BackgroundGoal-setting within rehabilitation is a common practice ultimately geared toward helping patients make functional progress.ObjectiveThe purposes of this study were to (1) qualitatively analyze data from a wellness program for patients with spina bifida (SB) and spinal cord injury (SCI) in order to generate software requirements for a goal-setting module to support their complex goal-setting routines, (2) design a prototype of a goal-setting module within an existing mobile health (mHealth) system, and (3) identify what educational content might be necessary to integrate into the system.MethodsA total of 750 goals were analyzed from patients with SB and SCI enrolled in a wellness program. These goals were qualitatively analyzed in order to operationalize a set of software requirements for an mHealth goal-setting module and identify important educational content.ResultsThose of male sex (P=.02) and with SCI diagnosis (P<.001) were more likely to achieve goals than females or those with SB. Temporality (P<.001) and type (P<.001) of goal were associated with likelihood that the goal would be achieved. Nearly all (210/213; 98.6%) of the fact-finding goals were achieved. There was no significant difference in achievement based on goal theme. Checklists, data tracking, and fact-finding tools were identified as three functionalities that could support goal-setting and achievement in an mHealth system. Based on the qualitative analysis, a list of software requirements for a goal-setting module was generated, and a prototype was developed. Targets for educational content were also generated.ConclusionsInnovative mHealth tools can be developed to support commonly set goals by individuals with disabilities.

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Does experiencing pollution mobilize or dampen political participation? Extant theory and historical evidence offer competing answers, and empirically resolving this tension is difficult because pollution and politics are endogenous. We partner with a prominent political action organization in the United States to collect data on commitments to participate in their events. We then use wind speed as an instrument to estimate the effect of surface-level particulate matter concentrations on participation across 414 counties in the Western United States. Our results show that exposure to air pollution undermines political participation, likely through people experiencing and anticipating pollution's health effects. This negative relationship is strongest among relatively high-income and pro-Democratic counties -- the counties which, theoretically, face the lowest barriers to collective action. Our study yields important insights for scholars of political participation, policy feedback, and environmental justice. By undermining the prospects mass mobilization and systemic change, pollution may beget more pollution.

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