Enhancing leisure participation in spinal cord injury rehabilitation: A co-design study

Study design: Co-design study.Objectives: To develop proposals for intervention components to support leisure participation during and after inpatient rehabilitation for individuals with spinal cord injury (SCI).Setting: spinal cord injury Center of Western Denmark, Denmark.Methods: A co-design approach, informed by participatory research principles and the Medical Research Council framework for developing complex interventions, was applied. Data collection included semi-structured interviews with six healthcare professionals, analyzed using reflexive thematic analysis. A series of stakeholder workshops involving individuals with SCI, clinicians, and community stakeholders informed the development of proposed intervention components.Results: Four themes were identified: (1) leisure was inconsistently addressed in clinical practice; (2) engagement depended on patient readiness and timing; (3) prior leisure involvement supported re-engagement; and (4) access to community opportunities was limited after discharge. Based on these findings, intervention components were proposed across three phases: admission, discharge, and post-discharge. These included a peer mentor program, a leisure resource directory, automated referral to Parasport Denmark, scheduled mentor follow-ups, a cultural events calendar, tailored discharge materials, and referral guidelines for local services.Conclusion: The proposed intervention components address key barriers to leisure participation after SCI through structured support, peer involvement, and improved links to community resources. Further research is needed to evaluate feasibility and implementation.