University of Pittsburgh Model Center on Spinal Cord Injury
NIDRR Grant # H133N060019
2006-2011
Principle Investigator: Michael Boninger, MD
SCI Model System Research Publications
Projects:
Investigation of Assistive Technology for Mobility Used by Individuals with a Spinal Cord Injury
Developing an Expert Model of Assistive Technology for Mobility Prescription Process
___________________
Investigation of Assistive Technology for Mobility Used by Individuals with a Spinal Cord Injury
Principal Investigator/s: Michael L. Boninger, MD
Co-Investigator/s: Rory A. Cooper, PhD; Michael J. Fine, MD, MSc
Collaboration with Health Sciences R&D Center
Assistive technology for mobility (ATM) is an integral part of the lives of individuals with spinal cord injury. This technology can literally take an individual who is completely dependent on others and make him/her independent. Despite the importance of this technology, insurance coverage for this equipment is under attack due to recent fraud. The impact of changes in coverage are likely profound, but can only be measured if they are tracked. The objective of this study is to investigate the ATM used by individuals with spinal cord injury. Collecting information on ATM will also enable us to fully explore the issue of disparity in ATM prescription. This study is being conducted at six different model SCI centers including the National Capital Spinal Cord Injury Model System, Rehabilitation Institute of Chicago, MetroHealth Spinal Cord Injury System, Northern New Jersey Spinal Cord Injury System, Regional Spinal Cord Injury System of Delaware Valley, and the University of Pittsburgh Model System on Spinal Cord Injury. This first part of the study uses questionnaires to collect data on demographics, assistive technology related to mobility and other personal health questions related to the spinal cord injury. We have enrolled over 500 individuals from all participating centers in the first part of the study. A subset of the individuals who participated in the first part of the study will complete the second part which will investigate wheelchair usage, skill in using a wheelchair and patient related factors. Currently, a total of 220 subjects have been enrolled in the second part of the study. Data collection on both parts of the study is ongoing. A manuscript is in preparation to determine readiness for evacuation in individuals with SCI who use a wheelchair in an emergency situation. The findings from this study will inform efforts to reduce disparity in ATM provision for vulnerable populations and improve the quality of the wheelchair provision process.
Developing an Expert Model of Assistive Technology for Mobility Prescription Process
Collaboration with Health Sciences R&D Center
The complexities of the decision-making process resulting in prescribed wheelchairs are not well understood. The aim of this study is to develop a descriptive, conceptual model of the multi-stakeholder decision-making process of prescribing assistive technology for mobility (ATM) to people with spinal cord injuries (SCI). Specific aims are to a) identify the key stakeholders (people or groups who influence or who are affected by in some way the prescribing process b) identify the interactions between stakeholders and other influences on the decision-making process; and c) explore the manifestations of and determinants of disparity in the prescription process. We employed expert elicitation techniques, through individual, semi-structured interviews with 10 academic, clinical, regulatory, or industry professionals with identified expertise in the relevant field of research. A manuscript is in press which utilized the data collected from this study along with information from a literature review to develop a preliminary model of wheelchair service delivery. The development of this model can assist researchers and clinicians in identifying factors that may be related to disparities in wheelchair service delivery, and to intervene to reduce such disparities.