Virtual Peer Health Coaching as an Effective Intervention for Increasing Physical Activity in Adolescents With Physical Disability

Spaulding Rehabilitation Hospital2 个研究点分布在 1 个国家目标入组 25 人开始时间: 2020年7月1日最近更新: 2022年10月25日

适应症

试验速览

阶段: 不适用
状态: 进行中（未招募）
发起方
入组人数: 25
试验地点: 2
主要终点: Feasibility: Attrition

研究概览研究设计入排标准结局指标研究者研究点记录与标识符相似试验

研究概览

简要总结

Participation in physical activity (PA) confers clear physical and psychosocial benefits. Yet, many adolescents with physical disabilities such as cerebral palsy and spina bifida do not engage in regular PA, putting them at increased risk for the detrimental impact of sedentary lifestyles such as high rates of obesity/overweight - adverse health trends that continue into adulthood. To address this PA gap, a feasibility pilot randomized controlled trial is proposed evaluating the utility of a peer health coach intervention to promote PA participation and to improve outcomes related to self-autonomy, self-efficacy, and quality of life in adolescents with physical disabilities. Peer health coaches will themselves be young adults with disabilities, trained in concepts of motivational interviewing and self-determination theory, enabling them to meet participants "where they are at" in their understanding of PA and readiness to change PA behaviors. This study will be novel given that: 1) for the first time, an adult peer health coaching model targeting PA will be adapted to the needs of adolescents with disabilities, 2) the study will employ text messaging and other social media platforms that are highly relevant to an adolescent population, and 3) the study will assess PA participation with use of ActiGraph activity trackers, designed to monitor both duration and intensity of PA in individuals with mobility impairment. The results of this study will be used to inform the design of a future, definitive RCT evaluating the efficacy of a peer health coaching intervention to create meaningful change in physical and psychosocial outcomes. By empowering adolescents with disabilities to take control of their own physical and psychosocial health, this work has the potential to impact the well-being and quality of life of participants for many years to come.

详细描述

Physical activity is an often overlooked, yet incredibly powerful, tool for empowering adolescents with disabilities to take control of their own physical and psychosocial health. At least 60 minutes of daily physical activity (PA) is recommended for children and adolescents ages 6-17, yet the vast majority of young people with disabilities do not meet these goals. As a result, children and adolescents with disabilities are more likely than their non-disabled peers to experience the detrimental impact of sedentary lifestyles such as high rates of obesity/overweight - adverse health trends that continue into adulthood. Additionally, given that children and adolescents with disabilities remain systematically excluded from community and school-based sports and PA opportunities - a mainstay of social development and confidence-building in able-bodied youth - those with disabilities are more likely to experience social isolation and thus threats to well-being and quality of life.

In this context, prior research has focused on the role of peer health coaching (PHC) to enhance health self-management in individuals with disabilities, demonstrating efficacy in reducing rates of secondary conditions and improving self-efficacy and life satisfaction. PHCs simultaneously act as advisor, supporter, and role model, providing the "hook" that stimulates behavior change. Although the PHC model has also been used to promote participation in PA, studies have focused on adults primarily with spinal cord injury. While it is well known that engagement in PA in adolescence is correlated with similar behaviors in adulthood, no prior trials have explored the efficacy of PHCs in stimulating PA behavior in adolescents with childhood-onset disability.

To explore effective solutions that stimulate PA participation to promote equity and quality of life in adolescents with disabilities, this pilot study will target adolescents with cerebral palsy (CP) and spina bifida (SB), the 2 most common types of childhood-onset physical disability, with the following specific aims:

Primary Objective:

To evaluate the feasibility of conducting an efficacy trial of the first virtual PHC intervention aimed to increase PA participation in adolescents with CP and SB. This will include assessing the acceptability of the intervention to our key stakeholders - adolescents with disabilities and their families.

研究设计

研究类型: Interventional
分配方式: Randomized
干预模型: Parallel
主要目的: Supportive Care
盲法: None

入排标准

年龄范围: 12 Years 至 17 Years（Child）
性别: All
接受健康志愿者: 是

入选标准

•Adolescents ages 12-17 years
•Primary residence in cities and towns within greater Boston
•Presence of CP or SB resulting in mobility limitation
•CP - Gross Motor Function Classification System (GMFCS) level II and III
•SB - myelomeningocele, lipomyelomeningocele, or tethered cord syndromes with motor impairment
•Fluent in conversational English
•Able to utilize a personal cell phone for verbal and text message communications
•Intentions of engaging in PA

排除标准

•Presence of significant cognitive impairment - IQ below 55 as measured by Wechsler Intelligence Score for Children (WISC) or Wechsler Adult Intelligence Scale (WAIS), or those below a 3rd grade reading level
•Use of power mobility as the primary form of mobility on a daily basis

结局指标

主要结局

Feasibility: Attrition

时间窗: Months 1-3 for participants; Months 1-15 of overall study

Measuring feasibility of participation by measuring ability to meet goal of having \>80% of individuals complete all outcome measures

Acceptability: Intervention Participants Qualitative Impact of Peer Health Coach Intervention

时间窗: Month 6 (3 months post-intervention) for intervention participants

Measuring acceptability of peer health coach intervention through qualitative analysis of data from semi-structured interview. Three months after completion of intervention, each intervention participant has a semi-structured interview with the research team, with questions about ongoing impact of peer health coaching intervention on removing physical activity barriers.

Feasibility: Stratification for diagnosis

时间窗: Months 1-12 for the overall study

Measuring balance of recruitment by goal of intervention/control groups being balanced for diagnosis

Feasibility: Stratification for age

时间窗: Months 1-12 for the overall study

Measuring balance of recruitment by goal of intervention/control groups being balanced for age

Feasibility: Stratification for sex

时间窗: Months 1-12 for the overall study

Measuring balance of recruitment by goal of intervention/control groups being balanced for sex (male versus female)

Feasibility: Peer Health Coach Engagement and Implementation of Intervention: Coaching Sessions