Title: “The Effects of Knowledge Translation through Peers vs. Non-Peer Students on Exercise Self-Efficacy and Physical Activity Levels in People with Spinal Cord Injury”
Thesis Supervisor: Dr. Tania Lam (Kinesiology)
Committee members: Dr. Guy Faulkner (Kinesiology), Dr. Chris McBride (Executive Director of Spinal Cord Injury-BC)
Chair: Dr. Jean-Sebastien Blouin (Kinesiology)
Abstract: A spinal cord injury (SCI), results in a myriad of serious secondary health complications including cardiovascular disease, pressure ulcers and obesity due to immobility, and suicide due to the prevalence of depressive disorders. These health conditions and chronic illnesses could be reduced by improving fitness and mobility by participation in physical activity and exercise. However the SCI population has been found to have the lowest levels of physical activity (PA) when compared to the general population. The reasons for this has been attributed to the many extrinsic barriers that those living with an SCI face daily, including cost, transportation, lack of access to specialized knowledge, adapted equipment or facilities and support services. In May 2013, the Physical Activity Research Centre (PARC) at ICORD opened its doors in an effort to reduce the structural and extrinsic barriers preventing people living with SCI from accessing physical activity. 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, health service providers, and family members when discussing behavioural changes and self-efficacy as it relates to physical activity and health. Here, our goal was to investigate whether peers can also enable change in PA behavior and bring this knowledge to action.
Methods: In this pilot randomized controlled trial, ten individuals with a spinal cord injury were randomly assigned to meet with a peer or non-peer students (controls) to discuss the PA guidelines for SCI. After the initial intervention, we investigated the effectiveness of peers, compared to non-peer students, to translate the physical activity guidelines to an SCI participant. We then instructed participants to meet with their peer/non-peer student as desired for the remainder of the 3-month study. Exercise self-efficacy and overall physical activity levels were compared between baseline, week 1 and week 12. During an exit interview we explored the effect on intrinsic barriers to exercise in individuals with SCI along with their 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 guidelines.
Conclusion: Our findings suggest that non-peer students could be as effective as peers as it relates to overcoming intrinsic barriers and increasing overall physical activity within the SCI population.