title: Differential Impact and Use of a Telehealth Intervention by Persons with MS or SCI.
abstract: OBJECTIVE
  The objective of this study was to compare outcomes and patterns of engaging with a telehealth intervention (CareCall) by adult wheelchair users with severe mobility limitations with a diagnosis of multiple sclerosis (MS) or spinal cord injury (SCI).
  
  
  METHODS
  The design of this study is a secondary analysis from a pilot randomized controlled trial with 106 participants with SCI and 36 participants with MS.
  
  
  RESULTS
  General linear model results showed that an interaction between baseline depression score and study group significantly predicted reduced depression at 6 mos for subjects with both diagnoses (P = 0.01). For those with MS, CareCall increased participants' physical independence (P < 0.001). No statistically significant differences in skin integrity were found between study groups for subjects with either diagnosis. All participants were similarly satisfied with CareCall, although those with MS engaged in almost double the amount of calls per person than those with SCI (P = 0.005). Those with SCI missed more calls (P < 0.001) and required more extensive support from a nurse (P = 0.006) than those with MS.
  
  
  CONCLUSIONS
  An interactive telephone intervention was effective in reducing depression in adult wheelchair users with either MS or SCI, and in increasing health care access and physical independence for those with a diagnosis of MS. Future research should aim to enhance the efficacy of such an intervention for participants with SCI.
authors.affiliation: From the MGH Institute of Health Professions, Boston, Massachusetts (HWM, AMJ); New England Regional Spinal Cord Injury Center, Boston University Medical Center, Boston, Massachusetts (HWM, BVH, AMJ); and Health and Disability Research Institute, Boston University School of Public Health, Boston, Massachusetts (PN, AMJ).
authors.forename: Hannah W
authors.initials: HW
authors.lastname: Mercier
authors.forename: Pensheng
authors.initials: P
authors.lastname: Ni
authors.forename: Bethlyn V
authors.initials: BV
authors.lastname: Houlihan
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
mesh_terms: D000328:Adult; D003863:Depression / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology / Q000628:therapy*; D003668:Pressure Ulcer / Q000517:prevention & control*; D019114:Remote Consultation / Q000706:statistics & numerical data; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology / Q000628:therapy*