Introduction The challenges of global ageing and the growing burden of chronic diseases require innovative interventions acting on health determinants like social participation. Many older adults do not have equitable opportunities to achieve full social participation, and interventions might underempower their personal and environmental resources and only reach a minority. To optimise current practices, the Accompagnement-citoyen Personnalise d’Integration Communautaire (APIC), an intervention demonstrated as being feasible and having positive impacts, needs further evaluation. Methods and analysis A pragmatic multicentre, prospective, two-armed, randomised controlled trial will evaluate: (1) the short-term and long-term effects of the APIC on older adults’ health, social participation, life satisfaction and healthcare services utilisation and (2) its cost-effectiveness. A total of 376 participants restricted in at least one instrumental activity of daily living and living in three large cities in the province of Quebec, Canada, will be randomly assigned to the experimental or control group using a centralised computer-generated random number sequence procedure. The experimental group will receive weekly 3-hour personalised stimulation sessions given by a trained volunteer over the first 12 months. Sessions will encourage empowerment, gradual mobilisation of personal and environmental resources and community integration. The control group will receive the publicly funded universal healthcare services available to all Quebecers. Over 2 years (baseline and 12, 18 and 24 months later), self-administered questionnaires will assess physical and mental health (primary outcome; version 2 of the 36-item Short-Form Health Survey, converted to SF-6D utility scores for quality-adjusted life years), social participation (Social Participation Scale) and life satisfaction (Life Satisfaction Index-Z). Healthcare services utilisation will be recorded and costs of each intervention calculated. Ethics and dissemination The Research Ethics Committee of the CIUSSS Estrie – CHUS has approved the study (MP-31-2018-2424). An informed consent form will be read and signed by all study participants. Findings will be published and presented at conferences. Trial registration number NCT03161860; Pre-results.

/pdf/effect-of-personalised-citizen-assistance-for-social-1agfoemynr.pdf

Effect of personalised citizen assistance for social participation (APIC) on older adults’ health and social participation: study protocol for a pragmatic multicentre randomised controlled trial (RCT)

Résumé La présente étude visait à documenter l’implantation de l’Accompagnement-citoyen personnalisé d’intégration communautaire (APIC), lors duquel des bénévoles soutiennent la participation sociale d’aînés, dans des organismes communautaires en identifiant les facteurs favorables et défavorables ainsi que ses conditions essentielles. Soutenu par un devis qualitatif descriptif de type recherche clinique, une rencontre et six entretiens semi-dirigés ont été réalisés afin de documenter cette implantation dans six organismes communautaires œuvrant en milieu urbain au Québec (Canada). Selon les six coordonnatrices de l’APIC, les cinq directeurs généraux et l’agente de recherche, le principal facteur favorable est la conviction des responsables de l’implantation en la valeur ajoutée de l’intervention, incluant sa concordance avec la mission et les valeurs des organismes et les besoins de la population qu’ils desservent. Les facteurs défavorables sont principalement la répartition aléatoire et le temps accordé pour l’implantation. Ces résultats permettront de mieux guider l’implantation de l’APIC à plus grande échelle. 

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/F245C042F96657B8DE0F64D4DC3F3193/S0714980823000132a.pdf/div-class-title-implantation-de-l-accompagnement-citoyen-personnalise-d-integration-communautaire-apic-vers-l-optimisation-de-la-mise-en-oeuvre-de-cette-approche-novatrice-visant-la-participation-sociale-des-aines-div.pdf

Implantation de l’Accompagnement-citoyen personnalisé d’intégration communautaire (APIC) : vers l’optimisation de la mise en œuvre de cette approche novatrice visant la participation sociale des aînés

La présente étude visait à documenter l'implantation de l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC), lors duquel des bénévoles soutiennent la participation sociale d'aînés, dans des organismes communautaires en identifiant les facteurs favorables et défavorables ainsi que ses conditions essentielles. Soutenu par un devis qualitatif descriptif de type recherche clinique, une rencontre et six entretiens semi-dirigés ont été réalisés afin de documenter cette implantation dans six organismes communautaires œuvrant en milieu urbain au Québec (Canada). Selon les six coordonnatrices de l'APIC, les cinq directeurs généraux et l'agente de recherche, le principal facteur favorable est la conviction des responsables de l'implantation en la valeur ajoutée de l'intervention, incluant sa concordance avec la mission et les valeurs des organismes et les besoins de la population qu'ils desservent. Les facteurs défavorables sont principalement la répartition aléatoire et le temps accordé pour l'implantation. Ces résultats permettront de mieux guider l'implantation de l'APIC à plus grande échelle.

[Implantation de l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC) : vers l'optimisation de la mise en œuvre de cette approche novatrice visant la participation sociale des aînés].

Importance: Developed in California to enable community-dwelling older adults to maintain healthy and meaningful activities, Lifestyle Redesign® is a well-known cost-effective preventive occupational therapy intervention. The impact of a newly adapted French version on older French-Canadians was, however, unknown.

Objective: To explore the influence of Lifestyle Redesign on older French-Canadians’ health, social participation, leisure, and mobility.

Design: A mixed-methods design included a preexperimental component (questionnaires administered before and after the intervention and 3 and 6 mo postintervention) and an exploratory descriptive qualitative clinical study. Individual semidirected interviews were digitally audiotaped and transcribed, then underwent thematic content analysis using mix extraction grids.

Setting: Community.

Participants: Sixteen volunteers (10 women) aged 65–90 yr (mean = 76.4, standard deviation = 7.6), 10 without and 6 with disabilities. Inclusion criteria were age ≥65 yr, normal cognitive functions, residence in a conventional or senior home, and French speaking.

Intervention: French-Canadian 6-mo version of Lifestyle Redesign.

Outcomes and Measures: Health, social participation, leisure, and mobility were measured using the 36-item Short Form Health Survey, Social Participation Scale, Leisure Profile, and Life-Space Assessment, as well as a semistructured interview guide.

Results: The French-Canadian Lifestyle Redesign had a beneficial effect on participants’ mental health (p = .02) and interest in leisure (p = .02) and, in those with disabilities, social participation (p = .03) and attitudes toward leisure (p = .04). Participants reported positive effects on their mental health, leisure, mobility, and social participation, including frequency and quality of social interactions, and indicated that having an occupational routine fostered better health. None of the participants reported no effect.

Conclusion and Relevance: The translated and culturally adapted Lifestyle Redesign is a promising occupational therapy intervention for community-dwelling older French-Canadians.

Influence of Lifestyle Redesign® on health, social participation, leisure and mobility of older French-Canadians

RESUMECette etude visait a identifier les facilitateurs, les obstacles et la faisabilite d'implanter un Accompagnement-citoyen personnalise d'integration communautaire (APIC) pour des aines en perte d'autonomie et vivant dans la communaute. L'APIC est un suivi hebdomadaire de trois heures realise par un accompagnateur non professionnel forme et supervise qui vise a optimiser la realisation d'activites sociales et de loisirs de personnes ayant des incapacites. Une recherche-action a permis de realiser des entretiens semi-diriges aupres de 16 participants de la communaute. Les principaux facilitateurs de l'implantation sont l'adaptabilite de l'APIC et son appui scientifique, la reconnaissance d'un besoin, l'expertise et la collaboration. La presence de leaders ouverts a la nouveaute et d'individus offrant du soutien est favorable. Le financement de l'implantation, associe a un contexte economique defavorable, est un obstacle. La majorite des participants percoivent qu'il serait faisable d'implanter l'APIC en l'integrant a des structures benevoles deja existantes. Ces connaissances permettront d'optimiser l'implantation de l'APIC ou d'interventions similaires dans la communaute.

Pré-implantation de l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC): Adaptabilité, collaboration et financement, les déterminants d'une implantation réussie.

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Pré-implantation de l'Accompagnement-citoyen personnalisé d'intégration communautaire (APIC): Adaptabilité, collaboration et financement, les déterminants d'une implantation réussie.