Evaluation of a Smartphone-delivered Peer-led Physical Activity Counselling Program for Manual Wheelchair Users

Study Overview
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Brief Summary
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Despite physical activity (PA) being a valuable modality for promoting health, the evidence for effective PA intervention strategies for manual wheelchair (MWC) users is underdeveloped. Community-based programs and telephone-counselling interventions to increase PA among MWC users have had some success, but the uptake and adherence to these interventions remains low within this population. Community-based programs may not reach MWC users who live in rural areas and have issues with transportation, while health professionals may not optimally relate with MWC when providing telephone counselling. Although the PA needs of MWCs are not fully understood, there is reason to believe that including peers into intervention delivery may have benefits. A feasibility trial is critical and prudent prior to moving forwards with a large and expensive multi-site randomized controlled trial (RCT) to ensure that: the intervention meets the needs of the target population; the right outcomes are measured; and that the intervention is feasible to administer. The objective of this study is to evaluate the feasibility of a Smartphone-delivered Peer-led Physical Activity Counselling (SPPAC) program for MWC users.

Official Title
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Feasibility Evaluation of a Smartphone-delivered Peer-led Physical Activity Counselling Program for Improving Physical Activity in Manual Wheelchair Users

Conditions
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Physical Activity

Intervention / Treatment
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* Behavioral: SPPAC intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: live in the community have used a manual wheelchair for ≥ 1 year able to self-propel a manual wheelchair for at least 10m able to communicate in English or French have physical activity or mobility goals cognitively able to set goals (Mini-mental State Exam Score ≥ 25) Exclusion Criteria: anticipate a health condition or procedure that contraindicates training (e.g., surgery scheduled which would impair physical activity) have a degenerative condition that is expected to progress quickly (e.g., Amyotrophic Lateral Sclerosis are concurrently or planning to receive manual wheelchair mobility training over the period of the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SPPAC intervention<br>Smartphone-delivered peer-led physical activity counselling | Behavioral: SPPAC intervention<br>* A peer coach will deliver a physical activity counselling intervention using a Smartphone. Individualized programs will be based on participants physical activity/wheelchair mobility goals.<br>|
| No Intervention: Control group<br>Pragmatic no-contact control group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Objective physical activity | Physical activity will be measured objectively using Actigraphy, a small, lightweight accelerometry-based tri-axial activity monitor (Actigraph 3GTX) that is worn on the wrist and MWC without impeding bodily movements or PA. Information about motion direction and speed are integrated to produce an electrical current with variable magnitude and duration. The electrical current data are stored in the monitor as 'activity counts.' | Change in physical activity from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Subjective physical activity (Leisure-Time Physical Activity Questionnaire (LTPA)) | Self-reported frequency (number of bouts) and duration (min per bout) of light, moderate and heavy intensity PA over the past 7 days. | Change in LTPA from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Wheelchair skills capacity and performance (Wheelchair Skills Test- Questionnaire (WST-Q)) | Subjective evaluation of the skills capacity and performance of 32 manual wheelchair skills. | Change in WST from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Physical activity motivation (Behavioural Regulation in Exercise Questionnaire (BREQ-2)) | Subjective evaluation of motivation for physical activity is measured using 5 subscales of regulation: external, introjected identified, intrinsic and amotivation. | Change in BREQ-2 from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Perceived autonomy support (Health Care Climate Questionnaire (HCCQ)) | Subjective evaluation of perceived autonomy support | Change in HCCQ from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Satisfaction of psychological needs (Psychological Need Satisfaction in Exercise Scale (PNSES)) | Subjective evaluation of satisfaction of psychological needs (i.e. autonomy, competence, relatedness) for physical activity will be measured only in the intervention group. | Change in PNSES from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Self-efficacy to overcome barriers to leisure-time physical activity (Leisure-time Physical Activity Barrier Self-efficacy Scale) | Subjective evaluation of self-efficacy to overcome salient barriers to physical activity participation (e.g. when faced with transportation problems, bad weather, pain and fatigue). | Change in Self-efficacy to overcome barriers to leisure-time physical activity from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Wheelchair use self-efficacy (Wheelchair Use Confidence Scale Short Form (WheelCon-SF)) | Subjective evaluation of situations that challenge self-efficacy while using a manual wheelchair. | Change in WheelCon-SF from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Satisfaction with participation in physical activity using a wheelchair (Wheelchair Outcome Measure (WhOM)) | A semi-structured interview that allows participants to select important physical activity/wheelchair mobility participation goals. The importance and current level of satisfaction is evaluated. | Change in WhOM from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Measure of self-efficacy in performing functional activities of daily living in individuals with Spinal Cord Injury (Moorong Self Efficacy Scale - MSES) | Subjective evaluation of self-efficacy in carrying out activities of daily living. Minimum value 1 and maximum value 7. A higher score indicates a higher perceived self efficacy. | Change in MSES from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention | 
| Measure the degree to which individuals who have experienced traumatic or incapacitating illness achieve reintegration into normal social activities (Reintegration to Normal Living Index - RNLI) | Subjective evaluation of the reintegration to normal living activities | Change in RNLI from baseline to post-intervention (10 weeks post-baseline) and at follow-up (3 months post-intervention |