Abstract
Study design
Qualitative descriptive study using semi-structured interviews
Objective
The purpose of this study was to examine the barriers and facilitators of weight management in individuals with spinal cord injury (SCI) from the perspective of SCI health care providers.
Setting
Veterans Health Administration and Midwest Regional SCI Care Systems.
Methods
Health care providers (n = 25) who care for individuals with SCI completed semi-structured interviews. Thematic analysis methodology was used to identify emergent themes around barriers and facilitators to weight management in SCI.
Results
Sixteen subthemes emerged for barriers and seven subthemes emerged for facilitators for weight management in SCI. Barriers included individual-level factors (e.g., physical ability/mobility limitations, lack of interest, psychological obstacles, lack of knowledge, poor dietary strategies), socio-environmental factors (e.g., challenges with family support, lack of access to weight management resources, dependency on others, difficulties obtaining weight measurement), and organizational factors (e.g., lack of integration/inconsistent weight management support from healthcare systems, pushing calorie intake early post-injury). Facilitators included individual-level factors (e.g., motivation, education/knowledge, participation in exercise and physical activity) and socio-environmental factors (e.g., positive support network, access to/use of healthy dietary strategies, access to exercise facilities/adaptive equipment, participating in weight management with others).
Conclusions
Healthcare providers identified individual-level, socio-environmental, and organizational barriers and facilitators that influence weight management efforts in individuals with SCI. Future weight management resources and programs should consider addressing common barriers identified by healthcare providers, individuals with SCI, and their caregivers, and develop strategies to promote facilitators to enhance weight management in this population.
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Data availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request under institutional restrictions.
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Funding
This work was supported by the Department of Defense Office of the Congressionally Directed Medical Research Programs (CDMRP) Spinal Cord Injury Research Program (SCIRP) Qualitative Research Award (SC160051: Perspectives and Preferences for Weight Management After Spinal Cord Injury). 9/2017-9/2021; PI: LaVela. The views expressed in this manuscript are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.
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CAP assisted with the coding of the data, interpretation of the results, and drafted the manuscript. LB and KJ assisted with the data collection, coding of the data, interpretation of the results, and/or critical revision of the manuscript. SLL conceived the research idea and assisted with the acquisition of data, coding of the data, interpretation of results, and critical revision of the manuscript.
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Pellegrini, C.A., Burkhart, L., Jones, K. et al. Health provider identified barriers and facilitators to weight management for individuals with spinal cord injury. Spinal Cord 59, 1061–1071 (2021). https://doi.org/10.1038/s41393-021-00614-8
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DOI: https://doi.org/10.1038/s41393-021-00614-8
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