Monday, October 7, 2024
10/7/2024
Based on input from individuals with spinal cord injury (SCI), family members, caregivers, community organizations, and rehabilitation professionals, the Northern California Spinal Cord Injury Model System of Care (NCSCIMS) proposal includes evidence-based rehabilitation research relevant to individuals with SCI. The NCSCIMS will continue promoting improved long-term outcomes for individuals with SCI by 1) conducting a site-specific research project (SSRP), 2) participating in the SCIMS database project by enrolling 80% of eligible patients and conducting follow up interviews on participants previously and prospectively enrolled at NCSCIMS, and 3) participating in a module research project (MRP). The NCSCIMS is part of a multidisciplinary system, providing rehabilitation services across the continuum of care. SCIMS Database Project: The NCSCIMS will continue the assessment of long-term outcomes of SCI by enrolling 56 participants per year into the longitudinal portion of the SCIMS database and continuing to collect follow-up assessments. NCSCIMS has been a part of the Model Systems program since its inception, was a funded SCIMS center 1974-1985 & 1990-2006, and has been a follow-up center from 2007 to present. NCSCIMS currently follows a diverse sample of over 870 participants up to 45 years post-injury. SSRP Background: In the chronic phase of injury, persons with SCI can develop a wide array of secondary complications including cardiometabolic disease (CMD), bowel and bladder dysfunction, spasticity, pain, and pressure injuries.1,2 In particular, cardiovascular disease (CVD) is a leading cause of death after the first year of injury and the mortality rate due to CVD is 228% higher than individuals without SCI.4 However, the risk of developing CMD among individuals with SCI is modifiable and may be mitigated by targeted nutrition intervention. Utilizing the USDA’s 2020-2025 Dietary Guideline for Americans, the Academy of Nutrition and Diet etics SCI Nutrition Practice Guidelines, and the Consortium for Spinal Cord Medicine Clinical Practice Guidelines, this study proposes to deliver individualized medical nutrition therapy to individuals with chronic SCI. A dietitian with SCI specialization will deliver treatments 1) videoconferencing sessions (bimonthly iPad FaceTime calls) and 2) between session support and monitoring (Ate App photo-journal and messaging). This approach provides an ecologically valid, individualized intervention that is consistent with standard clinical practice, while meeting the needs of individuals with SCI by providing accessible specialized care. SSRP Method: The SSRP will enroll 96 individuals to a randomized, waitlist control study with three primary outcome time points (baseline, 3-months post-baseline, and 6-months post-baseline). The immediate treatment group will receive bimonthly telenutrition (TN) counseling during the first 3 months followed by a 3-month follow-up period. Delayed treatment group will receive the intervention during months 4-6. Specific Aim 1: Prospectively examine the effect of TN on diet quality. Specific Aim 2: Prospectively examine the effect of TN on physiological risk components of CMD. Specific Aim 3: Prospectively examine the effect of TN on bowel and bladder function and subsequent changes in the incidence of autonomic dysreflexia and quality of life. Deliverable: Sharing Recipes for Healthy Eating. MRP: The NCSCIMS proposes a study of successful aging for individuals with SCI. Stakeholder Involvement: A diverse advisory board that includes individuals with SCI and SCI physician-scientists will ensure stakeholder feedback while a robust dissemination plan. including publications, presentations, our website, and the NIDLRR MSKTC will ensure access to results generated by NCSCIMS.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
