Exploring Loneliness in the Spinal Cord Injury & You Study Participants

Abstract

<h3>Research Objectives</h3> Loneliness is emerging as a fundamental risk factor for poorer health outcomes. Little is known about loneliness in the US spinal cord injury (SCI) population. The SCI&U intervention occurred entirely during the global COVID-19 pandemic, affording an opportunity to assess prevalence of loneliness among participants. SCI&U is a virtual health self-management program utilizing the Peer Health Coaching (PHC) model to support health, well-being, and enhanced quality of life for community-dwelling individuals living with SCI. <h3>Design</h3> PHCs are experienced peer mentors with SCI, trained to coach others with SCI. PHCs used smartphones and an online platform, combining videoconferencing with an SCI health resource library, specified talking points, and conversation flow charts. <h3>Setting</h3> Community dwellings. <h3>Participants</h3> 23 adults, 1-23 years post-traumatic SCI. <h3>Interventions</h3> PHCs completed up to 14 coaching calls during 30-45-minute-long scheduled sessions with participants, supporting them as they addressed issues related to their health. Participants completed assessments through the secure SCI&U platform. <h3>Main Outcome Measures</h3> Participants completed baseline assessments prior to the intervention, including the NIH Toolbox Loneliness Survey, which has high construct validity. <h3>Results</h3> 17 of the 23 participants scored 60+ points, suggesting a high-level of loneliness. 3 participants scored < 40, which suggests a low-level of loneliness, and the remaining 3 participants scored between 40 and 60 points, an average range of self-reported loneliness. <h3>Conclusions</h3> Limitations include the small sample size, the measure's lack of predictive and concurrent validity, and of clinically meaningful thresholds. High scores of the majority may warrant heightened surveillance or concern, particularly considering COVID. Virtual coaching by a PHC is a viable form of support to address health-related issues and factors that impact loneliness for people with SCI who may be isolated due to COVID, or other ongoing barriers. <h3>Author(s) Disclosures</h3> The authors do not have any conflicts to disclose.