Journal Article

A pilot randomised controlled trial of the Spinal Cord Injury and You (SCI&U) online peer health coaching self-management program

Jaglal, Susan B., McBride, Christopher B., Guilcher, Sara J. T., Thorson, Teri, Craven, B. Catharine, Mortenson, W. Ben, Shepherd, John D., Linassi, A. Gary, Salbach, Nancy M., Moineddin, Rahim, Munce, Sarah, Allin, Sonya J., Tomasone, Jennifer R., Sweet, Shane N.

2026

Overview

Background The Spinal Cord Injury and You (SCI&U) intervention aims to improve self-management skills for persons living with SCI using a web-based, peer health-coaching model. This study assessed feasibility of a future definitive trial of SCI&U, specifically feasibility of recruitment and retention, program usability and quality, effect size estimates for self-management outcomes and rehospitalisation rates (i.e. health-related quality of life). Methods A two-group, randomised, controlled, pilot trial with prospective recruitment, concealed group allocation, blinded outcome evaluation and waitlist control was conducted. We aimed to recruit 60 adult participants living in the community at least 6 months post-injury who could speak and read English and had a family physician. The intervention included up to 14 1-h online client-coach videoconferencing sessions, goal setting, action planning and a sortable resource library. Data were collected at baseline, 2, 6 and 12 months post-randomisation. SCI&U was offered to waitlist participants at 12 months. Results Trial methodology and procedures were feasible. Recruitment and retention targets were achieved. Individuals were randomised to intervention ( n  = 31) and waitlist control ( n  = 34). Mean time since SCI was 25.6 years (intervention) and 20.2 years (control). Timeline for completion of online sessions was extended from 2 months to 6 months. Outcome data were gathered for 86% (6 months) and 89% (12 months) of participants. Program usability and quality were highly rated on the Mobile App Rating Scale. Difference in Skill and Technique Acquisition subscale between intervention and control was 0.56 (95%CI -0.41, 1.52) at 6 months and 0.72 (95%CI -0.28, 1.72) at 12 months. Other Health Education Impact Questionnaire subscales had large effect sizes: self-monitoring and insight 1.51 (95% CI 0.39, 2.69); emotional distress -1.40 (95%CI -3.04, 0.23). In 12 months post-recruitment, 5 intervention and 4 control participants spent median 11 (95% CI 3-19) and 24 (95% CI 5-95) nights in hospital, respectively. Conclusions Trial methodology and procedures were feasible. The SCI&U intervention was acceptable to participants and positively impacted an individual’s ability to self-manage. A definitive trial is warranted to build on these findings, particularly in those with recently acquired SCI. Future recruitment efforts will focus on inpatient rehabilitation hospitals to recruit individuals < 5 years post-injury. Trial registration ClinicalTrials.gov, NCT04474171, retrospectively registered 07/13/2020; https://clinicaltrials.gov/study/NCT04474171#study-record-dates .

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Biomedicine / Chronic illnesses / Coaching / Consumer organizations / Data collection / Education / Family medicine / Goal setting / Health Sciences / Internet-based intervention / Intervention / Length of stay / Medicine / Medicine & Public Health / Peer group / Pilot study / Primary care / Rehabilitation / Self-efficacy / Self-management / Skills / Social networks / Spinal cord injuries / Statistics for Life Sciences / Usability