The co-development of theory-based behaviour change intervention to promote leisure time activity in family support providers of people with spinal cord injury

Family, partners, and friends often support people with spinal cord injury (SCI) to manage the physiological changes and secondary conditions related to the injury and address environmental and social barriers. While this support is associated with a multitude of benefits for people with SCI and those that provide support, research also suggests that family support providers experience higher rates poor mental health and burden than their non-support providing counterparts. Despite these findings, few interventions exist to support this population. This dissertation aimed to co-develop a behaviour change intervention for family support providers of people with SCI using an Integrated Knowledge Translation approach and the Behaviour Change Wheel (BCW). The four dissertation studies followed a systematic and stepwise approach in partnership with three Canadian provincial SCI community-based organizations. First, a scoping review guided by the BCW was conducted to develop a theoretical understanding of behaviours impacted by the SCI family support provider role. Second, a qualitative interview study was conducted guided by the Theoretical Domains Framework to identify outcomes, affected behaviours, and factors influencing behaviours. Third, findings from the first two studies were synthesized using the BCW to co-develop the standard of practice for an intervention to promote leisure time activity among family support providers of people with SCI. The standard of practice was co-developed in partnership with experts including the community-based organization partners. Finally, the acceptability and preliminary efficacy of the resulting intervention, which integrated Brief Action Planning and Brief Cognitive Reframing, was examined in a feasibility study using a single subject, pretest-posttest study design. The findings of this dissertation highlighted that many behaviours are impacted by the family support provider role, including leisure time activities. Leisure time activity is influenced by family support providers’ physical and social environment and motivational factors, including emotions, beliefs about outcomes, and intentions. A theory-based intervention that adopts a person-centred approach showed promise in addressing these barriers to leisure time activity. The co-development and examination of this behaviour change intervention addresses a critical gap in the literature and may support the development of urgently needed resources for family support providers of people with SCI.Health and Social Development, Faculty of (Okanagan)Health and Exercise Sciences, School of (Okanagan)Graduat