Exploring Peer Health Coach Roles in the Online Health Management Program for Adults With Spinal Cord Injury

There are 296,000 people in the United States living with Spinal Cord Injury (SCI) and approximately 30% of them require re-hospitalization within a year after discharge (NSCISC, 2021). Individuals with SCI are at higher risk of developing secondary health issues, many of which can be prevented or managed by health management knowledge and strategies (Houlihan et al., 2017). Having a Peer Health Coach (PHC) plays a powerful role in promoting health-management among peers (Skeels et al., 2017). SCI-PHCs are experienced SCI peer mentors who are trained to coach and support their peers to adjust life changes and manage health challenges (Skeels et al., 2017). Peer Health Coaches receive over 6 months of evidence-based training & certificate focusing on various communication tools (e.g., reflective listening) and information delivery strategies (e.g., action planning) to support health self-management and knowledge. An online health management program (SCI&U), which utilizes the SCI-PHC model, has shown potential in improving self-efficacy and ability to address secondary SCI complications (Allin et al., 2020). While further research is still needed, the SCI-PHC model appears to be a powerful client-centered method to support health self-management, well-being, and enhanced quality of life (QOL) among participants. The purpose for this project is to explore PHC roles in relation to traditional roles of peer & peer mentor and evaluate the PHC training process of the online peer-coach health-management program (SCI&U). The investigator observed 24 PHC team meetings to build relationship with the team and inform the training evaluation as well as the PHC roles. Current literature related to PHC and peer mentor positions was reviewed to develop an overall understanding & to inform PHC roles. Focus group discussion as well as individual interviews were held with PHC, PHC trainers, and participants to gather information for PHC roles/impacts and training experience. Results indicates that PHC fulfills four major roles including SCI-Peer, Supporter, Advocate, and Coach. All peer mentors are peers and all peer health coaches are peer mentors and peers. PHC switches between roles naturally to meet the specific needs of peers. Training is the ‘gear stick’ that allows a PHC to recognize and shift into different modes as needed. The PHC model highlights peer-interaction and puts a focus on health management; two important areas of occupational therapy. Occupational therapy practitioners have a unique role in advocating for the PHC model and supporting PHC training, which can be beneficial to individuals’ mental and physical health, self-efficacy, as well as QOL.

References

Allin, S., Shepherd, J., Thorson, T., Tomasone, J., Munce, S., Linassi, G., McBride, C. B., Jiancaro, T., & Jaglal, S. (2020). Web-based health coaching for spinal cord injury: Results from a mixed methods feasibility evaluation. JMIR Rehabilitation and Assistive Technologies, 7(2), e16351. https://doi.org/10.2196/16351

Houlihan, B. V., Brody, M., Skeels, S. E., Pernigotti, D., Burnett, S., Zazula, J., Green, C., Hasiotis, S., Belliveau, T., Seetharama, S., Rosenblum, D., & Jette, A. (2017). Randomized trial of a peer-Led, telephone-based empowerment intervention for persons with chronic spinal cord injury improves health self-management. Archives of Physical Medicine and Rehabilitation, 98(6), 1067–1076.e1. https://doi.org/10.1016/j.apmr.2017.02.005

Skeels, S. E., Pernigotti, D., Houlihan, B. V., Belliveau, T., Brody, M., Zazula, J., Hasiotis, S., Seetharama, S., Rosenblum, D., & Jette, A. (2017). SCI peer health coach influence on self-management with peers: a qualitative analysis. Spinal Cord, 55(11), 1016–1022. https://doi.org/10.1038/sc.2017.104

Taylor, R. R. (2020). The intentional relationship: Occupational therapy and use of self. F.A. Davis Company.