Clustering change patterns among learners of an online Recovery College in Quebec

Filippo Rapisarda^1,2Catherine Briand^1,2*Catherine Vallée³Brigitte Vachon^2,4Galaad Lefay^1,2

• ¹Université du Québec à Trois-Rivières, Trois-Rivières, Canada
• ²Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada
• ³School of Rehabilitation Sciences, Université Laval, Québec City, Canada
• ⁴School of Rehabilitation, University of Montreal, Montréal, Canada

Introduction. Recovery Colleges (RCs) are educational hubs offering free courses on mental health, well-being, and recovery through mutual and transformative learning. These co-learning spaces bring together individuals with diverse backgrounds-such as those with lived experience of mental illness, family members, and mental health practitioners-to co-produce knowledge on mental health topics. Studies have shown RC participation leads to improvements in several psychosocial dimensions (e.g. mental health literacy, self-, empowerment, well-being, reduced anxiety, stigma) and healthcare utilization. However, the methodological approach of averaging outcomes across all participants can mask relevant outcome trajectories, which is particularly significant given the heterogeneity of RC learners. In light of these limitations, this study aims to explore the heterogeneity of change among RC learners by identifying different trajectories of change and exploring their determinants.Methods. The study adopts a quasi-experimental longitudinal design with repeated measures, utilizing data from 353 participants recruited from a French-language RC in Quebec, Canada. Data were collected at three time points: baseline (T0) prior to program participation, one-month postprogram (T1), and three to four months post-program (T2). The study uses clustering techniques to identify patterns of change across participants, focusing on key outcome measures such as well-being, anxiety, resilience, empowerment, and stigma.Results. The results identified three distinct clusters of change trajectories. The largest cluster (A) demonstrated moderate improvements in well-being, anxiety reduction, and slight increases in empowerment and resilience. Cluster B, characterized by participants with higher baseline well-being and lower stigma, showed improvements in empowerment and a slight reduction in stigma, often linked to participants with clinical backgrounds, such as healthcare practitioners. Cluster C, primarily composed of participants with clinical levels of anxiety and lower baseline empowerment, exhibited significant reductions in anxiety and increases in empowerment over time.Discussion. This study contributes to a more nuanced understanding of the diverse outcomes associated with RC participation and highlights the importance of tailoring RC programs to meet the heterogeneous needs of learners. It also reinforces the role of empowerment as a central mechanism of change within the RC model, suggesting that empowerment fosters not only personal growth but also improved well-being and reduced stigma.