Bethlyn Vergo Houlihan1, Miriam Brody2, Sarah Everhart-Skeels2, Diana Pernigotti3, Sam Burnett4, Judi Zazula2, Christa Green5, Stathis Hasiotis3, Timothy Belliveau5, Subramani Seetharama6, David Rosenblum3, Alan Jette2. 1. New England Regional Spinal Cord Injury Center Model Systems Network, Boston, MA; The Health and Disability Research Institute, Department of Health Policy and Management, Boston University School of Public Health, Boston, MA. Electronic address: bvergo@bu.edu. 2. New England Regional Spinal Cord Injury Center Model Systems Network, Boston, MA; The Health and Disability Research Institute, Department of Health Policy and Management, Boston University School of Public Health, Boston, MA. 3. New England Regional Spinal Cord Injury Center Model Systems Network, Boston, MA; Rehabilitation Services and Outpatient Services, Spinal Cord Injury Program, Gaylord Hospital, Wallingford, CT. 4. Centre for Collaboration, Motivation and Innovation, Hope, British Columbia, Canada. 5. New England Regional Spinal Cord Injury Center Model Systems Network, Boston, MA; Hospital for Special Care, New Britain, CT. 6. New England Regional Spinal Cord Injury Center Model Systems Network, Boston, MA; Hartford Hospital, Hartford, CT.
Abstract
OBJECTIVE: To evaluate the impact of "My CareMy Call" (MCMC), a peer-led, telephone-based health self-management intervention in adults with chronic spinal cord injury (SCI). DESIGN: Single-blinded randomized controlled trial. SETTING: General community. PARTICIPANTS: Convenience sample of adults with SCI (N=84; mean time post-SCI, 9.9y; mean age, 46y; 73.8% men; 44% with paraplegia; 58% white). INTERVENTIONS: Trained peer health coaches applied the person-centered health self-management intervention with 42 experimental subjects over 6 months on a tapered call schedule. The 42 control subjects receivedusual care. Both groups received the MCMC Resource Guide. MAIN OUTCOME MEASURES: Primary outcome-health self-management as measured by the Patient Activation Measure (PAM). Secondary outcomes-global ratings of service/resource use, health-related quality of life, and quality of primary care. RESULTS: Intervention participants averaged 12 calls over 6 months (averaging 21.8min each), with distinct variation. At 6 months, intervention participants reported a significantly greater change in PAM scores (6mo: estimate, 7.029; 95% confidence interval, .1018-13.956; P=.0468) compared with controls, with a trend toward significance at 4 months. At 6 months, intervention participants reported a significantly greater decrease in social/role activity limitations (estimate, -.443; P=.0389), greater life satisfaction (estimate, 1.0091; P=.0522), greater services/resources awareness (estimate, 1.678; P=.0253), greater overall service use (estimate, 1.069; P=.0240), and a greater number of services used (estimate, 1.542; P=.0077). Subgroups most impacted by MCMC on PAM change scores included the following: high social support, white persons, men, 1 to 6 years postinjury, and tetraplegic. CONCLUSIONS: This trial demonstrates that the MCMC peer-led, health self-management intervention achieved a positive impact on self-management to prevent secondary conditions in adults with SCI. These results warrant a larger, multisite trial of its efficacy and cost-effectiveness.
RCT Entities:
OBJECTIVE: To evaluate the impact of "My Care My Call" (MCMC), a peer-led, telephone-based health self-management intervention in adults with chronic spinal cord injury (SCI). DESIGN: Single-blinded randomized controlled trial. SETTING: General community. PARTICIPANTS: Convenience sample of adults with SCI (N=84; mean time post-SCI, 9.9y; mean age, 46y; 73.8% men; 44% with paraplegia; 58% white). INTERVENTIONS: Trained peer health coaches applied the person-centered health self-management intervention with 42 experimental subjects over 6 months on a tapered call schedule. The 42 control subjects received usual care. Both groups received the MCMC Resource Guide. MAIN OUTCOME MEASURES: Primary outcome-health self-management as measured by the Patient Activation Measure (PAM). Secondary outcomes-global ratings of service/resource use, health-related quality of life, and quality of primary care. RESULTS: Intervention participants averaged 12 calls over 6 months (averaging 21.8min each), with distinct variation. At 6 months, intervention participants reported a significantly greater change in PAM scores (6mo: estimate, 7.029; 95% confidence interval, .1018-13.956; P=.0468) compared with controls, with a trend toward significance at 4 months. At 6 months, intervention participants reported a significantly greater decrease in social/role activity limitations (estimate, -.443; P=.0389), greater life satisfaction (estimate, 1.0091; P=.0522), greater services/resources awareness (estimate, 1.678; P=.0253), greater overall service use (estimate, 1.069; P=.0240), and a greater number of services used (estimate, 1.542; P=.0077). Subgroups most impacted by MCMC on PAM change scores included the following: high social support, white persons, men, 1 to 6 years postinjury, and tetraplegic. CONCLUSIONS: This trial demonstrates that the MCMC peer-led, health self-management intervention achieved a positive impact on self-management to prevent secondary conditions in adults with SCI. These results warrant a larger, multisite trial of its efficacy and cost-effectiveness.
Authors: Sarah E P Munce; Sonya Allin; Dalton L Wolfe; Karen Anzai; Gary Linassi; Vanessa K Noonan; Susan B Jaglal Journal: J Spinal Cord Med Date: 2017-07-30 Impact factor: 1.985
Authors: S E Skeels; D Pernigotti; B V Houlihan; T Belliveau; M Brody; J Zazula; S Hasiotis; S Seetharama; D Rosenblum; A Jette Journal: Spinal Cord Date: 2017-10-10 Impact factor: 2.772
Authors: Stephanie L Silveira; Tracey A Ledoux; Craig A Johnston; Claire Kalpakjian; Daniel P O'Connor; Michael Cottingham; Ryan McGrath; Denise Tate Journal: J Spinal Cord Med Date: 2018-12-17 Impact factor: 1.985
Authors: Robert M Cronin; Tim Lucas Dorner; Amol Utrankar; Whitney Allen; Mark Rodeghier; Adetola A Kassim; Gretchen Purcell Jackson; Michael R DeBaun Journal: Pain Med Date: 2019-08-01 Impact factor: 3.750
Authors: Amanda McIntyre; Stephanie L Marrocco; Samantha A McRae; Lindsay Sleeth; Sander Hitzig; Susan Jaglal; Gary Linassi; Sarah Munce; Dalton L Wolfe Journal: Top Spinal Cord Inj Rehabil Date: 2020