Stephanie L Silveira1, Tracey A Ledoux2, Craig A Johnston2, Claire Kalpakjian3, Daniel P O'Connor2, Michael Cottingham2, Ryan McGrath4, Denise Tate3. 1. Department of Health and Human Performance, University of Houston, Houston, TX, USA; Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: ssilveira@uab.edu. 2. Department of Health and Human Performance, University of Houston, Houston, TX, USA. 3. Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA. 4. Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA.
Abstract
BACKGROUND: Individuals with spinal cord injuries (SCI) often struggle with lifestyle adjustment following injury. Effective wellness interventions may aid in improving quality of life; however, treatment response heterogeneity is a concern for behavioral interventions. OBJECTIVE: To identify differences among adults with SCI who were responders and non-responders in a wellness intervention. METHODS: There were 29 persons with SCI who received a wellness intervention. Participants engaged in six in-person workshops over a 3-month period, led by wellness experts with peer mentors available. Individual intervention participant change was compared to the mean among control group participants target outcomes variables (i.e., satisfaction with life, self-efficacy for health practices, secondary conditions, health promoting behaviors, and perceived stress) to classify responders versus non-responders. RESULTS: Of the 29 participants, 18 who completed the intervention were classified as responders and 11 were non-responders. The mean age was 43.2 ± 11.2 years, and years post-injury were 12.0 ± 9.8. Decision tree regression analysis for demographic variables and injury characteristics showed that single/divorced participants were more likely to not respond to the intervention (52%), compared to married participants (17%). Further, participants who were single/divorced and ≤50 years old were more likely to not respond to the intervention (62%) than those who were older (25%). CONCLUSIONS: Single/divorced individuals with SCI may respond differently to behavioral wellness interventions than married individuals. Additionally, the effects of age on treatment response in behavioral interventions should be further examined. Identifying non-modifiable factors related to response heterogeneity may help guide the creation of tailored interventions specific to patient characteristics.
BACKGROUND: Individuals with spinal cord injuries (SCI) often struggle with lifestyle adjustment following injury. Effective wellness interventions may aid in improving quality of life; however, treatment response heterogeneity is a concern for behavioral interventions. OBJECTIVE: To identify differences among adults with SCI who were responders and non-responders in a wellness intervention. METHODS: There were 29 persons with SCI who received a wellness intervention. Participants engaged in six in-person workshops over a 3-month period, led by wellness experts with peer mentors available. Individual intervention participant change was compared to the mean among control group participants target outcomes variables (i.e., satisfaction with life, self-efficacy for health practices, secondary conditions, health promoting behaviors, and perceived stress) to classify responders versus non-responders. RESULTS: Of the 29 participants, 18 who completed the intervention were classified as responders and 11 were non-responders. The mean age was 43.2 ± 11.2 years, and years post-injury were 12.0 ± 9.8. Decision tree regression analysis for demographic variables and injury characteristics showed that single/divorced participants were more likely to not respond to the intervention (52%), compared to married participants (17%). Further, participants who were single/divorced and ≤50 years old were more likely to not respond to the intervention (62%) than those who were older (25%). CONCLUSIONS: Single/divorced individuals with SCI may respond differently to behavioral wellness interventions than married individuals. Additionally, the effects of age on treatment response in behavioral interventions should be further examined. Identifying non-modifiable factors related to response heterogeneity may help guide the creation of tailored interventions specific to patient characteristics.
Authors: Rachel Müller; Kevin J Gertz; Ivan R Molton; Alexandra L Terrill; Charles H Bombardier; Dawn M Ehde; Mark P Jensen Journal: Clin J Pain Date: 2016-01 Impact factor: 3.442
Authors: Brad E Dicianno; John Lovelace; Pamela Peele; Christopher Fassinger; Patricia Houck; Alexandra Bursic; Michael L Boninger Journal: Arch Phys Med Rehabil Date: 2016-06-14 Impact factor: 3.966