Data access has been approved for research to generate robust Canadian evidence on whether day programs have positive, negative, or no effects on various older adult and caregiver outcomes.
The study is part of a larger program of research on the effects of day programs with researchers partnering with a cross-Canadian team of 32 experts to design a population-based retrospective cohort study covering the Canadian provinces of Alberta, British Columbia, and Manitoba.
The team will collaborate with experts throughout the study. Experts include older adults (some with dementia), their caregivers, Alzheimer societies, caregiver organizations, day program staff and managers, and government and health system decision makers. These experts will provide intimate knowledge of day programs, and the experience of attending them or caring for an attendee, which will help the team interpret and contextualize its findings. This partnered approach will ensure that the research addresses the priorities of those in need of care, their caregivers, and health systems, and it will facilitate rapid translation of findings into day program practice and policy.
The project is being led by Dr. Matthias Hoben, Associate Professor at York University, and funded by The Carswell Family Foundation via an Endowed Research Chair.
“We will identify essential elements of day programs and how they can be improved and provide critical evidence for health systems to leverage the full potential of day programs to provide appropriate care, prevent inequities, and mitigate the need for emergency, hospital, and congregate care,” says Dr. Hoben. “Ultimately, this will be a prerequisite to improving the quality of life of older adults (including those with dementia) and their caregivers, alleviating caregiver burden, and reducing social costs associated with poor health and well-being.”
This population-based retrospective cohort study will use clinical and health administrative data of older adults (65+ years of age) who received publicly funded continuing care in the community in the Canadian provinces of Alberta, British Columbia, and Manitoba between January 1, 2012, and December 31, 2024. Population Data BC will link 7 data sets from the BC Ministry of Health with data sets from regional continuing care registries and the Canadian Index of Multiple Depravation for the analysis.
The study will compare patterns of day program use between provinces and assess changes over time and compare characteristics of older adults (e.g. age, sex, physical or cognitive disability, area-based deprivation indices, and caregiver availability or distress) by pattern of day program use or non-use, province, and time. Finally, the team will create a propensity score–matched comparison group of older adults in the community, who have not attended a day program. Using time-to-event models and general estimating equations, the team will assess whether day program attendees compared with non-attendees enter care homes later; use emergency, acute, or primary care less frequently; experience less cognitive and physical decline; and have better mental health.
Using an integrated approach, a substantial knowledge translation effort will include; a webinar series, briefing documents, workshops, peer-reviewed manuscripts, and presentations at conferences within Canada and internationally. In addition, key messages will be used to develop various lay summaries and an easily accessible, animated video that can be used for educational training on aging in place and care of individuals with dementia and their caregivers in the community. These will be posted on the study website and also on the websites of team members.
