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The effects of knowledge translation through peer versus student trainers on exercise self-efficacy and physical activity levels in people with spinal cord injury Brousseau, Jennifer Megan

Abstract

Background: A spinal cord injury (SCI), results in a myriad of serious secondary health complications including cardiovascular disease, obesity, and pressure sores due to immobility. These health conditions could be reduced by improving fitness and mobility by participation in physical activity (PA) and exercise. However the SCI population has been found to have the lowest levels of PA when compared to the general population. The reasons for this have been attributed to the many extrinsic barriers that those living with an SCI face daily, including cost, transportation, and lack of adapted equipment or facilities. In May 2013, the Physical Activity Research Centre (PARC) at ICORD opened its doors in an effort to reduce the extrinsic barriers, however, this did not address the many intrinsic barriers to exercise participation, including lack of motivation, time, and knowledge about where or how to exercise. Previous studies have indicated that the preferred messenger for the delivery of PA knowledge includes peers, and health service providers. Here, our goal was to investigate whether peers can change PA behavior and bring this knowledge to action. Methods: In this pilot randomized controlled trial, ten individuals with a SCI were randomly assigned to meet with a peer or student trainer (control) to discuss the PA guidelines for SCI. After the initial intervention, we investigated the effectiveness of peer trainers, compared to student trainers, to translate the PA guidelines to a SCI participant. We then instructed participants to meet with their peer/student trainer as desired for the remainder of the 3-month study. Exercise self-efficacy and overall PA levels were compared between baseline, week 1 and week 12. During an exit interview we explored the effect on intrinsic barriers to exercise along with participant satisfaction with the study. Results: Overall no statistically significant findings were detected between groups, however nearly all participants scored well on knowledge acquisition and are now meeting the recommended PA guidelines. Conclusion: Our findings suggest that student trainers could be as effective as peer trainers as it relates to overcoming intrinsic barriers and increasing overall PA within the SCI population.

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