Susan Robinson-Whelen1, Rosemary B Hughes2, Heather B Taylor3, Rachel Markley4, José C Vega4, Thomas M Nosek5, Margaret A Nosek6. 1. Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA; Center for Research on Women with Disabilities, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA. Electronic address: susanrw@bcm.edu. 2. The Rural Institute for Inclusive Communities, University of Montana, Missoula, MT, USA; Department of Psychology, University of Montana, Missoula, MT, USA. 3. Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA; McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), USA. 4. Spinal Cord Injury and Disability Research Center, TIRR Memorial Hermann, Houston, TX, USA. 5. Department of Physiology and Biophysics, Case Western Reserve University, School of Medicine, Cleveland, OH, USA. 6. Center for Research on Women with Disabilities, H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
Abstract
BACKGROUND: There are no known interventions addressing self-esteem in women following spinal cord injury (SCI). OBJECTIVES: To test the feasibility of an online self-esteem intervention for women with disabilities, as modified for women with SCI. METHOD: We conducted a randomized, controlled feasibility test of a self-esteem intervention (N = 21). Participants were randomly assigned to the intervention or control group that received intervention materials at the end of the study. Intervention participants met as avatars for 7 weekly real-time group sessions in Second Life (SL), a free online virtual world. Feasibility indicators were study engagement, acceptability of SL and the intervention, and improvements on measures of psychological health promoting behaviors, social support, self-efficacy, self-esteem, and depression. RESULTS: Intervention participants (n = 10) were highly engaged, and most described the SL program as more enjoyable and more convenient than in-person programs. All rated the intervention as "good" (n = 4) or "very good" (n = 6), and all 10 rated themselves has having made positive life changes as a result of the program. Intervention participants experienced significantly greater change than controls on two measures of health-promoting behavior (Health Promoting Lifestyle Profile-II Spiritual Growth/Self-actualization; Interpersonal Relations). Examining change in the intervention group using regression analyses, we found medium-to-large effects of the intervention on these behaviors and measures of depression (CESD-10, PHQ-9). The intervention had small effects on remaining measures. CONCLUSION: We found preliminary support for the feasibility of this modified self-esteem intervention offered in SL. Such programming may help circumvent barriers to community-based psychological services and may improve psychological health.
RCT Entities:
BACKGROUND: There are no known interventions addressing self-esteem in women following spinal cord injury (SCI). OBJECTIVES: To test the feasibility of an online self-esteem intervention for women with disabilities, as modified for women with SCI. METHOD: We conducted a randomized, controlled feasibility test of a self-esteem intervention (N = 21). Participants were randomly assigned to the intervention or control group that received intervention materials at the end of the study. Intervention participants met as avatars for 7 weekly real-time group sessions in Second Life (SL), a free online virtual world. Feasibility indicators were study engagement, acceptability of SL and the intervention, and improvements on measures of psychological health promoting behaviors, social support, self-efficacy, self-esteem, and depression. RESULTS: Intervention participants (n = 10) were highly engaged, and most described the SL program as more enjoyable and more convenient than in-person programs. All rated the intervention as "good" (n = 4) or "very good" (n = 6), and all 10 rated themselves has having made positive life changes as a result of the program. Intervention participants experienced significantly greater change than controls on two measures of health-promoting behavior (Health Promoting Lifestyle Profile-II Spiritual Growth/Self-actualization; Interpersonal Relations). Examining change in the intervention group using regression analyses, we found medium-to-large effects of the intervention on these behaviors and measures of depression (CESD-10, PHQ-9). The intervention had small effects on remaining measures. CONCLUSION: We found preliminary support for the feasibility of this modified self-esteem intervention offered in SL. Such programming may help circumvent barriers to community-based psychological services and may improve psychological health.