Canadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2025
Adapting Lifestyle Redesign®: Navigating Fidelity and Contextual Fit Across Four Case Examples.
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Schepens Niemiec Stacey L, Styer Lauren, Chapman Jasmine, Pyatak Elizabeth A, Levasseur Mélanie, Granados Gabrielle, Tapia Valerie A, Rice Collins Chantelle, Martinez Robyn, Tan Tze-Woei
Аннотация
BACKGROUND: Lifestyle Redesign® occupational therapy (LR-OT) originated in the Well Elderly studies as a preventive intervention for older adults, demonstrating positive health and cost outcomes. Although LR-OT later expanded to chronic condition management and inspired numerous programme adaptations for different contexts and populations, systematic reporting of intervention modifications remains scarce. This gap extends beyond OT, reflecting a broader movement in implementation science.
PURPOSE: This study applies the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to systematically document adaptations across four LR-OT programmes. Additionally, we examine fidelity-consistency by mapping programme components to the Well Elderly programme and core LR-OT elements. Methods. Four teams implementing adapted programmes-diabetic foot ulcer self-management, primary care chronic condition management, Remodeler sa Vie for French-Canadian older adults, and LR weight management-participated in a structured mapping exercise to align programmes with FRAME and LR-OT principle components. Results. Adaptation approaches varied from highly structured to loosely standardized methods. Despite numerous modifications, all programmes strongly aligned with LR-OT's core characteristics and domains. Conclusion. This study highlights LR-OT's adaptability across diverse contexts while maintaining fidelity to its foundational framework. Findings contribute to implementation research, providing a model for systematically documenting and characterizing adaptations made to client-centred, evidence-based OT programmes.
PURPOSE: This study applies the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to systematically document adaptations across four LR-OT programmes. Additionally, we examine fidelity-consistency by mapping programme components to the Well Elderly programme and core LR-OT elements. Methods. Four teams implementing adapted programmes-diabetic foot ulcer self-management, primary care chronic condition management, Remodeler sa Vie for French-Canadian older adults, and LR weight management-participated in a structured mapping exercise to align programmes with FRAME and LR-OT principle components. Results. Adaptation approaches varied from highly structured to loosely standardized methods. Despite numerous modifications, all programmes strongly aligned with LR-OT's core characteristics and domains. Conclusion. This study highlights LR-OT's adaptability across diverse contexts while maintaining fidelity to its foundational framework. Findings contribute to implementation research, providing a model for systematically documenting and characterizing adaptations made to client-centred, evidence-based OT programmes.