Lifestyle Redesign® : An application example of the DLW model

Lifestyle Redesign® : An application example of the DLW model

Blog written by Mélanie Levasseur and Marie-Hélène Lévesque, translation by Nicole Moll

Why Lifestyle Redesign®?

Lifestyle Redesign® (LR) is an occupational therapy intervention developed by researchers in California with the aim of enhancing development of a meaningful, healthy lifestyle for seniors.  Two randomized clinical trials (Clark et al., 1997; 2012) have demonstrated the cost-effectiveness of this intervention (under $50,000 of Quality-Adjusted life years) and its significant positive impact on the quality of social interactions among seniors, as well as improvements in their mobility, vitality, mental health, and overall life satisfaction.  Due to individualized support and ongoing partnerships, 90% these improvements were maintained over time (Clark et al., 2001).  Furthermore, a study comparing the use of health and social services demonstrated that participants in LR tended to use fewer services ($967), than seniors who did not receive the intervention ($3,334) or or those who participated in only social activity groups ($1,726) (Hay et al., 2002). This group intervention performed primarily in the community within a multi-ethnic context can address several challenges related to health promotion practice.

What is Lifestyle Redesign®?

Built around the central theme of health through daily occupations, the intervention takes place over a period of 6-9 months (26-39 weekly two-hour meetings) and individual personalized meetings at home (5-10 one-hour meetings). In general, the intervention aims to optimize the social participation of seniors and encourage the development of routines favouring the adoption of healthy lifestyles and involvement in meaningful activities. Each group included about 9 participants and was facilitated by an occupational therapist trained in implementing LR. The number of individual meetings is about one per months and varies depending on the needs of the participants. These individual meetings aim to customize the information and make recommendations on the various themes emerging from the group meetings; to identify specific interests of the seniors; to promote engagement in personally meaningful activities; and to help them to achieve their desired changes (personalized follow-up).

The basic elements of the LR are: 1) identification and application of realistic and long-term activity changes; 2) development of plans to overcome obstacles (e.g. pain, transportation); and 3) participation in specific activities involving the practice, and repetition of changes in daily routine. The reflections and analysis proposed by the occupational therapist concerning the relative importance of the occupations, their meaning and their impact on health allow the participant to receive personalized feedback that favours development of specific abilities and maintain acquired habits.  The counselling on social participation, lifestyle and involvement in significant activities is centred on the person and allows evaluation of knowledge and motivation, to provide information, reinforce desirable behavior or to advise on changing of prejudicial behavior, and ensure long-term follow-up of accomplishments.

How is the LR related to the DLW model?

Although the LR does not come from DLW, both are based in evidence-based principles of occupational science.

  1. What similarities to do you see with the LR and the DLW model?
  1. Which parts of the DLW model are also found in the LR?
  1. How could the DLW model add to the LR approach?


Clark FA, Azen SP, Zemke R, Jackson JM, Carlson ME, Mandel D, Hay J, Josephson K, Cherry B, Hessel C, Palmer J and Lipson L. Occupational therapy for independent-living older adults: A randomized controlled trial. Journal of the American Medical Association. 1997;278:1321-1326.

Clark F, Jackson JM, Carlson M, Chuo C, Cherry BJ, Jordan-Marsh M, Knight B, Mandel D, Blanchard J, Granger D, Wilcox R, Lai M, White B, Hay J, Lam C, Marterella A and Azen S. Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: Results of the Well Elderly 2 Randomised Controlled Trial. Journal of Epidemiology and Community Health. 2012;66:782-790.

Clark F, Azen S, Carlson M, Mandel D, LaBree L, Hay J, Zemke R, Jackson J and Lipson L. Embedding health-promoting changes into the daily lives of Independent-Living Older Adults: Long-Term Follow-Up of Occupational Therapy Intervention. J Gerontol B Psychol Sci Soc Sci. 2001;56:60-63.

Hay J, LaBree L, Luo R, Clark F, Carlson M, Mandel D, Zemke R, Jackson J and Azen S. Cost-effectiveness of preventive occupational therapy for independent-living older