs. Ensuring that healthcare professionals would be involved in the ALLWheel program alleviated safety concerns, and experts agreed there were benefits of peers delivering the program.

Practical Implications

Program Development

The study provides valuable insights for developing effective LTPA programs for iSCI, emphasizing the importance of personalization, fun, and integration of psychological factors.

Clinical Practice

Healthcare professionals can use the findings to incorporate peer support and digital technologies into their rehabilitation programs to improve physical activity outcomes for iSCI.

Policy and Funding

The study supports the need for increased funding and policy support for community-based LTPA programs that utilize peer-led and digital approaches to reach a wider population of iSCI.

Study Limitations

1
The sample size was relatively small for a Delphi consensus and may have lacked cultural contexts and perspectives.
2
Expert opinions were gained from various stakeholders (i.e. clinicians, iSCI, community partners) and the interdisciplinary research team represented four Canadian cities.
3
There may also be some inherent bias among the sample, as iSCI were interested in participating in LTPA and already active.

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