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This study proposes and tests a conceptual model to explain the role of personal characteristics, injury characteristics, prescribed treatments, environmental support and health behavior factors on bladder and bowel complications and downstream effects on quality of life (QOL) in persons with chronic SCI. The scope of this study builds on and broadens research in this area by accounting for not only physiological factors such as injury level, but also contextual factors such as the environment, alliance with care providers and behaviors. This study will use cross-sectional and Day Reconstruction methodologies. We will recruit 450 adults with chronic SCI who are at least 5 years post injury and who have neurogenic bowel and bladder. Through a telephone interview and medical record reviews, we will collect information in the areas of interest. A subsample of 40 participants will then be recruited to complete to complete daily diaries to collect data on daily life context as it related to the conceptual model factor. This methodology allows for more in-depth assessment of both activities and subjective experiences.