Investigating Gabs in Self-management, Secondary Conditions, and Quality of Life among Aging Blacks with Spinal Cord Injury - Over the project period, the fellow will conduct a mixed method study of self-management experiences, self-efficacy, needs, behaviors, and preferences of middle age and older (age 40 and above) Black with spinal cord injury (SCI) who also have secondary health conditions (example pressure ulcers, pain, depression, bowel and bladder problems, and others). This study focuses on the Switzer Fellowship’s aim to support high quality, original research that develops knowledge toward maximizing the health, function and community living and participation of individuals with SCI. There is paucity of information on what self-management of secondary health conditions looks like among Blacks aging with SCI. The goal of this project is to improve health outcomes and quality of life of Blacks aging with SCI and secondary health conditions (SHC) by assessing gaps in self-management knowledge, experiences, self-efficacy, cultural considerations, needs, behaviors, and attitudes of Blacks with SCI and those of primary care providers (physicians, physician assistants, and nurses) when working with Blacks with SCI. The specific aims of the proposed study are to (1) conduct a mixed method study with 22 middle age and older Blacks with SCI who also have secondary health conditions; (2) Conduct interviews with 4 Black and 4 White (total of 8) primary care providers (PCPs; physicians, physician assistants, and nurses) who provide care for middle age and older Blacks with SCI; (3) Evaluate the impacts of multiple factors on SHC and self-management using rigorous qualitative analysis and quantitative analysis based on demographics, SCI/SHC-related, and socioeconomic data collected. An embedded concurrent mixed methods design will be used in this study. This design involves the concurrent collection of qualitative and quantitative data with more focus on collecting detailed qualitative data. This design is also referred to as a mixed method integration design. A small quantitative component is embedded into the study to compliment the dominant qualitative data that will be collected. Qualitative data will be collected via individual interviews with individuals with SCI and the primary care providers. A short survey will be used to collect quantitative data for research questions 1.1 and 1.2 under specific aim 1. Data analyses will involve descriptive statistics and correlational analysis for the quantitative data. Qualitative data will be managed and analyzed using MAXQDA Software. After data collection, transcribed data and field notes will be triangulated (verified for accuracy) by the research team. Data analysis will involve data coding, text analysis, and identifications of emerging themes and result interpretation. Anticipated outcomes are (1) gain knowledge and understanding on self-management experiences, self-efficacy, and healthcare-related needs of Black aging with SCI and SHC (2) an understanding on how to develop health promotion/health literacy interventions for aging Blacks with SCI and SHC. The expected products are infographics on self-management, SCI, and SHC, academic publications, conference presentations, report dissemination through existing venues (e.g., in writing through NARIC), and plans for follow-up grant and research.
