Understanding health outcomes: Physical secondary conditions in people with spinal cord injury.

Objective: To examine the association of predisposing characteristics and enabling characteristics with physical secondary conditions through health practices and health care use in people with spinal cord injury (SCI). Design: Cross-sectional survey mailed to adults in portions of the northeastern and northwestern United States. Participants: Two hundred seventy adults with SCI recruited through durable medical equipment supply companies. Main Outcome Measures: Self-reported health practices, health care use, and physical secondary conditions. Results: In the Andersen behavioral model, F increment tests supported findings that predisposing characteristics accounted for 12% of variance in secondary conditions, enabling characteristics accounted for 16%, and health practices and health care use accounted for another 13%. Path analysis revealed that health care use mediated self-efficacy and interpersonal support. Conclusions: Predisposing characteristics including self-efficacy, enabling characteristics, and health care use are associated with physical secondary conditions in complex ways. More research is needed on measures of health practices and their relation to secondary conditions.