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  4. Barriers and Facilitators to Lifestyle Intervention Engagement and Weight Loss in People Living With Spinal Cord Injury

Barriers and Facilitators to Lifestyle Intervention Engagement and Weight Loss in People Living With Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2021 · DOI: 10.46292/sci20-00025 · Published: January 1, 2021

Spinal Cord InjuryNutrition & Dietetics

Simple Explanation

People with spinal cord injuries often struggle with obesity and related health problems. This study looked at what helps or hinders people with SCI from participating in and losing weight through a lifestyle program. The results showed that motivation, relationships, and confidence in healthy eating play a big role in their success.

Study Duration
12 Months
Participants
31 SCI participants
Evidence Level
RCT secondary analysis

Key Findings

  • 1
    Higher nutrition self-efficacy at the start of the program predicted better engagement.
  • 2
    Relationship issues during the program were linked to lower engagement.
  • 3
    Lack of motivation was a major barrier to weight loss.

Research Summary

This study examined the barriers and facilitators to engagement and weight loss among SCI participants enrolled in the Group Lifestyle Balance Adapted for individuals with Impaired Mobility (GLB-AIM), a 12-month intensive lifestyle intervention. Participants were middle-aged (mean age, 48.26 ± 11.01 years), equally male (50%) and female, White (80.7%), and unemployed (65.6%). Improving engagement and weight loss for persons with SCI in the GLB-AIM program may be achieved by addressing lack of motivation, relationship issues, and nutrition self-efficacy.

Practical Implications

Enhance early support for dietary change

Provide supplemented meals, meal plans, facilitated cooking, or a stepped approach to self-monitoring for participants with low initial self-efficacy.

Address relational challenges

Further attention to relationship issues, such as reducing burnout in caregivers and facilitating access to counseling, may be appropriate for SCI participants.

Monitor and enhance motivation

Monitoring participants’ motivation toward program goals throughout the 12-month intervention may provide additional insight into motivation change over time and facilitate timely, tailored implementation of strategies to enhance motivation.

Study Limitations

  • 1
    Small sample size
  • 2
    Generalizability issues
  • 3
    Reliance on self-reported data

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