Benefits and Challenges of a Telehealth Eating and Mealtime Intervention for Autistic Children: Occupational Therapy Practitioners' Perspectives.

Eating and mealtime challenges are common in autistic children, yet intervention access is limited. Telehealth may provide opportunities to address this gap and increase access for underserved families. This study examined the occupational therapy practitioner's perceptions of transitioning from a caregiver-mediated, in-home eating, and mealtime intervention for autistic children to telehealth owing to COVID-19 while considering the impact on accessibility, challenges, and benefits. Family characteristics were compared between groups. Thematic analysis of semi-structured interviews explored practitioners' experiences of telehealth. Statistical findings and themes were directly compared and contrasted. The following three themes emerged: Intervention Adaptations, Challenges for Interventionists, and Benefits of Telehealth. The differences in the families' geographic location were identified. Themes and family characteristic differences supported increased intervention accessibility for the telehealth group. This study provides preliminary evidence that telehealth can increase access to specialized services. There are benefits and challenges to implementing telehealth with families and autistic children.

Meaningful Activities and Recovery (MA&R): a co-led peer occupational therapy intervention for people with psychiatric disabilities. Results from a randomized controlled trial.

BACKGROUND: Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities. AIM: To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery. METHODS: In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up. RESULTS: Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes. CONCLUSION: We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness. TRIAL REGISTRATION: The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.

Current Practice in Occupational Therapy for COVID-19 and Post-COVID-19 Conditions.

The onset of the pandemic highlighted the need for a review of rehabilitation practices to ensure coordinated, effective, and efficient services for people affected by COVID-19. This paper reports on a global survey highlighting the delivery of occupational therapy services to people with COVID-19/post-COVID-19 condition (PCC) and makes recommendations to facilitate quality service delivery for this population. An online cross-sectional descriptive survey was developed and distributed to the global occupational therapy community via member organisations and communication channels of the World Federation of Occupational Therapists to collect information for this study. The survey obtained qualitative and quantitative data from respondents who were occupational therapists or occupational therapy assistants regarding (i) demographic characteristics, (ii) work experience with persons with COVID-19 and PCC, (iii) modes of working, (iv) education and training, (iv) occupational therapy intervention provided to persons with COVID-19 and PCC, and (v) the perceived quality of the occupational therapy services provided. Findings indicate that respondents provided a range of occupational therapy interventions for people affected by COVID-19/PCC aligned with evidence-based practice guidelines. While respondents identified a strong role for occupational therapy and generally rated their services as effective, issues related to the accessibility of their services impacted quality and user satisfaction. The study highlighted the need to advocate for access to occupational therapy to facilitate engagement in desired and needed occupations for COVID-19 survivors. Other recommendations emerging from the findings include the need to develop, disseminate, and use research evidence for guiding services for people with COVID-19/PCC, create quality service standards, and ensure the availability of necessary resources and supports such as referral pathways and screening criteria, availability of staff, training, personal protective equipment, and assistive devices and technology.

Exploring Distress and Occupational Participation Among Older Canadians During the COVID-19 Pandemic.

Background. The coronavirus disease 2019 (COVID-19) pandemic disrupted daily life with corresponding implications on levels of distress. Purpose. To describe factors associated with high distress among community-dwelling older adults during the first lockdown and explore how occupational participation was managed. Methods. A mixed methods design whereby multivariate regression analysis of a survey (N = 263) identified factors associated with high distress, as per the Impact of Events of Scale-Revised (IES-R). Follow-up interviews with a sub-sample of those surveyed who reflected a range of IES-R scores were conducted (N = 32). Findings. Those with lower resilience and anxiety/depression had 6.84 and 4.09 greater odds respectively of high distress. From the interviews, the main theme, "Lost and Found," and subthemes (Interruption and Disruption; Surving, not Thriving; Moving Forward, Finding Meaning) highlighted the process and corresponding stages, including adaptive strategies, by which participants navigated changes in their occupational participation. Implications. While the results suggest that many older adults, including those with high distress, were able to manage daily life under lockdown, some experienced ongoing challenges in doing so. Future studies should focus on those who experienced or who are at-higher risk for such challenges to identify supports that mitigate adverse consequences if another event of this magnitude occurs again.

Quality of Physical Activity Participation Among Adults with Disabilities Through Pandemic Restriction.

Background. Physical activity (PA) is essential for maintaining well-being in adults with disabilities. This population experienced reduced PA during the COVID-19 pandemic; yet, the impact on quality of PA participation remains unclear. Purpose. This secondary analysis explored how pandemic restrictions impacted six experiential dimensions of quality of PA participation among adults with disabilities. Methods. An exploratory sequential mixed-methods design, including semi-structured interviews (n = 10) and self-reported surveys (n = 61), was conducted in May-2020 and February-2021. Quality of PA participation was measured using the Measure of Experiential Aspects of Participation (MeEAP). Participants included community-dwelling adults over 19 years of age (mean 59.2 ± 14.0 years) living with stroke, spinal cord injury, or other physical disabilities. Findings. Directed content analysis identified three themes related to adjusting PA participation for restrictions, motivation barriers, and valuing social support. These themes highlighted five factors, such as resilience, as potential quantitative predictors of quality of PA participation. While paired correlations with MeEAP scores were observed, these factors were not statistically predictive in multiple regression analysis (adjusted R2 = -0.14, F(10,50) = 0.92, p = .53). Implications. The interplay between Meaning, Autonomy, Engagement, and Belongingness dimensions of quality of PA participation was complex, with an emphasized role for mental health, in adults with disabilities.

Health Promotion and Wellness for All Students: School-Based Occupational Therapy as a Preventive Approach.

The coronavirus disease 2019 pandemic accelerated the impending youth mental health crisis in the United States, necessitating a comprehensive approach to providing mental health education and interventions. School-based occupational therapy practitioners' scope of practice includes wellness promotion, early detection, and evidence-based interventions for mental health challenges. Given the rise of school-based wellness programs, the growing legislation supporting the formation of such programs, and the burgeoning burden of pediatric mental health concerns, occupational therapy practitioners are uniquely positioned to create and implement interventions to support student access to the general education curriculum and can do so by using both prepandemic funding sources and pandemic response funds. This Health Policy Perspectives column is a call to action to refocus the occupational therapy practitioner's role in school settings to include providing high-quality, evidence-based preventive mental health education and interventions. In this column, we examine prevention-based occupational therapy services in Mason City Schools, Mason, Ohio, as a model of success in the execution of this vision for school-based practice. In addition, we outline the importance of expanding the role of occupational therapy practitioners in schools, which will in turn increase the visibility and relevancy of the profession and broaden its impact on mitigating the youth mental health crisis.

Pediatric Outpatient Occupational Therapy: Transitioning From In-Person Services to Telehealth.

The COVID-19 pandemic necessitated rapid adoption of telehealth for outpatient pediatric occupational therapy practice. The dose of therapy may have varied across diagnostic and geographical groups despite efforts to ensure access for all patients. The objective of the study was to describe the visit length of outpatient pediatric occupational therapy practice for three diagnostic groups at one institution both during and prior to the COVID-19 pandemic. Retrospective review of electronic health records for two time periods using both practitioner-entered and telecommunications data. Data were analyzed using descriptive statistics and generalized linear mixed model. Prior to the pandemic, average treatment length did not vary by primary diagnosis. During the pandemic, average visit length varied by primary diagnosis, with feeding disorder (FD) visits significantly shorter than cerebral palsy (CP) and autism spectrum disorder (ASD) visits. During the pandemic, visit length was associated with rurality for the whole sample and for patients with ASD and CP, but not FD. Patients with FD may have been seen for shorter durations during telehealth visits. The technology gap may affect services for patients living in rural communities.

Meaningful Activity, Psychosocial Wellbeing, and Poverty During COVID-19: A Longitudinal Study.

Background: Only a few studies have explored experiences of meaningful activity and associations with psychosocial wellbeing during COVID-19. None reflect a Canadian context or focus on persons living in poverty. Purpose: To identify experiences and associations between meaningful activity and psychosocial wellbeing for persons living in poverty during the first year of COVID-19. Method: We delivered a quantitative survey at three time points during the first year of the pandemic supplemented by qualitative interviews at Time(T) 1 and 1 year later at T3. Findings: One hundred and eight participants completed T1 surveys, and 27 participated in qualitative interviews. Several statistically significant correlations between indices of meaningful activity engagement and psychosocial wellbeing were identified across T1-T3. Meaningful activity decreased from T1-T3 [X2 (2, n = 49) = 9.110, p < .05], with a significant decline from T2-T3 (z = -3.375, p < .001). In T1 qualitative interviews, participants indicated that physical distancing exacerbated exclusion from meaningful activities early in the pandemic. At T3 (1 year later), they described how classist and ableist physical distancing policies layered additional burdens on daily life. Implications: Meaningful activity engagement and psychosocial wellbeing are closely associated and need to be accounted for in the development of pandemic policies that affect persons living in low income. Occupational therapists have a key role in pandemic recovery.

Changes in Daily Occupations Patterns, Optimism, and Positive Affect During COVID-19 Lockdown.

Background. The COVID-19 outbreak caused an initial 2-week lockdown throughout Israel. Purpose. To identify (1) changes in time-usage patterns of daily occupations during the first COVID-19 lockdown, by gender and employment status, and (2) correlations among optimism, positive affect, and daily occupations during the lockdown. Method. In a voluntary, anonymous, retrospective, online cross-sectional survey, 481 participants completed the Life Orientation Test, Positive Affect Questionnaire, and Occupational Questionnaire. Findings. During lockdown, participants spent more time in recreation, rest, and sleep regardless of their employment status, and more women than men lost their employment. Both before and during lockdown, women spent significantly higher percentage of time performing everyday tasks but reported less rest and sleep than men. Recreation was associated with positive affect. Conclusion. The COVID-19 pandemic created a temporary occupational disruption. Although people devoted their time differently, the lockdown forced people to find ways to continue engaging in their occupations.

Perception of COVID-19 Impact on Canadian Occupational Therapy Curricula: Academic and Fieldwork.

Background. Delivery of occupational therapy education programs in Canada faced significant disruptions and adaptations because of the COVID-19 pandemic. Curriculum changes were made rapidly under extreme conditions. Purpose. To document and explore changes to curricula (academic and fieldwork), instructional, and assessment methods implemented by Canadian occupational therapy programs in response to the pandemic and capture their perceived impact on student learning. Method. This convergent mixed method design study employed a cross-sectional descriptive survey followed by a member check focus group. Participant recruitment targeted Canadian occupational therapy university program directors, curriculum chairs, and fieldwork coordinators. Findings. Results highlight curriculum modifications included shifting from in-person to online delivery and re-sequencing or deferring in-person components. Fieldwork placements were similarly affected and included adoption of simulations and telepractice. Implications. The development of interpersonal "soft skills" are perceived as being the most disrupted, but the impact of student learning on actual practice is not yet known.

Losing Life's Sparkle: Experiences of Canadian Choral Musicians During the COVID-19 Pandemic.

Background. Singing in choirs, which previous research has identified as supporting wellbeing, has been restricted and altered during the COVID-19 pandemic. Purpose. The purpose of this study is to investigate and describe the experience of music-making for musicians in professional and semi-professional choirs in Canada 18-22 months into the COVID-19 pandemic. Method. Semi-structured interviews were conducted with 11 participants and analyzed using interpretive description. Findings. Four themes: (1) increased negative feelings associated with the music-making experience due to COVID-19 restrictions, (2) isolation and disconnection, (3) recognizing how music-making aids in their own mental health, the participants used music-making to help their communities cope with the pandemic, and (4) adapting in response to COVID-19 reinforced music-making's importance. Implications. Understanding how the COVID-19 pandemic has altered Canadian choral musicians' experience of music-making can help occupational therapists in supporting choral musicians return to this meaningful occupation.

Challenges and Facilitators to Telehealth Occupational Therapy for Autistic Children During COVID-19.

Pre-pandemic, telehealth occupational therapy (OT) for autistic children appeared promising, but research was limited. The pandemic provided a unique opportunity to investigate how clinics transitioned to telehealth. The purpose of this study was to examine barriers and facilitators that influenced delivery of OT services through telehealth for autistic children during the pandemic. We conducted semi-structured qualitative interviews with 13 participants (three administrators, six OTs, and four parents of autistic children) at three Los Angeles area clinics over a 7-month period. We used narrative and thematic analysis to identify four themes. We identified (a) Challenges and (b) Facilitators to Conducting Telehealth OT, including practical strategies for successful facilitation, and (c) Negative and (d) Positive Outcomes of Conducting Telehealth OT. As telehealth will likely remain a viable means of OT service delivery in the future, our findings provide insight into ways that it can be improved and sustained.

Quality improvement project to improve the standardisation and efficiency of occupational therapy initial contact and assessment within a mental health inpatient service.

Timely contact and assessment between occupational therapists (OTs) and patients are vital to understanding their needs and creating person-centred interventions. Any delays in completing contact and assessment will likely impact patients' experience and outcomes. The aim of this study was to ensure that 90% of all patients in a male and female ward received OT initial contact within two working days of admission by the end of June 2020.With the teams working in collaboration, the first change idea of increasing the initial contact in two working days was introduced and the impact assessed on two of the five wards. The Plan-Do-Study-Act cycles used for this test of change included: Standardising the initial contact, informal training for the audit tool created to measure the admission process, increasing efficiency for documenting OT contact, updated exclusion/inclusion criteria for OT initial contact, refining documentation for contact and assessment, and the impact of COVID-19 on initial contact and admission processes.Our test of change resulted in an increase in the average initial contact from 12.5% to 71.24%. Following this success, we spread the project to the three remaining wards. Feedback from OTs using the tools we introduced ensured that we made tools as user-friendly as possible. Likewise, teams who achieved particularly high compliance noted the importance of dedicating time to conduct initial contact.Our team embarked on a quality improvement project that aimed to set a standard and increase compliance for achieving this standard. Alongside this, we developed an appropriate and pragmatic measure to track our progress. While we did not achieve 90%, we observed substantial improvements made across the participating service. Using the findings from the project, we have spread this approach to other wards and believe that it could easily be transferrable as a discreet package to other mental health settings.

Occupational Therapy Practitioner Perspectives of the Role of Caregivers in Video Telehealth.

The current article examines the role of caregivers to support patient participation in video telehealth, using data from interviews with occupational therapy practitioners at Veterans Health Administration. We found that caregiver participation allowed patients who might otherwise not be able to access video telehealth to do so, with patient factors, such as low technical literacy, contributing to caregiver involvement. In addition, caregiver participation varied by type of task performed. There were also benefits and barriers to caregiver participation. This study enhances our understanding of caregivers' role enabling patients to access video telehealth, which has implications for nursing professionals. [Journal of Gerontological Nursing, 48(10), 15-20.].

The Influence of Occupational Therapy on College Students' Home Physical Exercise Behavior and Mental Health Status under the Artificial Intelligence Technology.

The core of occupational therapy is to help patients with mental illness recover their social work, give play to their self-worth, obtain financial resources, and improve their self-confidence. Occupational therapy can help patients relieve symptoms and restore social function, reduce disease recurrence, and improve the reemployment rate and the overall health level of patients. In order to deeply excavate the inner connection between the mental health status and physical exercise status of college students, the physical exercise behavior of college students during home isolation is studied. First, the "physical exercise behavior questionnaire" and "symptom self-assessment scale" were used to investigate the physical exercise behavior and mental health status of college students. Second, descriptive statistics, correlation analysis, independent sample t-test, and variance analysis were carried out on the survey results using mathematical statistics methods and big data technology. The survey results show high reliability, and the Cronbach's α coefficients were all greater than 0.9. There was a positive correlation between physical exercise methods and mental health in general, and the difference in the degree of exercise is significantly different from the mental health of students (p < 0.05). With the increase of exercise intensity, the score of "symptom self-assessment scale" first decreased and then increased, and the exercise intensity of medium and high intensity showed the best psychological state. And the correlation dimension of depression was the highest. This indicated that the students who liked family physical exercise were less likely to suffer from depression. In addition, depression was the most relevant dimension with self demand physical exercise, and interpersonal sensitivity was the most relevant dimension with social expansion physical exercise. The conclusion shows that the more active the students participate in family physical exercise, the healthier their mental state is. Occupational therapy has obvious curative effect on depression, which can improve patients' negative symptoms, their living ability, and social function. Meanwhile, analyzing data through big data technology reduces human workload and improves data processing efficiency and accuracy. The scheme proposed here provides some ideas for the application of big data technology in occupational therapy.

Applying 'cultural humility' to occupational therapy practice: a scoping review protocol.

INTRODUCTION: Cultural humility is becoming increasingly important in healthcare delivery. Recognition of power imbalances between clients and healthcare providers is critical to enhancing cross-cultural interactions in healthcare delivery. While cultural humility has been broadly examined in healthcare, knowledge gaps exist regarding its application in occupational therapy (OT) practice. This scoping review protocol aims to: (1) describe the extent and nature of the published health literature on cultural humility, including concepts, descriptions and definitions and practice recommendations, (2) map the findings from objective one to OT practice using the Canadian Practice Process Framework (CPPF), and (3) conduct a consultation exercise to confirm the CPPF mapping and generate recommendations for the practice of cultural humility in OT. METHODS AND ANALYSIS: We will search Ovid Medline, Ovid Embase, Ovid PsycINFO, Ebsco CINAHL Plus, ProQuest ASSIA, ProQuest Sociological Abstracts, ProQuest ERIC, WHO Global Index Medicus, and Web of Science databases. Published health-related literature on cultural humility will be included. There will be no restrictions on population or article type. Following deduplication on Endnote, the search results will undergo title, abstract, and full-text review by two reviewers working independently on Covidence. Extracted data will include descriptors of the article, context, population, and cultural humility. After descriptive extraction, data describing cultural humility-related content will be descriptively and interpretively analysed using an inductive thematic synthesis approach. The data will also be mapped to OT practice through deductive coding using the CPPF. Occupational therapists and clients will be consulted to further critique, interpret and validate the mapping and generate practice recommendations. ETHICS AND DISSEMINATION: Ethics approval was not required for this scoping review protocol. We will disseminate the findings, which can enhance understanding of cultural humility in OT, facilitate cross-cultural encounters between occupational therapists and clients and improve care outcomes through publications and presentations.

Gross and applied anatomy pedagogical approaches in occupational therapy education: protocol for a scoping review.

INTRODUCTION: Historically, dissection is considered the 'gold standard' for teaching foundational anatomy to student occupational therapists. However, many programmes no longer have access to gross anatomy laboratory resources, as it is considered too costly. To address this limitation, applied anatomy instructors have developed innovative novel approaches to teach gross and applied anatomy to student occupational therapists, including live/surface anatomy, medical imaging, and more recently, computer-aided instruction. The types of different anatomy pedagogical approaches used and their impact on learning outcomes in occupational therapy education are unclear. The purpose of this scoping review is to map the types of musculoskeletal gross and applied anatomy pedagogical approaches used in occupational therapy curricula. METHODS AND ANALYSIS: Using Arksey and O'Malley's (2005) six-stage scoping review framework, approximately 304 different search combinations will be searched across five electronic library databases (ie, MEDLINE, Embase, CINAHL, AMED and ERIC) from their inception to December 2021, in addition to conducting consultation exercises with relevant stakeholders. After title/abstract and full-text screening, included articles will be charted, collated and summarised. ETHICS AND DISSEMINATION: This study will not involve human or animal subjects. Therefore, research ethics approval is not required. The proposed scoping review will help the research, institutional and clinical rehabilitation communities to better understand the types of musculoskeletal gross and applied anatomy pedagogical approaches used to foster, build and promote musculoskeletal foundational knowledge in occupational therapy education. This could potentially inform the future physical medicine course curricula in occupational therapy programmes. The findings of this review will be disseminated to occupational therapy instructors, occupational therapists, researchers and organisations offering occupational therapy programmes (eg, Universities).

Research on Public Administration and Resource Allocation Based on Blockchain and Structured Occupational Therapy.

In order to explore the public administration and resource allocation based on blockchain and structured occupational therapy, this paper takes the public affairs in the prevention and control of the Corona Virus Disease 2019 (COVID-19) epidemic as an example to conduct research. On the basis of summarizing and analyzing the previous published literatures, this study expounded the research status and significance of public administration and resource allocations; elaborated the development background, current status and future challenges of blockchain, and structured occupational therapy; introduced the methods and principles of data quality collaboration model and multiparty collaboration standard management; analyzed the case background of public administration and resource allocation in the prevention and control of the COVID-19 epidemic; discussed the public administration mechanism based on blockchain and structured occupational therapy; established a resource allocation method based on blockchain and structured occupational therapy; fathomed the role of the distributed ledger established by blockchain to increase the information symmetry of public administration activities; proposed a blockchain-established special machine trust for resource allocation; and finally, anatomized the data security sharing and access control mechanism based on blockchain and structured occupational therapy. The research results show that the public administration and resource allocation in this paper can effectively realize the data integration of the whole process and all departments and show the whole data and realize the traceability of the whole process. The blockchain revolutionizes the hierarchical leadership method of traditional resource allocation, shortens the distance between superiors and subordinates, makes information dissemination more fluent, and handles things more efficiently, making resource allocation ultimately form a flatter organization structure. In the original trust system of resource allocation, the blockchain and structured occupational therapy realizes the reconstruction of the trust system by preventing information tampering, using information encryption technology, and using information traceability technology. The results of this paper provide a reference for further research on the public administration and resource allocation based on blockchain and structured occupational therapy.