Mobile Health Self-Management and Support System for Chronic and Complex Health Conditions

Individuals with chronic and complex conditions such as those with spinal cord injury
(SCI),Cerebral Palsy (CP), Spina Bifida (SB), and Traumatic Brain Injury (TBI), often require
complex self-management routines to manage various needs such as bowel and bladder, skin
integrity, and general health and wellness. Tasks such as self-catheterization, bowel
regimens, skin checks, and routine administration of medications require consistent
follow-through to prevent complications. Early detection and treatment of problems such as
urinary tract infections (UTIs) or wounds, can prevent serious complications like
osteomyelitis and sepsis which can result in hospitalization, death, and expensive medical
care. The investigators have developed an innovative mobile health (mHealth) system aimed at
improving self-management skills and preventing and detecting early signs of secondary
medical complications. The system consist of a mobile health applications (apps), a clinician
portal and a two-way secure communication system between the two. People with complex care
regimens can use the apps to get reminders or cues to carry out their self care routines such
as bowel/bladder routines, take medications, report success with their activities or new
problems (e.g. new wound, UTI symptoms etc.), and track symptoms of depression. A clinician
can use the portal to view the report and communicate with the users through a secure
communication system that is embedded in the apps.

This study will assess the benefits of using the system in improving users' wellness and
self-management skills compared to those who receive standard of care only.

Inclusion Criteria:

1. 12 years or older.

2. have a diagnosis of a chronic and complex condition such as Spina Bifida, Spinal Cord
Injury, Cerebral Palsy and Traumatic Brain Injury, etc.

3. live in a community setting (not within a residential facility that provides care to
them).

4. pass all the functional screening tests which include basic usage of a smart phone,
and impairment severity assessments

Exclusion Criteria:

1. Diagnosis of severe intellectual disability or severe and persistent psychiatric
illness.

2. Failing all the screening tests due to severe impairments that cannot be accommodated
by the mHealth system (for patient participants)