Participatory research in occupational science and therapy seeks to redress the occupational concerns of diverse communities. To explore occupational therapy practitioners' (OTP) perspectives on health enablers and barriers for Black people with intellectual and developmental disabilities (IDD). 23 OTPs, educators, and students participated in a World Café conference session. Participants were prompted to discuss facilitators, barriers, and the influence of OT on the health of Black adults with IDD. Three themes emerged: (a) Negotiating culturally specific and systemic understandings of health, (b) leveraging professional privilege and community partnerships to expand occupational possibilities and access, and (c) confronting implicit bias, racialized ableism, and structural barriers to health care and occupational engagement. OTPs are positioned as institutional agents of possibility and advocacy who can amplify client expertise, critically examine systemic barriers, and co-create health-promotion rooted in clients' realities. This study contributes to calls for anti-racist, justice-oriented OT praxis. Occupational Therapy Professionals Share Thoughts on Health Care for Black People With IDDBlack people with intellectual and developmental disabilities (IDD) often face barriers to quality health care due to racism, ableism, and other unfair systems. This study asked occupational therapy practitioners (OTPs) to share their thoughts about what helps or gets in the way of health for Black people with IDD and what role OTPs may play in supporting them. We used a participatory conversation method called the World Café at a state occupational therapy (OT) conference. OTPs, educators, and students came together in small groups to talk about important questions like: How can OTPs support the health of Black people with IDD? What makes it easier or harder for them to be healthy? Three main ideas came out of these conversations: (a) health means different things to different people; (b) OTPs can help open doors by using their position and privilege to create new opportunities for clients and to stand up against unfair practices; and (c) bias and stereotypes cause real harm. The group discussed racism and ableism in health care and how OTPs must reflect on their identities and experiences to better support Black people with IDD. This study shows that OTPs can make positive changes in the care of people with IDD by building relationships with communities, challenging unfair systems, and working alongside clients as partners. It also calls for the OT profession to commit to equity and justice in both health care and everyday life.
Adults with paralysis often experience restricted community participation, yet less is known about participation enfranchisement, including perceived control and importance. This study aimed to describe patterns of participation enfranchisement and examine associations with demographic and functional factors among adults with mobility impairments. Thirty adults with paralysis using mobility aids completed the Community Participation Indicators (CPI) at an adaptive fitness center. Social and recreational activities were most frequently performed, whereas employment, volunteering, and civic activities were least frequently performed. Adjusted CPI ratios indicated higher meaningful participation in social and household activities (≥.60) and lower meaningful participation in employment, volunteering, and civic roles (≤.36). Independent driving (τb = -.490, p =.002) and independent living (τb =.409, p =.009) were associated with greater perceived control. Longer disability duration (rs = -.573, p <.001) and earlier onset (rs =.481, p =.007) were associated with lower perceived importance. Findings highlight barriers and opportunities for occupational therapy to enhance participation enfranchisement. Understanding Community Participation and Meaning for Adults With Mobility ImpairmentsAdults living with paralysis often face challenges that make it harder to take part in community activities. This study explored how adults who use mobility aids participate in their communities and how meaningful those activities are to them. Thirty adults with paralysis completed a survey at an adaptive fitness center about their involvement in everyday activities. They also rated how important these activities were and how much control they felt they had over their participation. Participants were most involved in social and recreational activities and participated less often in employment, volunteering, and civic roles. The findings showed that participants were generally able to engage in social and household activities in ways that felt meaningful, but they were less able to participate in work, volunteering, and civic activities at levels that matched what they felt was important. Those who could drive or live independently felt a stronger sense of control and meaning in their participation. People who had lived with paralysis longer or since an earlier age viewed participation as less important overall. These findings suggest that community participation is influenced not just by physical ability but also by independence, opportunity, and social support. Occupational therapy can help by reducing barriers and supporting people to engage in activities that bring meaning and connection to their lives.
Older adults with subjective cognitive decline (SCD) experience emotional distress and report challenges or withdrawal from activities that support health and well-being. This qualitative descriptive study explored participation challenges of older adults with SCD, and their determinants. Data were collected through focus groups with 15 occupational therapists (OTs) working with older adults with SCD in community-based clinical settings, and analysed using deductive content analysis. OTs identified two key participation challenges: limited participation in healthy lifestyle activities, and negative occupational experiences (e.g., reduced enjoyment and diminished sense of competence). Personal determinants were subtle (yet normal) cognitive changes, ineffective strategy use, and limited knowledge about cognition and factors influencing it. Motivational determinants were adverse emotions and negative self-perceptions. Environmental determinants were insufficient social support and internalized age-related stigma. Future intervention for older adults with SCD should focus on supporting occupational experience and participation by addressing knowledge, skills, beliefs, and emotional regulation. What Shapes Participation in Daily Activities for Older Adults with Memory Concerns? Insights from Occupational TherapistsSome older adults notice memory problems, even though they do not have dementia or any other medical condition. This is known as subjective cognitive decline (SCD). Individuals with SCD sometimes withdraw from some of their social and leisure activities. This raises concern because staying involved in such activities is important for older adults’ health and well-being. The reasons behind this withdrawal are not well understood. In this study, occupational therapists who work with clients with SCD shared their insights about everyday issues they address. The occupational therapists observed that individuals with SCD may stop participating in activities the know are beneficial for their health, or they may continue doing them but find the activities less enjoyable or rewarding. For example, they may feel less pleasure, reduced connection with others, or a sense of incompetence. The occupational therapists identified several reasons for these changes in activity participation. Personal reasons were subtle (but normal) memory changes, not using helpful strategies, strong negative emotions like shame, and a loss of confidence. Other reasons involved the social environment, and included lack of support from family members or negative self-perceptions about aging and memory problems. Understanding these challenges and causes can assist occupational therapists in developing effective methods to support individuals with SCD in remaining engaged in meaningful activities that promote health and well-being.
The aging population in the United States continues to grow, emphasizing the need to promote independence and healthy aging. Oral health is an important indicator of overall well-being. Occupational therapists (OTs) are positioned to address oral health. This study examined the relationship between oral health and functional independence in self-care tasks among older adults. A secondary analysis of National Health and Nutrition Examination Survey (NHANES) data, years 2011-2018, was conducted with 4,791 adults aged 65 and older. A multivariable logistic regression was used to estimate odds ratios for self-care difficulty associated with oral health variables. Poorer self-reported oral health and less frequent flossing were significantly associated with difficulty in self-care tasks. Education, income, and age also demonstrated significant relationships with difficulty in self-care tasks. OTs should integrate oral health interventions into practice to enhance functional independence among older adults. Exploring the Relationship Between Oral Health and Self-Care in Older AdultsThis study used publicly available, federally collected data to test the relationship between oral health and self-cares in a sample of US-based older adults using bivariate analyses and multivariate logistic regression. We looked at self-care because as the population of older adults increases, it is important that we understand how to best support their independence in their daily lives. We were interested in oral health as it is an important health measure, associated with general well-being and other health factors, and is an area where occupational therapists can have an impact with their patients. We found that poorer self-reported oral health and less frequent flossing were associated with difficulty with self-care. We also found variables such as education, income, and age, to have significant relationships with self-care difficulty. These results confirm the importance of occupational therapists taking an active role in oral health interventions with their patients, ultimately supporting older adults in maintaining independence as they age.
Involving people with lived experience is important to mental health service design, development, and research. This study explored the personal meaning and impact of participating in lived experience opportunities for consumers and carers. Six semi-structured interviews with consumer and carer volunteers at an Australian community mental health service were analyzed through an interpretative phenomenological lens. A steering group, formed by staff with lived expertise, guided the research. Five themes were identified: "Transforming negative experiences into positive contributions," "Self-growth through lived experience participation," "Connections and support through lived experience participation," "Considerations for supporting consumers and carers in a team," and "Considerations for setting up voluntary lived experience participation roles." Lived experience engagement is meaningful to consumers and carers. Creating safe-enough environments that support participation in decision-making requires valuing diverse opinions, having supportive facilitators, acknowledging demands of sharing lived experiences, and paid remuneration. Meaning and Impact of Lived Experience EngagementInvolving people with lived experience of mental health challenges and recovery (consumers) and their supporters (carers) is important for mental health service design, development, and research. This study explored consumers’ and carers’ experiences of participating in lived experience opportunities, including the meanings and impacts. This paper explains the learnings from three consumers and three carers who volunteer at an Australian community mental health service. The interviews were analyzed through interpretative (understanding) phenomenological (experiences) analysis, which explores how people understand their experiences. Staff with lived expertise formed a steering group, which guided the research. The identified themes include: (a) Transforming negative experiences into positive contributions. (b) Self-growth through lived experience participation. (c) Connections and support through lived experience participation. (d) Considerations for supporting consumers and carers in a team. (e) Considerations for setting up voluntary lived experience roles. Involvement in mental health services is important for consumers and carers. Key strategies for creating safe-enough environments include valuing diverse opinions, having supportive facilitators, recognizing challenges of sharing, and providing payment.
Social frailty (SF) involves reduced social participation, roles, and support, and it is associated with adverse health outcomes. However, the relationship between SF and occupational participation, particularly hobbies, remains underexplored. We examined the association between SF and occupational participation, particularly hobbies, among older adults. A cross-sectional survey of 1,000 older adults in Japan (mean age: 74.08 ± 5.48 years) was conducted online. Participants were classified as robust, pre-SF (PSF), or SF using Makizako's five-item criteria. Occupational participation was assessed using the Self-Completed Occupational Performance Index. Hobby categories and their frequencies were also recorded. Occupational participation was lower in SF than in PSF and robust. Participation in productive activities was negatively associated with PSF and SF, while leisure activities and cultural and artistic hobbies were negatively associated with SF. Occupational therapy should emphasize occupational participation and hobby engagement to help older adults cope with social frailty. Staying Socially Active and Independent: How Hobbies Benefit Older Adults, According to a Study on Leisure and Meaningful ActivitiesAs people age, they often face health issues and challenges in maintaining social connections. “Social frailty” is a term used when a person becomes less socially active or loses contact with their friends and community. This condition can lead to feelings of loneliness, isolation, and depression, and may increase the risk of future health issues or the need for long-term nursing care. This study investigated whether engaging in meaningful leisure activities, specifically hobbies, could help prevent social frailty among older adults in Japan. We conducted an online survey of 1,000 people aged 65 years or older. The current results indicate that individuals experiencing social frailty were less likely to engage in leisure and productive activities compared to their healthier counterparts. Participation in cultural and artistic hobbies—such as music, painting, and crafts—was associated with lower odds of social frailty. Overall, this study suggests that engaging in fulfilling leisure activities, particularly hobbies, can help older adults maintain social participation and enhance their overall well-being, potentially delaying or preventing the need for long-term care. Community-based programs that encourage participation in hobbies may promote healthy aging.
Chronic pain may impede occupational participation in older adults, but links among mobility, social networks, cognitive function, and pain-related factors remain unclear. To examine the relationships among these factors in relation to occupational participation in community-dwelling older Japanese adults. In this cross-sectional study, 130 adults more than 60 answered questions about occupational participation, mobility, social networks, cognitive function, and pain. Exploratory factor analysis was used to extract latent variables representing key constructs. These were incorporated into structural equation modeling to examine their associations with occupational participation. Latent factors combining mobility and social networks (standardized coefficient: 0.75), and cognitive functions (0.35), were directly and positively associated with occupational participation, while pain-related factors were strongly negatively correlated with mobility/social networks (-0.79, -0.73) but showed no direct association with participation. Interventions addressing both physical and social function and pain-related barriers may support occupational participation in older adults. Mobility, Social Life, and Pain: Keys to Staying Active for Older Adults in JapanStaying active and involved in daily life is very important for the health and happiness of older adults. However, many older people live with chronic pain, which can make it difficult to participate in hobbies, social events, and even necessary daily tasks. To find better ways to support well-being, we wanted to understand the relationships between a person’s physical abilities, social life, thinking skills, and their experiences with pain. To do this, we invited 130 older adults who live in the community in Japan to take part in our research. We used a series of well-established questionnaires to ask them about their daily activities, mobility, social network, thinking skills, and pain-related issues. We then used a statistical analysis to look for connections and map out the relationships between all these factors. Our study found that the single most important factor associated with staying active was a combination of good mobility and a strong social network. Having good thinking skills was also directly linked to being more active. Interestingly, pain-related issues were not directly linked to lower activity levels in our group. However, these issues were strongly connected to having poorer mobility and weaker social networks. These findings suggest that to help older adults stay active, it is crucial to support both their physical ability to get around and their opportunities to socialize. Even though pain-related feelings might not be a direct roadblock, they seem to weaken the very foundations that make an active life possible. Therefore, healthcare professionals and community programs should consider offering support that addresses physical function, social connection, and pain management together.
Posttraumatic stress disorder (PTSD) significantly influences individuals' daily life, yet little is known about their experiences of occupational participation and the supporting resources they use. To explore the lived experiences of occupational participation among adults with PTSD and identify resources that support their participation in everyday life. Employing a qualitative design grounded in descriptive phenomenology, remote semi-structured interviews were conducted with 10 community-dwelling adults diagnosed with PTSD. Data were processed through reflexive thematic analysis. Analysis revealed three primary themes: (a) the occupational experience of living with PTSD including effort, motivational challenges, and dysregulation; (b) temporal dynamics of participation; and (c) resources supporting participation, such as balance, processing trauma through occupation and doing for others. The findings elucidate the ways in which trauma influences occupational experiences and highlight key resources that can facilitate participation, offering valuable insights to advance occupational therapy practice for individuals with PTSD. How People With PTSD Experience Everyday Occupations and What Supports Their ParticipationLiving with posttraumatic stress disorder (PTSD) can affect how people experience everyday occupations such as work, relationships, and self-care. This study explored how adults with PTSD experience their daily participation and which resources support their participation in occupations. Ten adults were interviewed about their everyday lives. Participants described that daily occupations often require high effort, feel less enjoyable, and are frequently driven by necessity rather than personal choice. Participation was also described as fluctuating over time, with days or periods of greater and lower participation. Participants identified several resources that helped them participate, including having routines, balancing activity and rest, caring for others, using occupations to cope with and process trauma, and receiving social support. These findings show that everyday occupations play an important role in recovery from PTSD and that supporting participation can improve quality of life.
The purpose of the study was to elucidate the occupational challenges of re-entrants. Convenience and snowball recruitment strategies were used to solicit participants for this exploratory, interpretive phenomenological approach study. Five re-entry service providers and four re-entrants completed extensive interviews. Three levels of open, axial coding were completed with the transcripts. Two primary contexts were acknowledged between service providers and re-entrants: Barriers and Successful Reintegration. Themes were identified: Appreciating Re-entrants' Narratives, Person Centered Approach, Networking and Relationships, and Process & Transformation. Service providers perceived re-entrants as focusing on stability in the re-entrants' lives. Re-entrants reflected on their occupational engagement to include obtaining employment, maintaining mental health stability, and adapting to the demands of society. The results suggest a need to better understand the unique and individual needs of re-entrants and the complexity of occupational engagement and co-occupations within community re-entry. Beliefs About How Someone Returns to the Community After Being Released From Prison and the Challenges of Daily Life: Thoughts From Individuals Who Were Released Back to the Community (Re-entrants) and Those Who Provide Needed Services to Those IndividualsPrevious research indicates the multiple challenges that re-entrants face when returning to the community. However, it is not clear from the research how those challenges are understood in everyday life activities. The purpose of the study was to highlight the perspectives of re-entrants and re-entry service providers on the challenges of returning to the community after incarceration. Individuals were recruited through various community agencies that provide services to re-entrants. Four re-entrants completed extensive interviews, communicating their experiences of living and working in the community. Five re-entry service providers shared their experiences when providing assistance to re-entrants. The re-entrants and the service providers shared what they believed to be barriers to living and working in the community and what it meant to be successful in their return to daily life. Themes throughout the interviews included the importance of appreciating the re-entrants’ stories, past and present, and the need to see the unique needs of each re-entrant, known as a client-centered approach. All participants spoke about the value of relationships and the significance of connecting with people and organizations throughout the process of re-entry. The service providers and re-entrants believed what was needed to find stability in their lives included obtaining employment, maintaining mental health stability, and adjusting to the demands of society; however, the results also suggest a more complex relationship with the service providers in engaging with these occupations. The re-entrants spoke of how their lives change through these relationships. The results suggest a need for service providers to understand the unique and individual needs of re-entrants and the complexity of engaging in daily life. The ongoing activities needed for successful re-entry, where both the re-entrant and another individual participate, referenced as co-occupations, require additional time and energy.
Many parents live with enduring health conditions; however, the impact of enduring health conditions on parenting roles is poorly understood. The aim of this study was to explore the experiences, support needs and preferences of parents in Ireland living with enduring health conditions. Data were collected using a custom e-survey, developed and refined using cognitive interviewing (n = 6). Quantitative data were analysed using descriptive statistics and group comparisons, while open-ended responses were analysed using interpretative content analysis. In total, 281 eligible parents completed the survey. Participants reported considerable difficulties with parenting tasks, particularly physically demanding tasks. Participants had limited access to formal services and many reported unmet needs and dissatisfaction with current services. Enduring health conditions have a significant impact on parenting capacity. There is a need for integrated support systems to ensure parents with enduring health conditions are supported to engage in parenting occupations and roles. Parents With Enduring Health Conditions: A Survey of Experiences, Support Needs and Service Delivery PreferencesThis study looked at the experiences of parents living in Ireland who live with an enduring health condition, including chronic diseases, disabilities or mental health conditions. Being a parent can be challenging, and these challenges can be even harder when someone also lives with an enduring health condition. A total of 281 eligible parents took part in an online survey. They shared how their health affects their ability to manage day-to-day parenting tasks and the types of services and supports that they believe would be beneficial to receive. Overall, the findings show that parents with enduring health conditions face extra challenges in their parenting roles and often feel unsupported. The results highlight the importance of creating more flexible and responsive services that take into account both the health and parenting needs of these individuals.
The World Federation of Occupational Therapists emphasizes sustainability as a core component of occupational therapy education and practice. This study examined how Israeli occupational therapists perceive and apply sustainability, formally recognized but inconsistently embedded in health and social care systems. Using a cross-sectional, exploratory design, an online survey with open- and closed-ended questions was distributed via email and social media. One hundred eleven occupational therapists from diverse practice areas participated. Data were analyzed using descriptive statistics and directed content analysis. Social equity was rated as the most important sustainability principle (78.4%), followed by economic prosperity (41.4%) and environmental integrity (31.5%). Reported barriers included lack of knowledge (21%), time constraints (15%), limited organizational support (14%), limited influence (11%), and lack of incentives (11%). Findings indicate that while Israeli occupational therapists value sustainability, additional education, resources, and institutional support are needed to facilitate its integration into practice, consistent with international patterns. Understanding Sustainability in Occupational Therapy: What Israeli Therapists Know, Value, and Need to PracticeSustainability refers to meeting present needs without compromising the ability of future generations to meet their own. In healthcare, this includes reducing waste, conserving resources, promoting economic and social responsibility, and ensuring equitable access to services. Occupational therapists support individuals’ participation in meaningful daily activities that promote health and engagement in everyday life, thereby playing an important role in advancing sustainable healthcare practices. In Israel, there is no educational, regulatory, or licensure pathway for occupational therapy assistants; therefore, occupational therapy services are provided exclusively by licensed occupational therapists. Accordingly, this manuscript refers only to occupational therapists. This study examined how occupational therapists in Israel understand and apply sustainability in their professional practice. An online survey was distributed nationwide, and 111 occupational therapists responded. The survey included questions addressing knowledge, attitudes, skills, and perceived barriers related to sustainability. Results indicated that most therapists valued sustainability and recognized its importance for individuals, communities, and the environment. Social equity, ensuring fairness and equal opportunities for all, was identified as the most important sustainability principle. However, participants reported limited knowledge about sustainability in occupational therapy and indicated that the topic had not been included in their professional education. The main barriers to implementing sustainable practices were a lack of knowledge, limited time, insufficient organizational support, and a lack of incentives. These findings suggest that although Israeli occupational therapists value sustainability, additional education, training, and workplace support are needed to integrate it into professional practice and promote more sustainable healthcare systems.
Formerly incarcerated women (FIW) face personal, societal, and systemic barriers to reintegration. Occupational therapy professionals (OTPs) are called to support marginalized groups and advocate for change. Guided by the Framework of Occupational Justice, this qualitative study examined how barriers and facilitators shape FIW's occupational participation and experiences of occupational injustice. Interviews with 20 FIW explored post-incarceration experiences in home, work, health, and social engagement. Data were analyzed thematically and organized into personal, societal, and systemic categories. Personally, FIW's self-efficacy and drive/persistence rebuilt their occupational identity, while choice overload contributed to occupational imbalance. Societally, support/opportunity, environment, and stigma/discrimination shaped the degree of help received, promoting or hindering occupational alienation. Systemically, parole/probation, state resources, and legislation facilitated reintegration or reinforced continued institutionalization, leading to occupational deprivation. Post-release challenges highlighted OTPs' role and advocacy with FIW. Voices Beyond Bars: Understanding Barriers and Supports to Daily Life and How Occupational Therapy Can Help with Reintegration for Formerly Incarcerated WomenWomen who leave prison often face many challenges when trying to return to their communities. These challenges can make it hard to find work, take care of their health, manage their homes, and connect with others. Occupational therapy professionals (OTPs) can help by supporting these women and advocating for fair access to resources. This study used an Occupational Therapy Justice Framework to explore how various barriers and supports affect women’s confidence and their participation in daily life. Researchers interviewed 20 women about their experiences after prison. The findings were grouped into three levels: personal, community, and state. At the personal level, traits like confidence and determination helped women succeed, while feeling overwhelmed or lacking direction made things harder. In their communities, encouragement and opportunity supported success, but stigma and discrimination created barriers. At the state level, systems like parole, probation, and government programs sometimes helped, but strict rules often limited women’s freedom and participation. The study shows where OTPs can make a real difference. By listening to women’s stories, promoting fair policies, and helping them find resources, OTPs can support these women in rebuilding their lives and returning to meaningful daily activities.
Adults on maintenance hemodialysis face transportation barriers that disrupt treatment adherence, roles, routines, and quality of life. To review evidence of transportation barriers in adults on hemodialysis and their impact on adherence, quality of life, and community participation. A systematic review was conducted, searching MEDLINE, CINAHL, Cochrane Library, and ScienceDirect (2015-2025) databases for English-language studies. Eleven studies (n = 28-115,982) from eight countries met inclusion criteria. Four interrelated themes emerged from the synthesis: travel distance and time, transportation costs, mode of transport, and service reliability and availability. These barriers collectively constrained treatment adherence, autonomy, and participation in daily occupations, ultimately diminishing autonomy and quality of life. Transportation is a key environmental constraint on occupational performance in hemodialysis. Occupational therapists should assess transport needs, promote mobility supports, and develop interventions to enhance adherence. How Transportation Problems Affect People on Hemodialysis: What This Means for Daily Life and Occupational TherapyPeople who receive hemodialysis must travel to a dialysis center three to four times each week. This travel can be stressful, tiring, expensive, and time-consuming. Our study reviewed research from several countries to understand how transportation difficulties affect the daily lives, health, and well-being of adults on hemodialysis, and why these challenges matter for occupational therapy. We found that many people have to travel long distances, often more than 30 min each way. Long travel times reduce their available energy for everyday activities such as household tasks, work, socializing, and self-care. Transportation can also be costly, with expenses like parking fees, fuel, or public transport fares causing financial strain. Some people rely on family members or public services to get to treatment, which can limit independence and lead to missed or delayed dialysis appointments when transportation is unreliable. These difficulties are not only inconvenient; they can seriously affect health. Several large studies showed that people who live farther from dialysis centers or who depend on public or medical transport services are more likely to miss treatments and even have higher risk of hospitalizations and death. From an occupational therapy perspective, transportation is a key part of community mobility and daily living. Transportation problems can disrupt routines, reduce participation in meaningful activities, and increase stress. Occupational therapists can help by assessing mobility needs, supporting clients in using community transportation or adaptive driving, working with caregivers, and advocating for better transportation services and policies. Our review shows that transportation is a major factor in the lives of people receiving hemodialysis. Improving transportation options can help people maintain their health, independence, and quality of life.
The use of complementary health approaches and integrative health (CHAIH) is increasing in the United States, yet its role within occupational therapy (OT) remains underexplored. This study examined the prevalence of CHAIH use among OT practitioners, identified commonly used therapies, and explored practitioners' perceptions. A cross-sectional online survey was distributed via email by NBCOT to over 132,900 registered OT practitioners; 4,420 responses were analyzed using descriptive statistics and difference between proportions. Most respondents reported using CHAIH, with deep breathing, sensory techniques, and yoga being most common. Practitioners who incorporated CHAIH reported significantly (p < .001) greater self-rated knowledge and more positive attitudes compared with those who did not. However, fewer than 18% rated themselves as "very" or "extremely" knowledgeable. Findings highlight a gap between practice and knowledge, suggesting a need for future research to guide evidence-based integration of CHAIH in OT practice. How Occupational Therapists Are Using Complementary and Integrative Health Approaches in Their WorkRegistered occupational therapy (OTR) practitioners in the United States are increasingly using complementary and integrative health approaches—like yoga, breathing exercises, and sensory techniques—in daily practice. These methods are known as complementary health approaches and integrative health (CHAIH). While use is growing, we don’t fully understand how often therapists use these techniques, which ones are most common, or how knowledgeable they feel about them. To explore this, our team created a national survey. It was sent by the National Board for Certification in Occupational Therapy (NBCOT) to over 132,000 licensed registered OT practitioners. Over 4,400 responded. We asked about their use of CHAIH in practice, familiarity with different therapies, and attitudes toward using them with clients. We found that the majority of registered OT practitioners (66%) are using CHAIH in their work. The most frequently used approaches were deep breathing, sensory-based strategies, and yoga. Therapists who reported using these therapies also had more knowledge and positive attitudes about them. However, we found a concerning discrepancy. While most OT practitioners reported using CHAIH, fewer than 1 in 5 (>18%) rated themselves as “very” or “extremely” knowledgeable about them. This suggests that many are using these therapies without feeling fully prepared or confident in their skills. These results highlight a clear gap: many therapists are using CHAIH, but not all feel fully informed or trained to do so. To keep clients safe and improve outcomes, more research and education are needed. This study suggests that the OT profession should prioritize training, research, and guidelines that help practitioners confidently and safely integrate CHAIH into their care. As health care continues to evolve, occupational therapists must stay informed about these approaches to meet the needs of their clients and collaborate effectively in interdisciplinary settings.
Clubhouses are an international community-based psychosocial approach to mental health recovery. The aim of the study was to investigate whether the current and future needs of Kindred Clubhouse members were being met. A co-design ethnographic methodology was used. Kindred Clubhouse met many needs of its members. It provides a collaborative, consistent, supportive and inclusive environment fostering connections, skill development, a sense of purpose and the maintenance of health and well-being through peer support and participation in meaningful activities and occupations. Areas for development were expanded operating hours, sufficient meaningful work to sustain a work-ordered day, and support for employment and housing. Lack of stable funding limits Kindred's ability to fully meet the needs of its members. Despite insecure funding, Kindred Clubhouse is a valued community service offering a member-led recovery approach supporting many of the occupational, social and community needs of people with mental health challenges. A Study of the Experiences of Members of an Australian Clubhouse Community Mental Health Service: Present and Future Service NeedsClubhouses are nonclinical mental health recovery-focused community services where members and staff work together on the many daily life activities that improve and sustain the mental health and well-being of members. Clubhouse principles and standards strongly align with the knowledge and practice of occupational therapy. There are more than 370 clubhouses across 32 countries. This article reports a study of the current and future service needs of the members and staff of Kindred Clubhouse in Hastings, Victoria, Australia. Kindred operates as a not-for-profit community mental health programme offering open flexible access and a place to belong for as long as members choose. This study found that Kindred Clubhouse was providing a valued community service that met many needs of its members. However, there is a need for the expansion of the opening hours of the service, increased opportunities for meaningful work, supported employment and housing. The current lack of secure funding limits the ability of the service to fully meet the current and future needs of its members.
Lifestyle research on cognitive health has been largely unidirectional and cross-sectional, with limited attention to multidimensional and bidirectional relationships; this study examines longitudinal associations in middle- and older adults. Data from the Korean Longitudinal Study of Aging (2006-2020) included physiological and psychosocial lifestyle factors and cognition assessed by the Korean version of the Mini-Mental State Examination (K-MMSE). Analyses used Mplus 8.9 with cross-lagged panel model (CLPM) and random intercept CLPM (RI-CLPM), adjusting for sex, age, smoking, drinking, and disability. CLPM showed significant lagged effects of lifestyle on cognition across waves (β = .010 to .013, p < .01), with intermittent reverse effects (β = .013 to .015, p < .05). The RI-CLPM confirmed a stable effect of lifestyle on cognition (β = .013 to .017, p < .05), whereas effects from cognition to lifestyle were mixed and nonsignificant (β = -.054 to .034, p > .05). A multidimensional lifestyle was associated with cognitive maintenance, whereas cognitive decline shows variable influences on lifestyle. The Role of Lifestyle in Cognitive Function Among Older Adults Over TimeAs people age, changes in memory and thinking become more common. Understanding what helps maintain brain health is important for supporting independence and quality of life. Many previous studies have focused on single lifestyle factors—such as exercise or diet—and often looked at them at only one point in time. This study examined how a combination of everyday habits relates to thinking ability over a long period. We used data from over 5,101 middle-aged and older adults in Korea who were followed for 14 years. We looked at several aspects of lifestyle, including physical activity, eating habits, social relationships, and participation in work or community activities. We then examined how these factors were related to changes in cognitive function over time. The findings showed that people with healthier and more active lifestyles tended to maintain better cognitive function over time. In contrast, declines in cognitive function did not consistently lead to changes in lifestyle. This suggests that daily habits may play a more important role in supporting brain health than changes in cognition do in shaping lifestyle. Overall, the results highlight the importance of maintaining a balanced and active lifestyle that includes both physical and social activities. Encouraging older adults to stay physically active, socially connected, and engaged in meaningful daily activities may help support their cognitive health. These findings are especially relevant for health care professionals, including occupational therapists, who work to promote healthy aging and independence in later life.
Driving self-efficacy influences driving behavior and decisions about continuing to drive, yet no validated Japanese measure has been available. This study examined the reliability and validity of the Japanese version of the Adelaide Driving Self-Efficacy Scale (ADSES-J) in 100 community-dwelling licensed drivers, with a 2-week retest in 20 participants. Internal consistency was assessed using Cronbach's α and test-retest reliability using ICC (2,1). Convergent validity was examined through correlations with driving-related measures, and discriminant validity through correlations with general self-efficacy and mental health scales. Exploratory factor analysis supported a unidimensional structure explaining 71.6% of the variance. The ADSES-J demonstrated excellent internal consistency (α = .962) and test-retest reliability (ICC = .965), with no floor or ceiling effects at the total score level, although Item 1 showed a ceiling effect. These findings indicate that the ADSES-J is a reliable and valid instrument for assessing driving-specific self-efficacy among community-dwelling drivers in Japan. Understanding Driving Self-Efficacy: A Japanese Questionnaire for Everyday DriversAutomobile driving supports community life through commuting, shopping, and social participation. For many people, including older adults and individuals with brain injuries, driving helps maintain independence and social roles. When considering whether to continue or resume driving safely, it is important not only to assess driving ability but also how accurately individuals judge their own ability. Driving self-efficacy refers to a person’s belief in their capability to manage driving situations safely and effectively. This study examined the reliability and validity of the Japanese version of the Adelaide Driving Self-Efficacy Scale (ADSES-J) in community-dwelling drivers in Japan. We surveyed 100 licensed drivers who had driven within the past year, and 20 participants completed the questionnaire again after two weeks to examine score stability. We evaluated whether the items consistently measured a single concept and whether scores were stable over time. We also examined how ADSES-J scores related to driving-related measures, including driving style and driving workload, and whether the scores were distinct from general self-efficacy and mental health. In addition, we assessed the questionnaire’s factor structure. The ADSES-J showed excellent internal consistency and very high test–retest reliability. The total score did not show floor or ceiling effects, although one item showed a ceiling effect. ADSES-J scores were positively associated with confidence in driving skills and negatively associated with several aspects of driving workload, but were not associated with general self-efficacy or mental health. Factor analysis supported a clear one-factor structure. These findings indicate that the ADSES-J is a reliable and valid tool for assessing driving-specific self-efficacy in Japan. It may support discussions about driving safety and appropriate driving support. Further studies in older and clinical populations are needed.
Sibling relationships are central to family life, and siblings of children with disabilities often play major caregiving roles. Yet, it remains unknown how a child's cerebral palsy (CP) impacts siblings' everyday experiences. To describe how siblings of children with CP experience participation in everyday activities and their perceived support and challenges. We used a qualitative descriptive design, semi-structured interviews with 16 families (25 siblings, 16 children with CP, 29 parents) in Switzerland, and qualitative content analysis. Siblings' participation experiences encompass (a) different types of meaningful activities; (b) distinct support needs, challenges, and feelings of being overlooked; (c) hidden tensions and ambivalent feelings when doing activities. Siblings have diverse experiences including joyful and challenging everyday activities. Tensions arise when navigating roles, family dynamics, and societal expectations. This study underscores the need to prioritize siblings' perspectives in research and practice to enhance their agency, inclusion, and well-being. Study Using Interviews With Families to Better Understand the Daily Life Experiences of Siblings of Children With Cerebral PalsyWhy was the study done? Siblings of children with disabilities play an important role, but little is known about their everyday experiences. We need to know more about how children experience everyday activities when growing up with a sibling with a childhood-onset disability, such as cerebral palsy (CP). We want to know what supports or challenges them. What did the researchers do? The researchers studied the everyday activities of siblings by interviewing siblings of children with CP and their families. They visited 16 families in Switzerland and asked about their experiences in daily life. What did the researchers find? There were three main findings: (a) Siblings do many different types of activities. Experiencing excitement, family connection, and personal independence were key motivations for doing activities. (b) Siblings described different types of support facilitating their activities, challenges hindering their activities, and feelings of being overlooked within family life. (c) Siblings experience tensions resulting from competing needs within their family and ambivalent feelings when doing activities in different social contexts. What do the findings mean? This study has identified the activities, experiences, resources, and challenges of siblings of children with CP. The findings show concrete activities that matter to siblings, relevant support strategies, and difficulties. However, their everyday activities can be complex. Siblings can be sensitive to the needs of their sibling with CP. They need to balance their own and their family’s needs. Professionals should acknowledge these complex situations. They should support the involvement of siblings in their services. They should also encourage parents to talk about siblings’ needs and involve their perspectives in decision-making, for example, about family activities. Future research needs to find out more about the factors influencing siblings’ participation and support strategies.
Culturally responsive care (CRC) is essential in occupational therapy (OT) to ensure equitable, relevant, and meaningful client engagement. The use of CRC in OT education and practice remains variable. We aimed to map how CRC is defined, implemented, and integrated in OT literature and to identify knowledge gaps. We systematically searched PubMed (NCBI), CINAHL (EBSCOhost), Scopus (Elsevier), and PsycINFO (ProQuest) using key terms related to OT and cultural responsiveness. Following Arksey and O'Malley's framework, we charted and analysed 53 studies using the Health Standards Organization (HSO) Cultural Safety and Humility Framework. CRC was conceptualized across a spectrum from cultural competence to cultural humility, with strong engagement in community partnerships, especially with Indigenous groups. Although CRC is a recognized priority in OT, its application across training and service delivery remains limited, especially from the global south. Addressing these gaps is essential for equitable and accountable OT practice to maximize client satisfaction. Culturally Responsive Occupational Therapy Education and Practice: A Scoping ReviewOccupational therapy (OT) enables individuals to participate in meaningful occupations that they want to, need to, or are expected to do. To make service delivery effective, OT must respect the cultural identities and lived experiences of the people they serve. This review examined 53 studies on how occupational therapists consider cultural factors and tailor therapeutic services to meet the needs of their clients. We also examined whether occupational therapists are taught to consider cultural nuances from the outset of their professional training. The findings showed that many occupational therapists are actively collaborating with Indigenous communities and employing thoughtful, respectful approaches to make therapeutic services culturally relevant and appropriate for their clients. We found consistent efforts to deepen students’ and practitioners’ exposure to diverse cultures and their influence on clinical decisions across both training and post-professional development. However, there are some gaps. We observed that people from non-Western countries need to be more included in the research. Therapists and educators also need better tools and support to know if their efforts to be culturally safe are working. Currently, cultural responsiveness is often viewed as an individual skill rather than an integral component of health systems, education, or policies. To move forward, occupational therapists must embed cultural respect in every part of their work, from how students are taught to how services are delivered, ensuring care is safe, inclusive, and guided by the people it aims to serve.
Goal setting is essential in pediatric rehabilitation to enhance participation and meaningful goals. This study examined the construct validity, internal consistency, and test-retest reliability of the Turkish version of the Perceived Efficacy and Goal-Setting System (PEGS) in children with disabilities. A methodological cross-sectional design was used with 120 children aged 7 to 9 years (90.9% cerebral palsy, 9.1% spina bifida), their caregivers, and teachers from three rehabilitation centers in Turkey. The adaptation process followed WHO guidelines. Data were collected with PEGS-Child, PEGS-Caregiver, PEGS-Teacher forms, and demographics. Exploratory and confirmatory factor analyses confirmed a single-factor structure consistent with the original, with factor loadings above 0.320 and acceptable fit indices (CFI > 0.90, RMSEA < 0.08). Cronbach's alpha ranged from 0.72 to 0.77. Test-retest reliability was high (ICC = 0.876-0.943). The Turkish PEGS is valid and reliable, supporting child participation in goal-setting and fostering collaboration between home and school. Adaptation of the “Perceived Efficacy and Goal-Setting System (PEGS)” Scale, Assessing the Participation of Children With Physical Disabilities in the Goal-Setting Process, Into TurkishThis study tested whether the Turkish version of the Perceived Efficacy and Goal-Setting System (PEGS) is a useful and trustworthy tool for children with physical disabilities. PEGS helps children show what they can do and choose goals that are meaningful to them. We worked with 120 children aged 7 to 9 years (most with cerebral palsy, some with spina bifida), together with their parents and teachers, in three rehabilitation centers in Turkey. The forms were carefully translated and adapted to Turkish following international guidelines. The results showed that the Turkish PEGS works well: children, parents, and teachers gave consistent answers, and repeating the test after 2 weeks gave very similar results. The structure of the test was also the same as the original version. In conclusion, the Turkish PEGS is a reliable and valid tool that can help children, families, and teachers work together to set goals during rehabilitation and support children’s participation in daily life.