Lifestyle Redesign® with older Quebecers: A realist evaluation of multiple case studies.

This multicenter research project is led by Mélanie Levasseur, full professor at the Université de Sherbrooke’s School of Rehabilitation, as well as researcher and director of the Connect research laboratory at the Research Centre on Aging of the CIUSSS de l’Estrie-CHUS. Co-developed by an interdisciplinary research team at the Université de Sherbrooke and funded by the Research Centre on Aging, this one-year project aims to develop an explanatory theory to understand the functioning of the Lifestyle Redesign: an effective preventive occupational therapy intervention aimed at developing healthy and meaningful lifestyles among older adults. 

Research team
– Mélanie Levasseur, OT, PhD
– Annie Carrier, OT, PhD
– Chantal Viscogliosi, OT, PhD
– Nancy Presse, RDN, PhD
– Eleonor Riesco, PhD (kin.)
– Marie-Hélène Lévesque OT, MOT, MSc (coordinator) 

In a context of demographic aging and post-pandemic recovery, the Lifestyle Redesign program is a way of optimizing health and social services by integrating more preventive approaches to address chronic disease, isolation and disability. Through experimenting the program in a variety of settings (public, private, community), this project will identify how and why it works for certain people and in different contexts.

To achieve this, a 3-month implementation will be carried out using a case study design in 3 Quebec settings chosen according to organizational variations deemed important to the program’s success, including Quebec City’s English-speaking community. Each case will include an occupational therapist trained to the program, her supervisor and 8 to 12 older adults. Through a literature review and expert consultations, hypotheses are first developed, then field-tested using qualitative and quantitative methods. By explaining how the program leads to effects, these hypotheses will form a theory for improving the program and deploying it in the Quebec context. 

In addition to supporting the implementation of an innovative solution for developing healthy lifestyles and optimizing the social participation of older adults, this project is an important and complementary step in future studies, including a pragmatic, multicenter, two-arm randomized controlled trial (RCT). Understanding the program’s inherent complexity upstream of the evaluation of its effects and cost-effectiveness will improve its logic model, highlight certain blind spots and understand the fine detail of its structure, which could have a major impact on the success of the intervention. Finally, the collaborative partnerships developed between research, the clinic and members of the English-speaking community could serve as an example and foster the creation of synergies with other partners, notably CISSS and CIUSSS public health programs-services and funders interested in investing in preventive occupational therapy. By contributing to a large-scale deployment adapted to the diversity of the Quebec context, this project also aims to enable older adults to thrive and age in good health in the place of their choice.