Date Presented 04/04/19
This study describes the initial efficacy results of the Israeli version of Lifestyle Redesign©, aimed to promote healthy aging and prevent functional deterioration. In a pilot study (N=9), an improvement was found in participation, quality of life, and depressive symptoms. The qualitative data shed light on the active ingredients of this group OT intervention. An ongoing study is aiming to assess the maintenance of these results after three months and to compare them to a matched control group.
Primary Author and Speaker: Talia Maeir
Additional Authors and Speakers: Yafit Gilboa
Contributing Authors: Aviva Beit-Yosef, Tamar Wechsler, Yael Safra
PURPOSE: Older people are subject to biopsychosocial changes putting them at risk of functional deterioration. Age-related declines can be delayed (World health organization, 2015) by interventions that promote engagement in a healthier lifestyle such as lifestyle redesign© (LR) (Clark et al., 2012). Recently, the intervention has been translated and adapted to the Israeli culture. The adapted version consists of 15 weekly group session and three one-on-one sessions lead by an occupational therapist. The aim of this ongoing pilot study is to examine the efficacy of the Israeli version of the LRD in community dwelling elderly. Specifically, we aimed to assess changes in function, quality of life (QoL) and mental and physical status in an intervention group versus a control group and to assess the maintenance of outcomes after 3 months.
DESIGN: A mixed-methods pre-post study with a control group. The Participants for both groups were recruited from a community center in Jerusalem. All participants are community dwelling, age 60 +, independent in ADL, and without severe cognitive decline (MOCA;Montreal cognitive assessment >19).
METHODS: Altogether, 35 women (age range 61-84) are participating in the study: 9 elderlies completed the Israeli version of the LR© intervention and 26 matched controls received a health promotion booklet written by the authors and inspired by the LR© content. Self-report and therapist rated assessments for the LR group were administered before and after the intervention and will be completed soon at 3 months follow up. The control group were assessed at base line and are currently being reassessed after 15 weeks. The outcome measures include evaluation of participation and goal attainment (COPM; Canadian Occupational Performance Measure, FAQ; Functional Activities Questionnaire), QoL (WHOQOL-BREF; World health organization QoL), depressive symptoms (PHQ; Personal Health Questionnaire) and physical status (TUG; timed up and go). In addition, semi-structured interviews were conducted after the intervention to further understand the perceived barriers and facilitators of the intervention. Currently, a one-tailed Wilcoxon signed rank test was conducted at the 0.05 alpha level to assess the hypotheses of positive treatment effects. Future analysis will examine the maintenance of these results and compare them to the control group.
RESULTS: Clinically significant changes (≥2 points) were found on 17/30 (56.7%) personal goals on the COPM. Most of the participant (7/9) clinically improved at least on one goal. In addition, significant improvements were found on the COPM (performance, Z=-2.52, p<.01; satisfaction, Z=-2.67, p<.01) depressive symptoms (Z=-1.68, p<.05) and 3 out of 4 aspects of QoL: physical (Z=-1.89, p<.05), social (Z=-2.13, p<.05) and environmental (Z=-1.76, p<.05). No significant changes were revealed in the FAQ and on the TUG. The qualitative data was merged into five themes: (a) the influence of the therapeutic setting; (b) positive social experience during group meetings; (c) changes in occupation due to intervention; (d) changes in knowledge and awareness to healthy lifestyle; and (e) changes in believes about one self and old age.
CONCLUSION: These preliminary results demonstrate the efficacy of the Israeli LR for improving personal goals, participation, QoL and depression amongst community dwelling elderly. The qualitative data shed light on the active ingredients of this group OT intervention.
Collectively, these results suggest a brief and low-cost OT intervention, which can easily be implemented in clinical setting. This research can contribute to the medical and social ambition regarding healthy aging.
References
Clark, F., Jackson, J., Carlson, M., Chou, C.-P., Cherry, B. J., Jordan-Marsh, M., . . . Granger, D. A. (2012). Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial. Journal of Epidemiology and Community Health, 66(9), 782-790.
World Health Organization. (2015). World report on ageing and health. World Health Organization
