Smartphone-Delivered Peer Physical Activity Counseling Program for Individuals With Spinal Cord Injury: Protocol for Development and Pilot Evaluation

Abstract

Background Leisure-time physical activity (LTPA) is a critical component of a healthy lifestyle for individuals with spinal cord injury (SCI). However, most individuals are not sufficiently active to accrue health benefits. The Active Living Lifestyles program for individuals with SCI who use manual wheelchairs (ALLWheel) targets important psychological factors that are associated with LTPA uptake and adherence while overcoming some barriers associated with participation restrictions. Objective The goal of the paper is to describe the protocol for the development and evaluation of the ALLWheel program for individuals with SCI who use manual wheelchairs. Methods The first three stages of the Medical Research Council framework for developing and evaluating complex interventions (ie, preclinical, modeling, exploratory) are described. The preclinical phase will consist of scoping and systematic reviews and review of theory. The intervention will be modeled by expert opinions and consensus through focus groups and Delphi surveys with individuals with SCI, clinicians, and community partners. Finally, the feasibility and potential influence of the ALLWheel program on LTPA and psychological outcomes will be evaluated. Results This project is funded by the Craig H Neilsen Foundation, the Fonds de Recherche du Québec–Santé, and the Canadian Disability Participation Project and is currently underway. Conclusions Using peer trainers and mobile phone technology may help to cultivate autonomy-supportive environments that also enhance self-efficacy. Following a framework for developing and evaluating a novel intervention that includes input from stakeholders at all stages will ensure the final product (ie, a replicable intervention) is desirable to knowledge users and ready for evaluation in a randomized controlled trial. If effective, the ALLWheel program has the potential to reach a large number of individuals with SCI to promote LTPA uptake and adherence. International Registered Report Identifier (IRRID) DERR1-10.2196/10798

Feasibility of a Peer-Led Leisure Time Physical Activity Program for Manual Wheelchair Users Delivered Using a Smartphone

“…The exploratory phase of the Medical Research Council Framework [27] was conducted in three Canadian cities (Quebec, Montreal, and Vancouver) using a single-arm pre-post design previously described by Best et al [22]. The study was approved by local research ethics boards at each site.…”

“…To further address the LTPA needs of people who use wheelchairs, Best et al developed a peer-led program called active living lifestyles for wheelchairs users (ALL-Wheel) [22]. The ALLWheel program engages peers as LTPA coaches and uses smartphones to provide LTPA counseling for people with disabilities who use wheelchairs.…”

“…Using a smartphone may help to overcome some accessibility and transportation barriers associated with LTPA [24]. Moreover, peers can provide a credible source of information to enhance motivation for LTPA through action and coping planning, and goal progression and monitoring in an empathetic way (i.e., through shared life experiences) [22]. The ALLWheel program focusses predominately on mild-intensity LTPA, which can have significant health benefits for people with disabilities and may be less daunting than starting a heavy-intensity exercise regime [20,25].…”

“…The ALLWheel program focusses predominately on mild-intensity LTPA, which can have significant health benefits for people with disabilities and may be less daunting than starting a heavy-intensity exercise regime [20,25]. Further details on the phases of development of the ALLWheel program have been published [22].…”

Evaluation of a Physical-Psychological Integrative (PPI) intervention for community-dwelling spinal cord injury survivors: Study protocol of a preliminary randomized controlled trial

“…One reason for the lack of trials might be due to barriers of transportation and lack of face-to-face interaction with healthcare professionals [ 22 ]. Two pilot trials that integrated community-based physical activities and telephone counseling from physiotherapists indicated positive effects of an activity-based intervention on functional improvement and physical fitness for community dwellers with SCI [ 23 , 24 ]. In addition, previous research also indicated positive effects of physical activities on SCI survivors’ mood (e.g., depression) and subjective well-being [ 12 ].…”