Web-Based Health Coaching for Spinal Cord Injury: Results From a Mixed Methods Feasibility Evaluation.

Eleven participants with no control group means any change over time could be natural variation, regression to the mean, or simply the effect of being watched and spoken to weekly. Participants were recruited from community organisations and needed internet access and motivation, so this says nothing about people who are isolated, newly injured, or without reliable connectivity. The majority had been injured for more than 10 years, with an average of 20 years since injury, so this is not a test with newly discharged patients who may need self-management support most. All outcomes were self-reported and measured only before and immediately after, so it is unknown whether any change lasted. The program ran in winter, and two participants said weather affected their mood, a confound the authors did not control. The coaches' own experience of the program's demands was not included in this paper. Only seven to nine of the eleven participants had usable data for each measure, and the participant who needed telephone delivery was excluded from the quantitative analysis entirely. Most participants used Zoom, Skype or Facebook Messenger instead of the study's platform, which the authors note may not have complied with Canadian health information privacy law.

The funding and conflicts of interest section states only "Conflicts of Interest: None declared" and names no funder. The coaching platform was built with an application program interface from a Toronto company called QoCHealth, and one author (JS) helped develop the educational materials used in the program.

Do not read the improvement in self-efficacy or the moderate effect sizes as evidence the program works. Every outcome was non-significant, the study had no control group, and only nine participants contributed to most measures. This is a feasibility pilot; a randomised controlled trial is still running.