UBC Theses and Dissertations

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UBC Theses and Dissertations

Developing recommendations for interventions that support individuals aging with spinal cord injury Giroux, Emily


Introduction: Although the life expectancy of people living with spinal cord injury (SCI) is increasing, efforts to understand successful aging (SA) continue to exclude those with long-term physical disabilities. Participation may be an ideal target behaviour for interventions, as evidence suggests participation is related to health, well-being, and life satisfaction. Theory provides a systematic approach to intervention development that may improve effectiveness and replicability. Additionally, use of integrated knowledge translation (IKT) may improve likelihood that findings will be relevant and useful to target populations. Objective: The purpose of this thesis was to work in partnership with SCI organizations to co-develop theory-based recommendations for interventions designed to enhance participation while aging with SCI. Accordingly, this thesis used an IKT approach to explore meanings of SA, identify barriers and facilitators to participation, and understand effective ways to deliver interventions. Methods: Semi-structured interviews were conducted with 22 people aging with SCI and transcribed verbatim. Abductive analyses addressed all three stages of intervention development. To understand the behaviour, inductive thematic analysis and deductive coding of barriers and facilitators using the Theoretical Domains Framework (TDF) was used. To identify intervention options, a behavioural analysis was conducted using the Behaviour Change Wheel (BCW). To identify content and implementation options, intervention messengers were extracted and deductive coding of modes of delivery was conducted using the mode of delivery taxonomy (MoDtv0). All findings were synthesized in partnership into intervention recommendations, and feasibility of implementation was assessed using the APEASE criteria. Results: Three themes were developed to understand meanings of SA with respect to definitions, barriers, and facilitators. Environmental context and resources, skills, and social influences were identified as relevant TDF domains to barriers and facilitators of participation. Six intervention functions and all policy categories were considered relevant to intervention design and implementation. Multiple messengers and modes of delivery were considered important for effectively delivering interventions. Through synthesis of all findings, four recommendations were co-developed and met APEASE criteria. Conclusions: These findings suggest that a variety of interventions will be needed to support people aging with SCI. Future efforts are needed to implement the recommendations to develop real-world interventions.

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