Co-developing evidence-informed considerations for an e-learning course : spinal cord injury peer health coaches' delivery of smoking cessation support

Abstract

Spinal cord injury (SCI) is life-altering and affects over 86,000 people in Canada. Damage to the spinal cord due to injury or disease can result in partial or complete paralysis and lasting effects such as loss of bladder control, neuropathic pain, and cardiovascular issues. People with lived experience of SCI report higher rates of cigarette smoking and a disproportionate burden of tobacco-related health disparities compared to individuals without SCI. Yet, there is a paucity of research related to tailored cigarette smoking cessation services for people with lived experience of SCI. Recommendations for SCI BC’s Peer Health Coaches to provide cigarette smoking cessation behavioural support were co-developed. Using an Integrated Knowledge Translation approach, in partnership with SCI BC, this research aimed to co-develop evidence-informed considerations to guide the instructional design of an e-learning course to support Peer Health Coaches in delivering cigarette-smoking cessation recommendations for people with lived experience of SCI. Semi-structured interviews were conducted virtually with participants who have expertise in SCI, peer support, smoking cessation, and e-learning course design. The first objective was to understand what e-learning content and design features address Peer Health Coaches’ barriers and facilitators to delivering the recommendations and engaging with the e-learning course. Application of the Theoretical Domains Framework revealed barriers related to referral processes for smoking-cessation medications, scope of practice, and ensuring that course content was representative of Peer Health Coaches’ professional role and personal identity. The second objective was to identify key elements of e-learning course design that may support Peer Health Coaches’ engagement with the e-learning course by applying the Inclusion, Design, Engagement, Evaluation, Assessment, and Support Framework. This revealed a preference for design features that meet accessibility standards, a variety of interactive activities, such as videos and role-playing scenarios, and opportunities to connect with others. Findings provide a long list of intervention strategies that may be used to support Peer Health Coaches’ delivery of the cigarette smoking cessation recommendations and engagement with the e-learning course. These findings inform the next steps for SCI BC to refine this list of considerations and begin to co-design the e-learning course to train Peer Health Coaches.