Health action process approach and spinal cord injury: a scoping review

Purpose: Spinal cord injury may result in chronic pain, difficulty walking and breathing, and/or paralysis. People with spinal cord injury (PwSCI) experience increased risk for chronic diseases and psychosocial distress (e.g. type 2 diabetes, substance use disorders) and premature mortality. The Health Action Process Approach (HAPA) is a social cognitive health behavior framework validated to explain modifiable preventative health behaviors (e.g. physical exercise, healthy eating, substance misuse) among people with chronic conditions. The present scoping review investigates what, how, and how much peer-reviewed research literature applies HAPA to preventative health behaviors among PwSCI. Materials and methods: A search was conducted in seven community health databases including PubMed, CINAHL, PsycINFO, SocIndex, Scopus, Web of Science, Sociological Abstracts, and Library and Information Science Source. Seven peer-reviewed articles were identified. Conventional content analysis was used in the full-text review to identify themes and calculate theme frequency. Results: All studies were quantitative and applied HAPA to physical exercise. HAPA explained differences in sports participation, leisure time physical activity, and strength training. Conclusions: A strong predictor of physical exercise was belief in the capability to overcome psychosocial barriers. More attention is needed on HAPA-identified barriers, and customized HAPA-based interventions to promote physical exercise among PwSCI.