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

OPINION/FEEDBACK: 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.