Development of a peer-led phone intervention for goal-setting primary health care needs in chronic spinal cord injury

introduction:

People with SCI are without needed support to access services and resources for self-management of health or advocating for better care.

My Care My Call (MCMC), an innovative peer-led, community-based telephone intervention was developed and piloted Fall 2014.

Pilot participants were living in the community with traumatic SCI 1+ years post-injury.

methods:

MCMC applies the Peer Health Coach (PHC) model used in chronic conditions.  MCMC provides goal-setting support, education, and resources to empower consumers in actively addressing primary care needs, via phone over 6 months.  

MCMC’s consumer-centered development process followed the Transtheoretical Model and Social-Cognitive Theory.  PHCs were certified in Brief-Action Planning, an evidence-based goal-setting empowerment technique.

The pilot tested MCMC’s feasibility and acceptability for participants and PHCs. PHCs called 7 participants (2 with paraplegia: 1 complete, 1 incomplete; and 5 with tetraplegia: 3 complete, 2 incomplete) 6 times over 3 weeks. Participants completed a brief online survey after calls, and qualitative exit phone interviews. 

results:

Participants completed 81% of calls; for 80% of calls, PHCs were rated very good or excellent. Mostly positive feedback highlighted feeling supported, confidence-building toward goals, and resource connection.  PHCs identified important process changes: 1) how to appropriately address participants’ needs beyond the study’s primary care focus; 2) refocusing PHC training on role plays to master PHC tools, as the peer component superseded the need for relationship-building training (e.g. Motivational Interviewing); and 3) more scripting of the PHC Toolkit. 

conclusion:

Recognizing the pilot’s positive results and identified process changes, a randomized controlled trial of MCMC began January 2015 (N=84).