Injuries, Spinal Cord Clinical Trial
Official title:
A Patient Centered Approach to Successful Community Transition After Catastrophic Injury: Clinical Trial to Evaluate One-to-one Peer Mentoring
The research will examine the effects of enhanced peer mentor interactions on facilitating a successful transition to community living following traumatic spinal cord injury (SCI). Participants in the research will be assigned to either (1) the control group that will receive traditional peer mentor types of interactions or (2) to the intervention group that will receive an enhanced peer mentor program called the One-on-One Initiative. Assignment to one of these two groups will occur randomly on admission to Shepherd Center; the only stratifying criteria is injury level - C6 and above vs. C7 and below.
The Peer Support Program was enhanced by the addition of Shepherd staff mentors and volunteer
mentors from the community. The Peer Support Supervisor recruited volunteer peer mentors who
are at least 10 months post injury, live within a 50 mile radius of Shepherd Center, and have
developed a successful reintegration into community living (employed, manage a family,
student, etc.). Volunteers completed Shepherd Center volunteer training and were paid a
stipend of $20 per patient interaction.
Each recruited volunteer mentor, along with Shepherd Center peer mentor employees,
participated in the Christopher and Dana Reeve Foundation peer support mentor training
program to help ensure quality interactions with Shepherd Center patients and
understand/practice patient confidentiality awareness. This Foundation provides training on a
national level by breaking up the country into eight regions - each with a regional
coordinator and training program schedule. The faculty and staff of the University of New
Mexico developed and maintain the training and certification program, including the mentor
management system. The certification program is a "hybrid" program - a series of on-line
modules followed by a one-day on-site session. On-line learning is great for conveying
information. It saves time and allows everyone to get that information at their own pace. The
one-day training session revisits topics covered in the on-line modules: effective peer
mentoring, ethics, communication and resources. It includes breakout groups and group
discussions. Benefits of partnering with the Foundation, including providing access to
certified peer mentors for patients who live outside the Atlanta area are outlined in the
attached document (ReevePeer Partnerships.pdf).
A special training session for Shepherd employees/volunteers involved:
1. Part 1: 3-hour on-line course (notification has been sent to potential mentors by CDRF)
2. Part 2: 6-hour face-to-face training meeting at Shepherd Center on March 10, 2014 These
training sessions typically are run on a regional basis, so having the program here at
Shepherd saved travel expenses and time for the volunteer participants. The PowerPoint
used for the March 10 session is attached.
Subjects in the control group received traditional peer support provided by Shepherd Center
currently:
1. Within 5-10 days of admission, the patient is introduced to the peer support team.
2. Patients are seen by peer mentors on a referral basis from therapists, nurses,
counselors, or physicians or on request from the patient or family.
3. Patients are made aware of monthly peer support meetings, women's groups and caregiver
support groups; participation in these groups is optional for patient and/or family.
4. Patients have access to the SCI Peer Support FaceBook page maintained by the Shepherd
Peer Mentors
Subjects in the intervention group (and his/her family) received the enhanced One-on-One
initiative:
1. Patient was assigned one primary certified peer mentor and 2-3 supplemental mentors to
meet individual patient/family needs (if needed). The Peer Support Supervisor matched
certified peer mentors with each patient based on characteristics such as age, date of
injury, level of injury, cause of injury, marital status, work status before and after
injury, interests, leisure activities, and adaptive equipment utilization. Secondary
mentors were used to supplement individual patient/family needs. For example, if
guidance is needed regarding airline travel, a peer mentor who has mastered airline
travel was consulted if the primary peer mentor did not have this experience.
2. Each patient/family evaluated the interaction with his/her peer mentors. PCORI
interviewers facilitated completion of this evaluation. Evaluations were reviewed within
one week post completion to modify support provided if indicated and ensure that
patient/family needs were met.
3. Patients participated in male and female discussion groups, community dinner, and
caregiver dinner sponsored by the peer team. Each meeting includes opportunities for
discussion in group settings.These meetings are included in the patients' schedules.
4. Peer mentors provide and organize social networking opportunities on FaceBook (Shepherd
SCI peers page), CDRF, SCILife, SPINALpedia, facingdisabilities.com,etc.
On the Shepherd SCI Peers Facebook page, the peer mentor supervisor posts questions posed by
patients or community members anonymously and feedback volunteered from any of the >2000
Facebook friends.This is especially helpful for sensitive topics that people may not want to
be associated with initiating the question.
Evaluation All study patients were interviewed during the 10th-15th day of their stay at
Shepherd Center and completed the Self Efficacy scale. Patients were contacted post via
telephone at 3, 30, 90 and 180 days post discharge. At each of these times, they were asked
healthcare utilization and Self Efficacy questions.
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