Urban–Rural Disparities in Community Participation after Spinal Cord Injury in Ontario

Healthcare, 2024 · DOI: 10.3390/healthcare12202089 · Published: October 20, 2024

Spinal Cord Injury Rehabilitation Public Health

Simple Explanation

This study examines how living in urban versus rural areas affects the community participation of individuals with spinal cord injuries (SCI/D) in Ontario, Canada. It uses surveys to measure self-efficacy and reintegration into normal life, and it also tests a new AI tool to quickly analyze survey data. The findings highlight that the level of functional ability and the environment (urban vs. rural) can impact how people with SCI/D perceive their community participation.

Study Duration

Between January and October 2022

Participants

85 individuals with SCI/D

Evidence Level

Not specified

Key Findings

1
Individuals with incomplete injuries in rural areas reported lower MSES and RNLI scores than those with complete motor injuries, whereas no significant differences were found in MSES and RNLI scores among urban residents based on impairment.
2
The lowest score among MSES domains was in response to sexual satisfaction.
3
The OMR tool had 97.4% accuracy in extracting data from the surveys.

Research Summary

This study evaluated CP using the RNLI and MSES among individuals living with complete or incomplete SCI/D who resided in major urban, non-major urban, or rural regions in Ontario, Canada. The study results revealed evident distinctions in the RNLI and MSES scores among individuals with AIS C and D compared to AIS A and B who live in rural or non-major urban settings, whereas such disparities were not observed among those residing in major urban areas. There are unique unmet needs for marginalized individuals residing in rural or non-major urban areas with incomplete SCI/D (AIS category C or D) to enhance CP.

Practical Implications

Targeted Interventions

The study highlights the need for targeted interventions to address the unique needs of individuals with motor incomplete SCI/D residing in rural areas to improve their community participation.

Sexual Health Focus

Rehabilitation programs should prioritize sexual health education and treatment programs to address the unmet needs of individuals with SCI/D in this area.

OMR Tool Utility

The OMR tool can be reliably used in future studies across urban and rural settings to monitor CP over time among individuals with SCI/D.

Study Limitations

1
The data collection process may have biased the survey results, with respondents able to self-complete the iPad surveys, whereas telephone surveys were conducted by SCIO trained staff, which may have increased the respondents’ reluctance to answer honestly.
2
The power of our analysis is likely to be improved by using a larger sample size to obtain more statistically robust results.
3
data collection and subsequent analysis did not account for potential seasonal variations in the RNLI and MSES scores.

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