A Patient-centered Approach to Successful Community Transition After Catastrophic Injury

Not Applicable

• Conditions: Peer Group; Spinal Cord Injury
• Interventions: Other: Peer directed education; Other: Patient Engagement Portal

• Registration Number: NCT02746978
• Lead Sponsor: Shepherd Center, Atlanta GA

Brief Summary

Shepherd Center is bringing a more patient-centered focus to educational, peer-support, and technology resources offered to patients with spinal cord injury and their families and is evaluating these changes.

Approximately 740 patients have provided information about healthcare utilization following inpatient rehabilitation. This information will help Shepherd Center staff follow utilization trends and plan programs targeted at the high-use areas.

Detailed Description

Research efforts are transforming the educational, peer-support and technology resources offered to patients and their caregivers, and evaluating how these changes help improve outcomes, including building patients' sense of self-efficacy - the belief that they can effectively manage their own care. Goals of the three focus areas include:

A. Patient and Family Education Revamp patient education modules for bladder management, skin management, and medical complications management to follow the chronic disease self management approach that replaces didactic lectures with participant-focused problem solving discussions led by peers (persons with SCI). Multiple baseline implementation approaches will be evaluated in interrupted time series analyses.

B. Peer mentoring and peer-led self-management training The peer mentor randomized clinical trial is reported separately on clinicaltrials.gov and not repeated here.

C. Patient and family web portal Shepherd Center, along with our collaborators at Craig Hospital in Denver, Colorado, are developing an engagement portal to provide a mechanism for patients to manage all aspects of injury following rehabilitation discharge and share information with other providers and caregivers.The portal will become a standard part of rehabilitation care and discharge planning for all Shepherd Center patients - starting first with patients with spinal cord injuries and later expanding to others. Stakeholders will be actively involved in providing feedback about portal usability and content so that the product continues to meet their needs.

Study Timeline

• Study Start: 2013-08
• Study First Submitted: 2016-02-29
• Status Verified: 2016-04
• Study First Submitted QC: 2016-04-18
• Last Update Submitted: 2016-04-18
• Study First Posted: 2016-04-21
• Last Update Posted: 2016-04-21
• Primary Completion: 2016-12
• Study Completion: 2016-12

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 800

Inclusion Criteria

• patient receiving inpatient rehabilitation at Shepherd Center following spinal cord injury
• discharge to community setting

Exclusion Criteria

• discharge to non-community setting
• patient without spinal cord injury at Shepherd Center

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Peer directed education	Peer directed education	A revised education approach that focuses on problem solving discussions delivered by peers and grounded clinical information is compared to traditional approach of didactic clinician-driven education lectures
Patient Engagement Portal	Patient Engagement Portal	A patient-owned portal to manage injury information is maintained in real-time by patients and families and shared with other care providers after inpatient rehabilitation discharge.

Primary Outcome Measures

Name	Time	Method
Rehospitalization	30 days post rehabilitation discharge	patient report on telephone interview

Secondary Outcome Measures

Name	Time	Method
Rehospitalization	90 days post rehabilitation discharge	patient report on telephone interview