Citizen Assistance For Social Participation Research Articles

Personalized Citizen Assistance for Social Participation (APIC) adapted for older adults with visual impairment: results from a mixed study

Purpose To explore the effects of the Personalized Citizen Assistance for Social Participation (APIC), an intervention adapted here for visual impairment, involving weekly stimulation sessions over six to twelve months, provided by trained and supervised attendants, on seven outcomes (social participation, leisure, independence, mobility, quality of life, health-related quality of life, and empowerment) in older adults with visual impairment, and to document its facilitators and barriers. Methods A mixed-method design, which included a pre-experimental and an exploratory qualitative clinical research component, was used on 8 older adults (7 women) with visual impairment aged 70–86, and 8 attendants (5 women) aged 20–74. Before the intervention, directly after, and four months later, older adults completed questionnaires on the 7 outcomes. During the intervention, attendants completed diaries and participated in monthly meetings. Semi-structured interviews were administered to all participants after the intervention. Results Social participation, leisure, mobility, quality of life and empowerment had increased immediately after the APIC. These improvements were still generally observed four months later. Participants reported that the APIC improved older adults’ capabilities, social participation, and social environment. Conclusions The APIC is a promising intervention which helps older adults with visual impairment to deal with social restrictions.

Strengths, challenges, and strategies for implementing pragmatic multicenter randomized controlled trials (RCTs): example of the Personalized Citizen Assistance for Social Participation (APIC) trial

BackgroundRandomized controlled trials (RCTs) are rigorous scientific research designs for evaluating intervention effectiveness. However, implementing RCTs in a real-world context is challenging. To develop strategies to improve its application, it is essential to understand the strengths and challenges of this design. This study thus aimed to explore the strengths, challenges, and strategies for improving the implementation of a pragmatic multicenter, prospective, two-arm RCT evaluating the effects of the Personalized Citizen Assistance for Social Participation (Accompagnement-citoyen Personnalisé d’Intégration Communautaire: APIC; weekly 3-h personalized stimulation sessions given by a trained volunteer over a 12-month period) on older adults’ health, social participation, and life satisfaction.MethodsA multiple case study was conducted with 14 participants, comprising one research assistant, seven coordinators, and six managers of six community organizations serving older adults, who implemented the APIC in the context of a RCT. Between 2017 and 2023, qualitative data were extracted from 24 group meetings, seven semi-directed interviews, emails exchanged with the research team, and one follow-up document.ResultsAged between 30 and 60 (median ± SIQR: 44.0 ± 6.3), most participants were women from organizations already offering social participation interventions for older adults and working with the public sector. Reported strengths of this RCT were its relevance in assessing an innovative intervention to support healthy aging, and the sharing of common goals, expertise, and strategies with community organizations. Challenges included difficulties recruiting older adults, resistance to potential control group assignments, design complexity, and efforts to mobilize and engage volunteers. The COVID-19 pandemic lockdown and health measures exacerbated challenges related to recruiting older adults and mobilizing volunteers and complicated delivery of the intervention. The strategies that mostly overcame difficulties in recruiting older adults were reducing sample size, simplifying recruitment procedures, emphasizing the health follow-up, extending partnerships, and recognizing and supporting volunteers better. Because of the lockdown and physical distancing measures, the intervention was also adapted for remote delivery, including via telephone or videoconferencing.ConclusionKnowledge of the strengths and challenges of pragmatic RCTs can contribute to the development of strategies to facilitate implementation studies and better evaluate health and social participation interventions delivered under real-life conditions.Trial registrationNCT03161860; Pre-results. Registered on May 22, 2017.

Feasibility of Increasing Social Participation for Older Adults with Disabilities

ABSTRACT This study aimed to adapt the personalized citizen assistance for social participation (APIC; French acronym for Accompagnement-citoyen personnalisé d’intégration communautaire) approach for older adults with disabilities and explore its feasibility. A qualitative clinical research design, including interviews, was used with 19 older adults with disabilities. They met with their nonprofessional attendant (citizen supervised by the research team) about 20 times and 16 of them completed the APIC. Personal facilitators and barriers to physical, intellectual, manual, artistic and social interaction experiences were related to health and sensory, motor or behavioral capabilities, including psychological and emotional availability. Results also highlighted environmental facilitators (e.g., paratransit, social support) and barriers (e.g. inaccessibility, weather, over-protective family). The APIC represents new opportunities for older adults to achieve community integration and enhance their social life and resources, while confirming the feasibility of addressing the global “aging well” priority.

Attendant\u2019s experience with the personalized citizen assistance for social participation (APIC)

BackgroundTo promote healthy aging, the social participation needs of older adults must be better met. Previous studies have shown the benefits of the Personalized citizen assistance for social participation (APIC), but few explored its influence on attendants. This study explored the assistance experience of attendants in providing the APIC to older adults with disabilities.MethodsA qualitative design inspired by a phenomenological approach was used with six female attendants who participated in individual interviews.ResultsThe APIC attendants felt useful, developed meaningful relationships with their older adults, and improved their self-knowledge. Attendants had the opportunity to reflect on their lives and self-aging. They contributed to older adults’ functional independence, motivation, and participation in social activities. Attendants encountered challenges related to withdrawn behavior in older adults, such as refusing to participate in activities.ConclusionsConsidering the identified benefits of the APIC for attendants, further studies should explore personalized assistance to preserve older adults’ health.

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

RÉSUMÉCette étude visait à identifier les facilitateurs, les obstacles et la faisabilité d'implanter un Accompagnement-citoyen personnalisé d'intégration communautaire (APIC) pour des aînés en perte d'autonomie et vivant dans la communauté. L'APIC est un suivi hebdomadaire de trois heures réalisé par un accompagnateur non professionnel formé et supervisé qui vise à optimiser la réalisation d'activités sociales et de loisirs de personnes ayant des incapacités. Une recherche-action a permis de réaliser des entretiens semi-dirigés auprès de 16 participants de la communauté. Les principaux facilitateurs de l'implantation sont l'adaptabilité de l'APIC et son appui scientifique, la reconnaissance d'un besoin, l'expertise et la collaboration. La présence de leaders ouverts à la nouveauté et d'individus offrant du soutien est favorable. Le financement de l'implantation, associé à un contexte économique défavorable, est un obstacle. La majorité des participants perçoivent qu'il serait faisable d'implanter l'APIC en l'intégrant à des structures bénévoles déjà existantes. Ces connaissances permettront d'optimiser l'implantation de l'APIC ou d'interventions similaires dans la communauté.

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)

IntroductionThe 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...

Developing and evaluating a continuum of innovative interventions promoting health and social participation in older adults

The challenges of global aging and the growing burden of chronic diseases require, as the World Health Organization warns, innovative interventions on determinants of health such as social participation. Even in industrialized countries, many older adults do not have equitable opportunities to achieve full social participation due to, e.g., inequitable access to activities and information. Moreover, interventions targeting social participation currently delivered by community organizations, health professionals and municipalities in Canada under-empower older adults’ personal and environmental resources reach a minority of them and increase health inequalities. Three promising and complementary interventions demonstrated as being feasible and having positive impacts might optimize current practices: Personalized citizen assistance for social participation (accompagnement-citoyen personnalisé d’intégration communautaire; APIC; individual intervention on community integration with volunteers), Lifestyle Redesign ® (group intervention on healthy routines with occupational therapists) and age-friendly communities (AFC; population intervention on policies, services and structures). These interventions need more study to further evaluate their effectiveness. The goal of the research program is to provide community organizations, health professionals and municipalities with a continuum of individual and population interventions efficiently promoting community-dwelling older adults’ social participation and health. Specifically, the program aims to evaluate the cost-effectiveness and impacts of APIC (objective 1) and Lifestyle Redesign ® (objective 2) on older adults’ social participation, health and life satisfaction. AFC will be explored to identify how and which components, i.e. community policies, services and structures, best foster positive health, social participation and health equity in older adults (objective 3). Two pragmatic multicenters randomized controlled trials will evaluate the cost-effectiveness and impacts of the APIC and Lifestyle Redesign ® on older adults’ health and social participation. In addition, one mixed-method study of AFC will identify how and which components best foster positive health, social participation and health equity in older adults. The achievement of the program to date is based on an exceptional and multidisciplinary network of collaborators already established between practice and research involving 10 national, 5 international researchers and 20 key partners. These health-promoting innovations will be optimized and ultimately implemented as one continuum of interventions reinforcing actual social participation and health practices across Canada.

Personalized citizen assistance for social participation (APIC): A promising intervention for increasing mobility, accomplishment of social activities and frequency of leisure activities in older adults having disabilities

BackgroundSocial participation, a determinant of health in older adults, requires innovative interventions. The personalised citizen assistance for social participation (APIC) involves weekly three-hour personalised stimulation sessions targeting significant social and leisure activities difficult to accomplish. Recently adapted for older adults, the APIC’s impact on this population is unknown. ObjectiveThis study explored the impact of APIC on older adults with disabilities. MethodsA mixed-method design including a pre-experimental component was used with 16 participants (11 women) aged 66–91 (79.4±8.7) with disabilities, living at home. They completed functional autonomy, social participation, leisure and quality of life questionnaires, and semi-structured interviews. ResultsAPIC increased older adults’ functional autonomy (p=0.02), accomplishment (p<0.01) and satisfaction (p=0.02) with social participation, and frequency of leisure practice (p<0.01). Post-intervention, participants wished to modify the practice (p<0.01) and frequency (p<0.01) of leisure activities, and difficulties in their social environment diminished (p=0.03). Their attitude toward leisure (p=0.04) as well as their health (p<0.01) and psychological (p=0.03) quality of life improved. Older adults thought APIC helped them resume, maintain, explore and experiment with significant social activities. It also increased their psychological and physical well-being, feeling of control, connectedness, self-esteem and motivation to accomplish activities. Finally, APIC can compensate for an unavailable and crumbling social network. ConclusionAPIC is a promising intervention that leads to new opportunities for older adults to increase community integration and enhance the social component of their lives. It can also optimise how the needs of older adults are met, including utilisation of personal and environmental resources.