Article

Even though weight management is essential for the health of
individuals with spinal cord injuries and disorders (SCI/D), little is known
about current practices, barriers, and facilitators. OBJECTIVE: To describe
weight management delivery in the Veterans Affairs (VA) SCI/D System of Care,
including barriers and facilitators experienced by health care providers.
METHODS: Qualitative focus groups were conducted in person at 4 geographically
dispersed VA medical facilities delivering care to Veterans with SCI/D.
Thirty-two employees involved in weight management efforts participated.
Audio-recordings were transcribed and analyzed using qualitative content analysis
techniques. RESULTS: Participants at SCI centers reported that weight management
treatment was delivered through the center by a multidisciplinary team using
education (eg, written materials) and counseling/consults. Participants at SCI
spoke facilities generally depended on facility-level programs (eg, MOVE!) to
deliver treatment. Spoke facilities discussed barriers to delivering treatment
through their SCI team, including staff shortages and resource and structural
issues. MOVE! staff discussed barriers, including limited wheelchair space in
classrooms. Staff participants across facilities noted that Veterans with SCI/D
were hesitant to use facility-level programs, because of nonspecific SCI-relevant
information and discomfort attending sessions with general Veterans. Other
barriers, for both centers and spoke facilities, included necessary medications
that increase weight, lack of evidence-based guidelines for weight management,
safety concerns, and facility layout/accessibility. Facilitators included
facility leadership support, provider involvement/prioritization, and community
resources. CONCLUSIONS: Weight management programs delivered through the SCI
team, with peers and SCI-relevant content, are likely more acceptable and
beneficial to individuals with SCI/D. Program classrooms should provide ample
space for individuals with SCI/D.

Langue : ANGLAIS