Get In Motion: An Evaluation of the Reach and Effectiveness of a Physical Activity Telephone Counseling Service for Canadians Living With Spinal Cord Injury

Background: Telephone-based counseling is an efficacious intervention strategy for maintaining leisure-time physical activity (LTPA) intentions and increasing LTPA behavior among adults with spinal cord injury (SCI). However, no research has examined the real-world application of this intervention strategy within the SCI community. Objective: To assess the individual-level impact of a previously tested telephone-based counseling intervention among adults within the SCI community by using the first 2 components of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Design: A prospective study. Setting: General community, tertiary care. Participants: Community-dwelling adults with SCI (n = 65; 57% men; mean [standard deviation], 50.4 +/- 12.8 years; mean (standard deviation) years after injury, 14.5 +/- 12.7 years) living in Canada who enrolled in a national telephone-based counseling service. Of the 65 clients who enrolled, 53 participated in the effectiveness evaluation component of the Get In Motion service. Intervention: A 6-month, individualized telephone-counseling program with a trained exercise counselor. The program was based on a previously tested intervention that used aspects of the Health Action Process Approach model, with a particular focus on developing and strengthening clients' social cognitions for engaging in self-managed LTPA. Main Outcome Measurements: On enrollment, all 65 clients completed demographics and staging questionnaires. The 53 clients who participated in the effectiveness evaluation also completed a validated LTPA intentions item, and the 7-day, self-report LTPA Questionnaire for People with SCI over the telephone at baseline, and 2, 4, and 6 months. Results: In terms of the reach of Get In Motion, a total of 65 clients enrolled in the service between June 2008 and June 2011, and were representative of the larger Canadian SCI population on most measured demographic characteristics. Evaluation of the effectiveness of the service showed that, as hypothesized, intentions for engaging in LTPA remained high throughout enrollment (P = .44), with a trend for more clients engaging in moderateto- heavy-intensity LTPA at 6 months (52%) versus baseline (35%) (P = .09). Conclusions: Telephone-based counseling is a promising strategy for promoting community-based LTPA behavior among Canadian adults with SCI. Continued evaluation of all 5 Reach, Effectiveness, Adoption, Implementation, and Maintenance framework components of Get In Motion will help establish the real-world impact of this intervention strategy on community-based LTPA participation within the SCI population.