Open AccessBarriers and Facilitators to Lifestyle Intervention Engagement and Weight Loss in People Living With Spinal Cord Injury
Author(s) -
Andrea C. Betts,
Christa Ochoa,
Rita Hamilton,
Seema Sikka,
Katherine Froehlich-Grobe
Publication year - 2021
Publication title -
topics in spinal cord injury rehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 35
eISSN - 1945-5763
pISSN - 1082-0744
DOI - 10.46292/sci20-00025
Subject(s) - medicine , attendance , weight loss , spinal cord injury , randomized controlled trial , physical therapy , intervention (counseling) , gerontology , obesity , demography , spinal cord , nursing , psychiatry , sociology , economics , economic growth
Background: Individuals living with spinal cord injury (SCI) have a high prevalence of obesity and unique barriers to healthy lifestyle. Objective: To examine barriers and facilitators to engagement and weight loss among SCI participants enrolled in the Group Lifestyle Balance Adapted for individuals with Impaired Mobility (GLB-AIM), a 12-month intensive lifestyle intervention. Methods: SCI participants (N = 31) enrolled in a wait-list, randomized controlled trial where all participants received intervention between August 2015 and February 2017. Analyses of pooled data occurred in 2020 to examine cross-sectional and prospective associations of hypothesized barriers and facilitators with (1) intervention engagement, comprised of attendance and self-monitoring, and (2) percent weight change from baseline to 12 months. We performed multivariable linear regression on variables associated with outcomes at p < .05 in bivariate analyses and controlled for intervention group. Results: Participants were middle-aged (mean age, 48.26 ± 11.01 years), equally male (50%) and female, White (80.7%), and unemployed (65.6%). In participants who completed baseline surveys ( n = 30), dietary self-efficacy explained 26% of variance in engagement ( p < .01); among the 12-month study completers ( n = 22, 71.0%), relationship issues explained 23% of variance in engagement ( p < .01). Money problems, health issues unrelated to SCI, lack of motivation, and experimental group explained 57% of variance in weight loss ( p for model < .01), with lack of motivation uniquely explaining 24% of variance (p < .01). Conclusion: Improving engagement and weight loss for persons with SCI in the GLBAIM program may be achieved by addressing lack of motivation, relationship issues, and nutrition self-efficacy.