Well on Wheels: A Holistic Wellness Intervention for Individuals with Spinal Cord Injuries: Risk Profile, Longitudinal Outcomes, and Success
Silveira, Stephanie L.
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Individuals with spinal cord injuries (SCI) report significantly lower satisfaction with life (SWL) than the general population. One ultimate goal of rehabilitation is to increase SWL. The Well on Wheels intervention was a pilot intervention aimed at increasing SWL in individuals with SCI. Seventy-two participants were randomized to either a seven-month intervention group or a no treatment control group and followed longitudinally with measurements at baseline, 3 months, 7 months, 1 year, and 2 years. This study is a secondary data analysis of this intervention with three primary aims. First, a decision tree regression model examined the relationship between SWL at baseline and demographics and injury characteristics that were associated with high and low SWL. Those with low SWL were more likely to be less than 4.5 years post injury or between 4.5 and 17.5 years post injury and single/divorced. Those with high SWL were more likely to be married and less than 49 years old. Next, linear mixed model analyses were used to examine changes over time by SWL group in primary, secondary, and exploratory variables of interest. Significant improvements in SWL occurred in individuals with low baseline SWL. Individuals with high baseline SWL also showed significant increases in total cholesterol 2 years following intervention. There were no other significant interaction effects. Finally, successful individuals in the Well on Wheels intervention were identified. A decision tree regression analysis for demographic and injury characteristics associated with success in the intervention. Successful individuals were more likely to be married and not successful individuals were more likely to be single/divorced and less than 50 years old. These aims help researchers and clinicians: 1) identify individuals at risk for secondary conditions and poor psychological wellbeing associated with low SWL who may benefit from interventions, 2) help researchers understand how participants in this intervention fared longitudinally who differed in baseline SWL, and 3) guide future research and program development as some individuals did not benefit from this intervention and may need different interventions. Findings from this research further delve into the role of social support in adjustment following SCI.