Linking People and Place: Facilitators & Barriers to Implementing Lifestyle Redesign in French-Canadian Context
Bibliographic record
Abstract
Abstract Lifestyle Redesign is a well-recognized group-based occupational therapy approach to foster healthy lifestyles and reduce social isolation and loneliness among older adults. Mainly studied for its effects and cost-effectiveness, little is known about what influences its implementation. Drawing on insights from occupational therapists (OTs), OT students and expert-partners, this pre-implementation study explored facilitators and barriers to implementing the French-Canadian version (Remodeler sa vie®). Guided by the Consolidated Framework for Implementation Research, an action research involved 58 purposefully recruited participants, including experienced OTs from public and private sectors, OT students in entrepreneurial stream, and expert-partners with diverse backgrounds (e.g. gerontology, decision-making, and community services). Eleven focus groups were conducted using two semi-structured interview guides led by two OTs trained in qualitative methods. Participants (86.2% women, aged 20 to 72; mean = 43.2, SD = 12.5) identified 36 influential factors, with public-sector OTs encountering the most barriers to implementation (17) compared to those in private practice (12) and expert-partners (7). Key enablers were the approach’s strong evidence, relevance to aging populations, engagement of key actors, and growing interest in health self-management. Barriers stemmed from approach complexity (e.g., duration), resource constraints (e.g. human), socio-political challenges, implementation demands, and uncertainty around older adults’ engagement. Equitable access was a common concern, notably regarding socioeconomic status, geographical location and disability profiles. Findings supported a detailed implementation plan with 7 key axes, 20 objectives, and 34 actions to help Remodeler sa vie reach its full potential in promoting healthy lifestyles and reducing social isolation and loneliness.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.018 | 0.005 |
| Scholarly communication | 0.006 | 0.002 |
| Open science | 0.003 | 0.007 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".