Original Article

SCI peer health coach influence on self-management with peers: a qualitative analysis

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Revised:
Accepted:
Published online:

Abstract

Study design:

A process evaluation of a clinical trial.

Objectives:

To describe the roles fulfilled by peer health coaches (PHCs) with spinal cord injury (SCI) during a randomized controlled trial research study called ‘My Care My Call’, a novel telephone-based, peer-led self-management intervention for adults with chronic SCI 1+ years after injury.

Setting:

Connecticut and Greater Boston Area, MA, USA.

Methods:

Directed content analysis was used to qualitatively examine information from 504 tele-coaching calls, conducted with 42 participants with SCI, by two trained SCI PHCs. Self-management was the focus of each 6-month PHC–peer relationship. PHCs documented how and when they used the communication tools (CTs) and information delivery strategies (IDSs) they developed for the intervention. Interaction data were coded and analyzed to determine PHC roles in relation to CT and IDS utilization and application.

Results:

PHCs performed three principal roles: Role Model, Supporter, and Advisor. Role Model interactions included CTs and IDSs that allowed PHCs to share personal experiences of managing and living with an SCI, including sharing their opinions and advice when appropriate. As Supporters, PHCs used CTs and IDSs to build credible relationships based on dependability and reassuring encouragement. PHCs fulfilled the unique role of Advisor using CTs and IDSs to teach and strategize with peers about SCI self-management.

Conclusion:

The SCI PHC performs a powerful, flexible role in promoting SCI self-management among peers. Analysis of PHC roles can inform the design of peer-led interventions and highlights the importance for the provision of peer mentor training.

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Acknowledgements

Content was made possible with support from: The National Institute on Disability and Rehabilitation Research Grant nos. H133N110019 and H133N120002 and the National Institute on Disability, Independent Living and Rehabilitation Research Administration for Community Living Grant no. 90SI5013. We thank Pennie Huggins Cuevas, PhD, MD, for her ongoing interest in and support of this work; Damara Gutnick, MD, formerly of the Centre for Collaboration, Motivation and Innovation, for providing training and insight that helped guide the intervention at its inception; and Sam Burnett, MA, Co-director of the Centre for Collaboration, Motivation and Innovation, for ongoing support and open-mindedness.

Author information

Affiliations

  1. Spaulding New England Regional Spinal Cord Injury Center Model Systems Network, Boston, MA, USA

    • S E Skeels
    • , D Pernigotti
    • , B V Houlihan
    • , T Belliveau
    • , M Brody
    • , J Zazula
    • , S Hasiotis
    • , S Seetharama
    • , D Rosenblum
    •  & A Jette
  2. The Health and Disability Research Institute, Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, USA

    • S E Skeels
    • , B V Houlihan
    • , M Brody
    • , J Zazula
    •  & A Jette
  3. Rehabilitation Services and Outpatient Services, Spinal Cord Injury Program, Gaylord Hospital, Wallingford, CT, USA

    • D Pernigotti
    • , S Hasiotis
    •  & D Rosenblum
  4. Hospital for Special Care, New Britain, CT, USA

    • T Belliveau
  5. Hartford Hospital, Hartford, CT, USA

    • S Seetharama

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to D Pernigotti.