Enhancing community re-integration following spinal cord injury.

This study assessed the efficacy of a community-based program designed to provide Independent Living services (ILS) to people with new, traumatic spinal cord injuries (SCI). The program was implemented in six communities throughout the US served by Model SCI Care Systems where services are provided by Centers for Independent Living. Participants consisted of eighty-one people with new, traumatic SCI (38% intervention participants and 62% comparison group members). Each group was assessed with regard to ILS received, unmet needs for services, satisfaction with services and three outcomes: perceived control, quality of life and societal participation. Results show that program participants and comparison group subjects differed little in terms of either measures of ILS or the outcome measures. There were numerous associations between ILS and outcomes; those who felt that they did not need ILS tended to have superior outcomes to both those who received these services and those who said that they had unmet needs. Advocacy services had the strongest association with study outcomes. The study highlights the importance of minimizing the need for ILS. It also indicates that there is a need for improved communication among rehabilitation professionals working in large medical institutions and those working in community organizations.