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A Longitudinal Study of Risk for Hospitalizations, Pressure Ulcers, and Subsequent Injuries After Spinal Cord Injury. Field Initiated Research Grant, National Institute on Disability and Rehabilitation Research, Department of Education; $449,990, October 1, 2005 to September 30, 2008.


The onset of spinal cord injury (SCI) increases the risk for the development of a number of secondary conditions that may adversely impact an individual’s life and even result in early mortality.  Most rehabilitation professionals believe secondary conditions are preventable with appropriate health care maintenance.  However, research has yet to sufficiently identify the factors that lead to secondary conditions, as most studies are limited by not using theoretical or empirical models in selecting variables, generally focusing on a single condition, or by investigating only a limited number of risk factors.  The purpose of this revised proposal is to perform a longitudinal study to identify protective and risk factors associated with the onset of multiple types of adverse health outcomes and secondary conditions among a large sample of individuals with SCI.

In 1997-8, we collected prospective data on 1,391 participants who included a substantial number of women (n = 362) and racial/ethnic minorities (n = 359). Risk and protective predictors were selected based on a general empirical risk model.  Predictor variables were first measured over a 10-month period in 1997-1998, including: (a) biographical status, (b) injury status, (c) psychological status, (d) environmental factors, and (e) health behaviors.  Several health outcomes measures were also used.  During the proposed follow-up, we will re-administer all of the predictor measures along with several outcome measures, several of which were also administered at Time 1.  These include: (a) general health, (b) adverse health events—pressure ulcers, subsequent injuries, and rehospitalizations, and (c) poor mental health.  Structural equation modeling will be performed to develop risk models for each outcome.  A consumer advisory committee will meet bi-annually to make recommendations regarding all components of the project.

This project addresses important National Institute on Disability and Rehabilitation Research (NIDRR) priorities on health and function and incorporates the new paradigm of disability.  The ultimate study goal is to enhance the lives of people with SCI by identifying the risk and protective factors associated with several secondary conditions to serve as a foundation for prevention efforts by rehabilitation and public health professionals. Consumers will be directly empowered to improve their own health by being provided with concrete information and recommendations to promote better health and avoid preventable secondary health complications. 

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