Background: The primary objective of this study was to assess the feasibility of the Healthy Lifestyles Program (HLP), a novel 12-month complex intervention based in cognitive behavioural therapy and theories of behavioural change, delivered in a community-based setting in Hamilton, Canada. The secondary objective was to explore implementation factors. Methods/ design: A pragmatic pilot randomised controlled trial using quantitative and qualitative evaluation methods. Participants were randomly allocated to either intervention group (n=15) or comparator group (n=15). The intervention group attended weekly group education sessions and met in-person with a healthcare team monthly to create personalized health goals and action plans. The comparator group met with a research assistant every three months to develop health goals and action plans. We assessed feasibility of the program by measuring recruitment, participation and retention rates, missing data, and attendance. All participant-directed and clinical outcome measures were analyzed for between and within group changes using Generalized Estimating Equations (GEE). Content analysis was conducted for qualitative data. Results: We recruited and randomized 30 participants to each group (n=15) within 3 months. Retention rate was 60% (9/15) for the intervention group and 47% (7/15) for the comparator group. Less than 1% of participant-directed and clinical outcomes were missing. Participants attended an average of 29 of 43 educational sessions and 100% of one-to-one sessions. The healthcare team valued the program’s holistic approach to care, increased time and interaction with participants, professional collaboration, and the ability to provide counselling and health supports. Location accessibility was an important factor facilitating implementation. Reducing the number of psycho-social education sessions and having access to a gym could improve retention and delivery of the program. Conclusion: This study has demonstrated the feasibility of the HLP with minor modifications recommended for a larger trial and for the intervention. / Thesis / Master of Public Health (MPH) / Rates of chronic physical and mental health illness are rising in Canada. Lifestyle or behavioural changes can prevent or manage chronic diseases. The aim of this pilot study is to test the feasibility of delivering a 12-month Healthy Lifestyles Program to participants in Hamilton, Canada. The Healthy Lifestyles Program is a complex intervention designed to help participants identify health goals and action plans to achieve those goals with the guidance of healthcare professionals. We observed that the program was successfully delivered, accepted by participants and staff and required minor changes to the study design for a scaled-up study. The program showed positive trends for improving goal attainment, depression, and loneliness scores. The results of this study will help inform the design and scale-up of a larger study.

Cette thèse s’inscrit de manière indirecte dans la problématique des risques psychosociaux. A la demande d’un groupe mondial de l’industrie électrique, nous sommes entré dans la question en renversant le problème. Nous avons étudié les instruments psychosociaux de la santé au travail chez les managers de proximité. Le développement du pouvoir d’agir protège la santé et la formation de nouveaux buts est un organisateur de ce développement. Nous avons donc cherché à comprendre et à expliquer comment de nouveaux buts se forment dans et par les dialogues entre pairs sur le travail. L’analyse de discours a permis d’identifier une opération langagière et deux opérations psychologiques qui concourent au renouvellement des buts d’action : la reprise de discours dans le discours, la différenciation des sources de but et l’institution de liaison entre les activités. Sur la base de ces résultats, nous définissons les conditions que les dialogues entre pairs doivent réunir pour être un instrument de la santé. / This thesis is a contribution to the field of psychosocial risks at work. It reports how, in order to respond to the command of an international corporation of electrics industry, we entered the question of psychosocial risk at work, and how we managed to reverse the question. We ‘ve been studying, in a team managers’ group, the psychosocial tools used in order to build and maintain health at work. in the perspective of Clinic of Activity, we know firstly that the development of « power to act » in activity protects and promotes health at work, and secondly that the creation of new goals is a medium of this development. That is why , in this research project, we aimed to understand the creation process of new goals in activity, and we studied this process in a specific frame : in and by the way of dialogues about work activity among professional peers. Discourse analysis permit to identify three different processes, a language process and two psychological ones, that all participate to a renew of goals. Those processes are : 1) a new iteration, in the discourse, of a verbal statement taken from another discourse ; 2) the differentiation of goal’s origins ; and 3) the elaboration of new links between activities. Those issues allows us to define some of the significant properties of dialogue as a tool for health promotion between peers at work.