Mixed-Methods Evaluation of the Pilot True Grit SCI Residential Program for Young Adults with Spinal Cord Injury

Young adults with spinal cord injury (SCI) face unique challenges during the transition to adulthood, including limited access to community-based programs that address participation, independence, and resilience.

To evaluate the pilot True Grit SCI program, a 5-day residential camp designed to support the transition to adulthood for young adults with SCI.

This qualitatively driven, embedded mixed-methods study employed a realist evaluation framework guided by social cognitive theory. Six male participants with SCI (ages 16-20 years) attended the July 2024 pilot program. Quantitative measures included the Goal Attainment Scale (GAS), SCI-QOL Resilience Short Form, and Pediatric Measure of Participation (PMoP), administered at baseline and 3-month follow-up. Qualitative data were collected through semi-structured post-camp interviews. Data were analyzed descriptively and thematically, with integration through triangulation.

All participants demonstrated progress toward individualized goals, with mean GAS improvement of +1.67 (SD 0.82). Resilience outcomes varied, with 3 participants improving and 3 declining. Participation scores increased modestly, with the largest gains among those with lower baseline scores. Qualitative analysis identified 4 themes: building community and belonging, shared experiences foster confidence to try new things, overcoming barriers and redefining identity, and envisioning futures and inspiring others. Integration of findings demonstrated that peer-supported, structured programming both reinforced observed goal attainment and contextualized variable resilience outcomes.

The evaluation of the True Grit SCI pilot suggests that short-term residential programming demonstrated the potential to promote resilience, participation, and self-efficacy among young adults with SCI. Variability in follow-up highlights the need for ongoing community supports to sustain gains.