Investigating the peer Mentor-Mentee relationship: characterizing peer mentorship conversations between people with spinal cord injury.

PURPOSE: This study aimed to: (1) develop a coding manual to characterize topics discussed and conversation techniques used during peer mentorship conversations between people with spinal cord injury (SCI); (2) assess the reliability of the manual; and (3) apply the manual to characterize conversations. MATERIALS/METHODS: The study was conducted in partnership with three Canadian provincial SCI organizations. Twenty-five phone conversations between SCI peer mentors and mentees were audio-recorded and transcribed verbatim. Ten transcripts were inductively analyzed to develop a coding manual identifying topics and techniques used during the conversations. Inductive technique codes were combined and deductively linked to motivational interviewing and behaviour change techniques. Two coders independently applied the coding manual to all transcripts. Code frequencies were calculated. RESULTS: The coding manual included 14 topics and 31 techniques. The most frequently coded topics were personal information, recreational programs, and chronic health services for mentors and mentees. The most frequently coded techniques were giving personal information, social smoothers, and closed question for mentors; and giving personal information, social smoothers, and sharing perspective for mentees. CONCLUSION: This research provides insights into topics and techniques used during real-world peer mentorship conversations. Findings may be valuable for understanding and improving SCI peer mentorship programs.Implications for RehabilitationSCI peer mentorship conversations address a wide range of rehabilitation topics ranging from acute care to living in the community.Identification of the topics discussed, and techniques used in SCI peer mentorship conversations can help to inform formalized efforts to train and educate acute and community-based rehabilitation professionals.Identifying commonly discussed topics in SCI peer mentorship conversation may help to ensure that peer mentors are equipped with the necessary knowledge and resources, or the development of those resources be prioritized.Developing a method to characterize the topics discussed and techniques used during SCI peer mentorship conversations may aid in designing methods to evaluate how rehabilitation professionals provide support to people with SCI.

Improving practice through collaboration: Early experiences from the multi-site Spinal Cord Injury Implementation and Evaluation Quality Care Consortium.

CONTEXT: Dedicated implementation efforts are critical to bridging the gaps between current practices and best practices. A quality improvement collaborative (QIC), the Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC), was established to meet this need, bringing together a network of clinicians and administrators to systematically improve the quality and equity of tertiary spinal cord injury or disease (SCI/D) rehabilitation care in Ontario, Canada. METHODS: Clinicians and leaders from five tertiary SCI/D rehabilitation centers and two not-for-profit SCI/D advocacy groups comprised a network dedicated to supporting implementation of the SCI-High quality indicators in prioritized domains of SCI rehabilitation and related best practices by: (1) building capacity through implementation science education of frontline clinicians; (2) providing resources and support to empower frontline clinicians to lead quality improvement efforts within their institutions; (3) promoting wider learning through a network for sharing ideas, efforts, and experiences; and (4) collecting indicator data to facilitate provincial evaluation of goal attainment. RESULTS: Network members and sites collaborated to implement best practices within six priority domains; in 18 months, significant progress has been made in emotional wellbeing, sexual health, walking, and wheeled mobility despite disruptions due to the COVID-19 pandemic. These efforts encompass heterogeneous challenges and strategies, ranging from developing clinical skills programs, to streamlining processes, to manipulating physical space. CONCLUSION: A QIC targeting SCI/D rehabilitation demonstrates promise for advancing the implementation of best practices, building implementation science capacity across multiple sites, and for promoting collaboration amongst SCI/D rehabilitation centers and organizational partners.

Exploring meanings of successful aging among people with long-term spinal cord injury.

Purpose/Objective: The purpose of the present study was to develop an understanding of successful aging (SA) meanings and influences that is informed by the lived experiences of people aging with long-term spinal cord injury (SCI). Method: This study was conducted in partnership with three Canadian provincial SCI organizations using an integrated knowledge translation (IKT) approach. To ensure findings were meaningful and practical to the three SCI organizations, the study was grounded in pragmatic philosophical assumptions. Semistructured interviews were conducted with 22 people aging with long-term SCI (minimum 45 years of age; minimum 10-years postinjury). All interviews were audio-recorded, transcribed verbatim, and subjected to a reflexive thematic analysis. Results: SA was understood as an interconnected and multifaceted concept that prioritizes health, participation, and independence. Participants discussed how SA was influenced negatively by personal (aging-related complications, intrapersonal emotional distress) and environmental (lack of available resources, differing community priorities) barriers. Participants reported that SA was positively influenced when individuals acted as self-advocates, were prepared and aware of aging-related changes, and maintained strong relationships with others. Conclusions/Implications: This study presents an initial, SCI-specific understanding of meanings and influences on SA. Although there were similarities between our findings and previous SA models, pertinent differences were also identified. Findings highlight that supporting quality participation experiences for people aging with long-term SCI may be an important direction SCI organizations can take to support their membership. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Enhancing participation while aging with spinal cord injury: applying behaviour change frameworks to develop intervention recommendations.

STUDY DESIGN: Knowledge translation study. OBJECTIVES: Use the Theoretical Domains Framework (TDF) and Behaviour Change Wheel (BCW) to (1) identify barriers and facilitators to participation in daily activities and social roles among people aging with spinal cord injury (SCI); and, (2) systematically co-develop participation-focused intervention recommendations with SCI community organizations that can support people aging with SCI. SETTING: Canadian SCI community. METHODS: Semi-structured interviews were conducted with 22 people (minimum 45 years of age; minimum 10 years post injury). Participants were asked about their experiences with participating in daily activities and social roles while aging and preferences for what participation-focused interventions should entail. Transcripts were analyzed to address three stages of behaviour change intervention design: (1) identify barriers and facilitators; (2) identify intervention functions and policy categories; (3) identify implementation options. Findings were synthesized into intervention recommendations and assessed for feasibility. RESULTS: Participation in daily activities and social roles was heavily influenced by three TDF domains: environmental context and resources, skills, and social influences. Six intervention functions and all policy categories within the BCW were considered viable intervention options. Multiple messengers and modes of delivery were identified as important. The synthesized recommendations included educating SCI organization membership, partnering with other disability organizations, and advocating to the provincial government. CONCLUSIONS: Findings suggest that multiple intervention formats delivered through a variety of implementation options are needed to enhance participation in daily activities and social roles while aging with SCI. Future efforts should focus on translating the recommendations into real-world behaviour change interventions.

Investigating Characteristics of Quality Peer Mentors With Spinal Cord Injury.

OBJECTIVE: To identify characteristics (1) of high- and low-quality spinal cord injury (SCI) peer mentors; (2) that should be used to match SCI peer mentors and mentees. DESIGN: The study was conducted in partnership with three Canadian provincial SCI organizations using an integrated knowledge translation approach. The Delphi exercise was completed in three rounds. In Round 1, people with SCI completed a thought-listing exercise to identify characteristics of high- and low-quality peer mentors and for matching. In Rounds 2 and 3, people with SCI and community organization staff rated characteristics from the previous round on an 11-point scale. After the final round, the remaining characteristics were thematically analyzed. SETTING: Community-based peer mentorship programs in three Canadian provinces. PARTICIPANTS: People with SCI and SCI community organization staff (Round 1, n=45; Round 2, n=27; Round 3, n=25). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Consensus-based list of characteristics. RESULTS: Participants reached consensus on 215 characteristics of quality peer mentors and 11 characteristics for peer mentor-mentee matching (ICC=0.96). A consensus-based characterization of high- and low-quality peer mentorship was created and included six overarching themes: competencies, personality characteristics, emotional state, mentor outlook, reason for mentoring, and role model. CONCLUSION: A consensus-based characterization of quality peer mentorship was co-developed with input from over 50 members of the SCI community. Findings highlight that peers have both interpersonal and intrapersonal characteristics that contribute to quality mentorship. The findings highlighted the importance of matching mentors on lived experience and shared interests. Findings will inform future research and SCI peer mentorship programs.

Transformational mentoring: Leadership behaviors of spinal cord injury peer mentors.

OBJECTIVE: The purpose of this study was to investigate the leadership behaviors of spinal cord injury (SCI) peer mentors and examine whether behaviors of peer mentors align with the tenets of transformational leadership theory. METHOD: A total of 12 SCI peer mentors aged 28-75 (M = 49.4) who had between 3 and 56 years (M = 13.9) of mentoring experience were recruited for the study. Utilizing a qualitative methodology (informed by a social constructionist approach), each mentor engaged in a semistructured interview about their experiences as a peer mentor. Interviews were transcribed verbatim and subjected to a directed content analysis. RESULTS: SCI peer mentors reported using mentorship behaviors and engaging with mentees in a manner that closely aligns with the core components of transformational leadership theory: idealized influence, inspirational motivation, individualized consideration, and intellectual stimulation. A new subcomponent of inspirational motivation described as 'active promotion of achievement' was also identified and may be unique to the context of peer mentorship. CONCLUSIONS: SCI peer mentors inherently use behaviors associated with transformational leadership theory when interacting with mentees. The results from this study have the potential to inform SCI peer mentor training programs about specific leadership behaviors that mentors could be taught to use and could lead to more effective mentoring practices for people with SCI. (PsycINFO Database Record

Peer mentoring of adults with spinal cord injury: a transformational leadership perspective.

PURPOSE: Drawing from the tenets of transformational leadership theory, the purpose of this study was to examine the nature of effective peer mentoring of adults with a spinal cord injury (SCI) from the perspective of mentees. METHODS: The study utilised a qualitative methodology (informed by a social constructionist approach), involving 15 adult mentees with a SCI (mean age = 47.2; mean time since injury = 14.5 years), in which data were obtained via semi-structured interviews. RESULTS: The results revealed that effective mentoring, as used by mentors with SCIs, closely aligns with the core components of transformational leadership. Specifically, all four dimensions of transformational leadership (idealised influence, inspirational motivation, individualised consideration and intellectual stimulation) as displayed by mentors with a SCI were evident in their interactions with mentees. Participants who perceived their mentors to use transformational leadership behaviours reported increases in motivation, self-confidence, hope and overall well-being, relatedness with their mentor, greater comfort/acceptance of their situation, a redefined sense of their limitations, as well as greater engagement in various life pursuits. CONCLUSIONS: Displays of transformational leadership by peer mentors (i.e. transformational mentoring) were reported by mentees to be associated with a range of adaptive psychological and behavioural outcomes. The results have the potential to inform the development and dissemination of peer mentor-based interventions and initiatives. Implications for Rehabilitation Within the context of spinal cord injury (SCI) rehabilitation, positive peer mentorship is reflected in mentors' use of transformational leadership behaviours (idealised influence, inspirational motivation, individualised consideration and intellectual stimulation). When SCI peer mentors use transformational leadership behaviours, mentees report a redefined sense of their limitations, and increased self-confidence, hope, motivation, acceptance, participation and overall well-being. The results of this study have the potential to inform future longitudinal and experimental research concerning the (causal) effects of peer mentoring on mentee outcomes. In particular, research should examine the effects of peer-mentorship training, informed by the tenets of transformational leadership theory, in relation to the mentee outcomes assessed in this qualitative study.

Testing the feasibility of training peers with a spinal cord injury to learn and implement brief action planning to promote physical activity to people with spinal cord injury.

OBJECTIVE: The present study tested the feasibility of training peers with spinal cord injury (SCI) to learn brief action planning (BAP), an application of motivational interviewing principles, to promote physical activity to mentees with SCI. METHOD: Thirteen peers with SCI attended a half-day BAP workshop. Using a one-arm, pre-, post-test design, feasibility to learn BAP was assessed in terms of peers' (1) BAP and motivational interviewing spirit competence; (2) training satisfaction; and (3) motivations to use BAP as assessed by measures of the theory of planned behavior constructs. Measures were taken at baseline, immediately post-training, and 1 month follow up. RESULTS: Following the training, participants' BAP and motivational interviewing competence significantly increased (P's < 0.05, d's > 2.27). Training satisfaction was very positive with all means falling above the scale midpoint. Participants' perceived behavioral control to use BAP increased from baseline to post (P < 0.05, d = 0.91) but was not maintained at follow up (P > 0.05). CONCLUSION: Training peers with a SCI to learn to use BAP is feasible. PRACTICAL IMPLICATIONS: BAP is a tool that can be feasibly learned by peers to promote physical activity to their mentees.