Research program

Lay summary (english)

Essentielle pour promouvoir la santé, prévenir les incapacités et favoriser l’équité en santé, la participation sociale est néanmoins restreinte pour environ la moitié des Canadiens âgés. La participation sociale implique des activités sociales et de loisirs, par exemple faire de l’exercice physique avec d’autres, rendre visite à des amis et faire du bénévolat, qui répondent aux besoins fondamentaux d’interaction et d’accomplissement personnel. Bien que généralement ciblées par les organismes communautaires, les professionnels de la santé et les municipalités, peu d’interventions sont mises en œuvre qui favorisent réellement la participation sociale et atteignent les populations canadiennes vulnérables. Des études préliminaires ont montré la faisabilité et les effets positifs de trois interventions prometteuses et complémentaires aidant respectivement les organismes communautaires, les professionnels de la santé et les municipalités à cibler la santé et la participation sociale: l’Accompagnement-citoyen personnalisé d’intégration communautaire (APIC; intervention individuelle de participation dans la communauté avec des bénévoles), le programme Remodeler sa vie (intervention de groupe sur des routines saines animé par un ergothérapeute) et des environnements inclusifs (intervention populationnelle sur les politiques, les services et les structures). Ces interventions nécessitent cependant d’être davantage étudiées et d’être bonifiées par des approches innovantes telles qu’une rupture avec l’âgisme et la robotique. Au cours des 4 prochaines années, je continuerai à perfectionner ces interventions en évaluant l’efficacité et les effets de l’APIC et du programme Remodeler sa vie sur la santé et la participation sociale des aînés. En outre, les environnements inclusifs seront explorés pour identifier comment et quelles composantes favorisent le mieux la santé positive, la participation sociale et l’équité en santé des aînés. Optimisé et mis en œuvre à travers le Canada, ce continuum d’interventions représente l’une des voies les plus prometteuses pour soutenir les pratiques de participation sociale actuelles et permettre aux aînés de mieux vieillir plus longtemps.

Lay Summary (English)

Social participation is critical to promote health, prevent disabilities and foster health equality in older adults and society but is restricted for approximately half of older Canadians. Social participation involves social and leisure activities, eg doing physical exercises with others, visiting friends and volunteering, that meet fundamental needs for interaction and self-accomplishment. Although generally targeted by community organizations, health professionals and municipalities, few effective social participation interventions that are implemented really reach the Canadian vulnerable populations. Preliminary studies demonstrated the feasibility and positive impacts of three promising and complementary interventions helping respectively community organizations, health professionals and municipalities target health and social participation: Personalized citizen assistance for social participation (APIC; individual intervention on community integration with volunteers), Lifestyle Redesign® (group intervention on healthy routines with occupational therapists) and inclusive environments (population intervention on policies, services and structures). These interventions need more study to further evaluate their impacts and bonified with innovative approaches including rupture with ageism and robotics. Over the next 4 years, I will continue to perfect these interventions by evaluating the cost-effectiveness and impacts of the APIC and Lifestyle Redesign on older adults' health and social participation. In addition, inclusive environments will be explored to identify how and which components best foster positive health, social participation and health equality in older adults. These three interventions will be optimized and ultimately implemented as one continuum reinforcing actual social participation practices across Canada. Since disabilities can be prevented or delayed by an active lifestyle and innovative interventions addressing determinants of health such as social participation, this research program points to one of the most promising avenues to live longer and better.

Detailed summary

This research program aims to promote older adults' health and social participation, according to a continuum of interventions (part 1) and innovative approaches (part 2). Traditional approaches will make it possible to evaluate this continuum of interventions to promote older adults' health and social participation. Demonstrated to be feasible and having positive effects, three promising and complementary interventions can optimize current practices:

  • Personalized citizen assistance for community integration (APIC; individual intervention aimed at participation in the community with the help of volunteers; Project 1);
  • Lifestyle Redesign® (group intervention aimed at developing a healthy and meaningful lifestyle with occupational therapists; Project 2)
  • inclusive environments that promote active aging (population intervention on policies, services, and structures aimed at mutual assistance between citizens and the revitalization of inclusive city centers; Project 3).
Figure 1. Continuum of interventions to promote older adults' health and social participation 
Adapted from: Sergerie, D., Bégin, C. & Boudreault, V. (2007). La prévention des chutes chez les aînés : Intervention multifactorielle personnalisée (volet soutien à domicile). National Institute of Public Health of Quebec; Quebec (Canada). 
http://www.inspq.qc.ca/pdf/publications/643-LaPreventionChutesServicesAinesVivantDomicile.pdf 

Preliminary results indicate that APIC, Lifestyle Redesign®, and inclusive environments have a high potential for concrete and positive benefits for individuals, mainly older adults and their loved ones, and society. However, these interventions need to be further studied, particularly to document their effectiveness. Over the next four years and thanks to CIHR grants, I will continue to perfect this continuum of interventions to enable community organizations, health professionals, and municipalities to promote older adults' health and social participation. Specifically, two pragmatic, multicentre randomized clinical trials will evaluate the cost-benefit ratio and effects of APIC (Project 1) and Lifestyle Redesign® (Project 2), respectively. This assessment covers health, social participation, life satisfaction, and the use of health services. A mixed design is also used to explore environments that are more conducive to health and social participation (Project 3). Finally, action research will be used to accompany the creation of inclusive environments, with the help of the APIC (Project 1), and the Lifestyle Redesign® (Project 2), during the revitalization of city centers (Project 3).

Transversal through the continuum of interventions and distinct from more traditional research, the projects of Part 2 aim to promote social participation in a different way by relying on innovative approaches. Developed by and for older adults (living laboratory), carried out with the help of action research, and funded mainly by the FRQ, two audacious projects thus aim respectively to override ageism (Project 4a) and to socially stimulate older adults with the robotics (Project 5). The effects of a large public dialogue on ageism will also be evaluated using a mixed design (Project 4b).

Generating new pragmatic scientific evidence and building on existing and new collaborations, this research program will provide a better understanding of how to intervene effectively to promote older adults' health and social participation. By offering new opportunities for better aging, these results will make it possible to optimize current practices and, ultimately, to implement the continuum of interventions enhanced with innovative approaches to ensure active and healthy aging among older Quebecers.