Results of a Community-Based Peer Mentor Program for Spinal-Cord Injury: A Pilot Trial

Abstract

Date Presented 04/04/19

The purpose of the study was to develop and evaluate the feasibility of a community-based peer mentor program to prevent and manage pressure ulcers and identify untreated depression for 20 individuals with spinal-cord injury. Based on this sample, community-based peer mentoring was feasible with positive outcomes for PU prevention; management of PUs and depression; self-management of chronic conditions; and community reintegration.

Primary Author and Speaker: Valerie Hill

Additional Authors and Speakers: Shawn Phipps

Contributing Authors: Christina Wolfe, David Ponce

Individuals with SCI are at high risk of developing pressure ulcers (PUs) and depression causing further health issues leading to decreased quality of life and increased health care costs. Occupational therapists are well suited to develop and manage such programs.

The purpose of the study was to evaluate a community-based peer mentor program to prevent and manage pressure ulcers (PU) and manage untreated depression for individuals with spinal cord injury (SCI).

DESIGN: Feasibility study. Participants were recruited from SCI clinics and support groups from a rehabilitation hospital. Inclusion criteria: 18 years or older; has a SCI; at high risk of developing a PU and/or depression.

METHODS: Outcomes: PU risk, depression, life satisfaction, community reintegration, home and community environment, PU and depression knowledge, self-management (readiness and confidence to change and self-efficacy), program adherence, and program cost.

Frequencies and percentages were used to report the number of PUs present in the study, instances of untreated depression, and number of sessions scheduled/attended. The averages and percentages were calculated for each of the outcome measures. T-tests were used to determine significant findings for each of the pre-post outcome measure scores.

INTERVENTION: Six-month tailored, manualized, peer mentoring program supervised by an occupational therapist. Intervention focus was on PU prevention/management and untreated depression for patients with SCI, and was provided in the homes and community of patients by peers with SCI.

RESULTS: Twenty individuals were enrolled in the study. Eleven PUs were present during the study; ten healed by the study end. All PUs were prevented from progressing into a stage that required surgery. There was a significant difference from pre- to post- testing in PU knowledge and a decrease in PU risk.

Fifty-five percent of the participants were positively screened for depression and referred to psychological services. Seventy three percent of the participants who had depression had a statistically significant decline in their depressive symptomology. There was an increase in average depression knowledge.

There was an increase in average self-management, independence, and community re-integration. One hundred percent of the participants were referred to medical, health, and community services. When compared with a matched patient control group, the intervention group had lesser inpatient hospital services and overall cost, and greater outpatient services and costs, than the control group; resulting in a cost savings of $500,000 for the intervention group.

CONCLUSION: All outcomes exhibited a positive trend in favor of PU prevention; management of PUs and depression; self-management; and community reintegration. Peer mentoring provided opportunities to patients that they otherwise wouldn’t have been achievable. Cost of the peer mentoring program as compared to traditional services was significantly lower and provided a large cost saving for a small sample.

IMPACT STATEMENT: This proposal is important to practice and policy because based on the cost-savings and positive outcomes this type of program could help minimize the cost of burdensome health issues for healthcare systems and improve the health and quality of life of individuals with spinal cord injury.

References

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