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.
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Stacey L. Schepens Niemiec
University of Southern California
Lauren Styer
University of Southern California
Jasmine Chapman
Canadian Journal of Occupational Therapy
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Niemiec et al. (Tue,) studied this question.
synapsesocial.com/papers/69401ef02d562116f28f9626 — DOI: https://doi.org/10.1177/00084174251397723
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