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Spinal
Cord Injury (SCI): CDC Activities
Programs Underway
Surveillance begins for SCI
With CDC funding and technical support, four states— Alaska, Minnesota, New Jersey, and New York — will collect data about SCI. These data will enable CDC to estimate the magnitude and severity of SCI nationally and to assist states in developing and implementing prevention efforts.
Accomplishments
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Defining CDC’s role in SCI prevention and control
On March 26–27, 2001, CDC convened an interagency meeting in Atlanta of federal and non-federal agencies that respond to public health issues related to SCI. Participants reviewed current public health activities, identified gaps in public health research and funding, explored future interagency partnerships, and recommended future public health priorities related to SCI. They also developed a prioritized list of surveillance and research questions for CDC. The highest priority areas focus on understanding and describing the population of persons who have a spinal cord injury, the types and number of services that are available and accessible to those persons, and the outcomes associated with various types of service.
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Prevention education realizes impressive results
Over one year, participants in a CDC-funded intervention experienced a 46% decrease in pressure sore occurrence and a 36% decrease in pressure sore severity. The intervention, part of the Arkansas Spinal Cord Commission’s Consumer Action to Prevent Pressure Sores (CAPPS) project, eliminated sores among one-third of the intervention group and saved $660,000 in hospital costs associated with pressure sores. The goal of the CAPPS project was to determine whether in-home education could prevent new pressure sores and reduce the number and severity of existing pressure sores among a rural, underserved population of persons with spinal cord injury. Public health nurses, trained using a Pressure Sore Prevention Education Manual developed by CAPPS project staff, visited participants’ homes to teach them about preventing and treating pressure sores. A similar group of persons with SCI who did not receive the intervention served as a control group. The findings from this project can be used to shape efforts to prevent SCI-related pressure sores in similar communities.
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Behavioral intervention improves outcomes
CDC funded the Rehabilitation Institute of Chicago to examine the efficacy of a behavioral intervention to prevent pressure sores after spinal cord injury. Researchers recruited study participants during acute rehabilitation and followed them after discharge. The control group received usual care, while the intervention group received usual care and a behavioral intervention that included a personal contract for behavior change and routine feedback to promote self-care after discharge. At one-year follow-up, only 2.5% of the intervention group had developed severe pressure sores compared with 19.4% of the control group; and 2% of intervention participants had been hospitalized, while 18% of the control group had been hospitalized for pressure sores.
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