Using behavioural science to develop recommendations for interventions that enhance social participation in people aging with long-term spinal cord injury


Background: Social participation is a promising target behaviour to support people aging with long-term spinal cord injury (SCI). Evidence suggests social participation relates to health, well-being, and life satisfaction. Behaviour change theory strengthens intervention development by providing a systematic and evidence-based approach. Additionally, use of an integrated knowledge translation (IKT) approach aims to improve the relevance and usefulness of interventions. Objective: Use an IKT approach to co-develop theory-based recommendations for interventions designed to enhance social participation while aging with SCI. To inform the recommendations, this study aims to identify a) barriers and facilitators to social participation, and b) intervention options. Methods: Semi-structured interviews were conducted with 22 people aging with SCI (Mean Age: 55.64, Mean Years Post-Injury: 32.27). To understand social participation, barriers and facilitators were deductively coded using the Theoretical Domains Framework. Behaviour change wheel analyses were used to identify intervention functions and policy categories. Methods of intervention delivery were extracted and coded using the mode of delivery taxonomy. All findings were synthesized into intervention recommendations, and assessed for feasibility using APEASE criteria. Results: Environmental context and resources, skills, and social influences were identified as the most influential barriers and facilitators. Six intervention functions and all policy categories were considered relevant to intervention design. Multiple methods of delivery (e.g. online, face-to-face) were identified as important. Four recommendations were co-developed and met APEASE criteria. Conclusions: Various interventions (e.g. individual, policy) delivered through multiple modes of delivery are needed. Continued efforts will allow for recommendations to be developed into real-world interventions.

Acknowledgments: First, we would like to acknowledge all participants in this study for their time and dedication. We would like to acknowledge Brianna Tsui, Randy Butler, and Isabelle Grant for their help with transcription. Finally, we would like to acknowledge the Michael Smith Foundation for Health Research for funding this study.