• Measures the frequency of health-related behaviour performance in individuals with SCI.
  • Designed to enable examination of the effectiveness of clinical and educational efforts for health maintenance and prevention of secondary impairments.
  • Items were developed from a review of the literature on secondary impairments related to SCI.  In addition, expert clinicians (physician assistants, nurses and physiotherapists) generated items describing health related behaviours. Each item describes different health behaviours.
  • The 5 subscales include:
    1. Cardiovascular
    2. Genitourinary
    3. Neuromuscular
    4. Skin
    5. Psychosocial

Clinical Considerations

  • Although the authors identified a comprehensive list of secondary conditions, only some of these impairments have been included in the tool. For example, some of the missed items include autonomic dysreflexia, deep vein thrombosis, pressure relief in bed, and adjustment to disability.
  • Individuals with SCI participated in item elimination during tool development therefore the included items should resonate with the population.

ICF Domain

Activity ▶ Self-Care

Administration

  • Self-report.
  • Administration time is usually 5-10 minutes.

Number of Items

25

Equipment

None

Scoring

  • A score is generated for each subscale by totaling scores of each item in the subscale.
  • The frequency with which each behaviour has been performed over the past 3 months is rated using an ordinal scale where 4-‘almost always’, 3-‘frequently’, 2-‘sometimes’, 1-‘rarely’ and 0-‘never’.
  • One item (genitourinary) is reverse scored.
  • A total score ranging from 0-100 is calculated by summing the 5 subscale scores.
  • Sub-scale scores may be used to identify/address specific areas of concern.

Languages

English

Training Required

No advanced training required.

Availability

Can be found here.

# of studies reporting psychometric properties: 2

Interpretability

  • Higher total scores are intended to indicate better performance of behaviours which promote health in individuals with SCI.
  • The scores could be used for each sub-scale or as a tool for general overall health.
  • There are no norms or reported cut scores for the SCI population.
  • Published data for the SCI population is available for comparison (see Interpretability section in the Study Details sheet).

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

Reliability

Internal consistency is high for the total SCILS (Cronbach’s a = 0.75 – 0.81) and low to high for the SCILS subscales (Cronbach’s a = 0.31-0.86).

(Pruitt et al. 1998; Shabany et al. 2018)

Validity

  • SCILS was tested against instruments measuring constructs other than that of the SCILS; correlations of the SCILS are low and non-significant for the following instruments as expected:
    • Functional Independence Measure (Pearson’s r = -0.06).
    • Brief Symptom Inventory (Pearson’s r = -0.16- -0.13).
    • Impact of Event Scale (Pearson’s r = -0.16).
    • Beck Depression Inventory (Pearson’s r = -0.17).
  • SCILS was tested against instruments measuring the same construct as that of the SCILS; correlations of the SCILS were moderate with:
    • Self-assessment of overall health behaviour (Pearson’s r = 0.51) (P<0.005).
    • Physician assistant’s assessment of overall health behaviours (Pearson’s r = 0.41) (P<0.005).
  • SCILS was tested against instruments measuring the same construct as that of the SCILS; correlations of the SCILS were low with:
    • Physical therapist’s assessment of overall health behaviour (Pearson’s r = 0.30) (non-significant).
    • Nurse’s assessment of overall health behaviour (Pearson’s r = -0.18).
  • SCILS was tested against instruments measuring the same construct as that of the SCILS; correlations of the SCILS were high with:
    • Health Behaviour Questionnaire (HBQ) (Pearson’s r = 0.65).

(Pruitt et al. 1998; Shabany et al. 2018)

Responsiveness

No values were reported for the responsiveness of the SCILS for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the SCILS for the SCI population.

Reviewers

Nicole Elfring, John Zhu, Matthew Querée, Joanne Chi

Date Last Updated

11 July 2019

Pruitt SD, Wahlgren DR, Epping-Jordan JE, Rossi AL. Health behavior in persons with spinal cord injury: development and initial validation of an outcome measure. Spinal Cord 1998;36:724-731
http://www.ncbi.nlm.nih.gov/pubmed/9800276

Shabany M, Nasrabadi AN, Rahimi-Movagahar V, Mansournia MA, Mohammadi N, Pruitt SD. Reliability and validity of the Persian version of the spinal cord injury lifestyle scale and the health behavior questionnaire in persons with spinal cord injury. Spinal Cord 2018 May;56(5):509-515.
https://pubmed.ncbi.nlm.nih.gov/29335476/