A community of practice intervention to increase education-focused mental health promotion actions among interdisciplinary professionals: a qualitative study.

Introduction Through a unique, inter-sectoral and interprofessional initiative, practitioners from education, health and social service sectors were invited to participate in communities of practice, facilitated online. The focus was on building workforce capacity to address the mental health needs of children and youth. Aim This paper explores interprofessional workforce development by translating knowledge from a mental health promotion initiative developed overseas into the Aotearoa New Zealand context. Methods Over a 6-month period, practitioners engaged in an iterative, capacity-building process, where they had access to the initiative materials and resources, shared practice stories, networked, and discussed barriers and facilitators for implementation. Qualitative thematic analysis was used to interpret data. Results Members of the communities of practice engaged in storytelling and made sense of the initiative in relation to their previous knowledge and experiences: practice and thinking were validated. Mental health promotion was positioned as the responsibility of all sectors and the need for effective interprofessional collaboration was deemed essential. Furthermore, translation of the initiative into the bicultural context of Aotearoa New Zealand demanded and deserved sustained attention. Discussion This study contributes interprofessional and inter-sectoral evidence for building workforce capacity to address the mental health needs of children and youth. Further research is warranted to investigate the outcomes for the children and youth served. Interprofessional communities of practice were shown to provide a sustainable mechanism by which knowledge can be received, transformed and translated into practice.

The Comfortable Cafeteria Program for Promoting Student Participation and Enjoyment: An Outcome Study.

A mixed-methods design was used to explore the outcomes of a 6-wk, occupational therapist-led Comfortable Cafeteria program designed to build cafeteria supervisors' and students' capacity to create a positive mealtime environment so that all students can successfully participate in and enjoy a healthy meal and socialization with peers. Students whose scores were in the low and mid-range at the outset had statistically significant improvements in pretest-posttest visual analog scale ratings of participation and enjoyment. Cafeteria supervisors demonstrated statistically significant improvements in their perceptions of knowledge and skills to supervise and to encourage healthy eating. Qualitative findings add further insight into the program, suggesting that students learned prosocial values (e.g., being kind, helping others), supervisors actively encouraged positive social interaction, and occupational therapists enjoyed implementing the program and recognized positive supervisor and student changes as a result of integrating services in the cafeteria.

Building Capacity of Occupational Therapy Practitioners to Address the Mental Health Needs of Children and Youth: A Mixed-Methods Study of Knowledge Translation.

PURPOSE: We explored the meaning and outcomes of a 6-mo building capacity process designed to promote knowledge translation of a public health approach to mental health among pediatric occupational therapy practitioners participating in a Community of Practice. METHOD: A one-group (N = 117) mixed-methods design using a pretest-posttest survey and qualitative analysis of written reflections was used to explore the meaning and outcomes of the building capacity process. RESULTS: Statistically significant improvements (p < .02) in pretest-posttest scores of knowledge, beliefs, and actions related to a public health approach to mental health were found. Qualitative findings suggest that participation resulted in a renewed commitment to addressing children's mental health. CONCLUSION: The building capacity process expanded practitioner knowledge, renewed energy, and promoted confidence, resulting in change leaders empowered to articulate, advocate for, and implement practice changes reflecting occupational therapy's role in addressing children's mental health.

Systematic review of occupational therapy and mental health promotion, prevention, and intervention for children and youth.

We describe the results of a systematic review of the literature on children's mental health using a public health model consisting of three levels of mental health service: universal, targeted, and intensive. At the universal level, strong evidence exists for the effectiveness of occupation- and activity-based interventions in many areas, including programs that focus on social-emotional learning; schoolwide bullying prevention; and after-school, performing arts, and stress management activities. At the targeted level, strong evidence indicates that social and life skills programs are effective for children who are aggressive, have been rejected, and are teenage mothers. The evidence also is strong that children with intellectual impairments, developmental delays, and learning disabilities benefit from social skills programming and play, leisure, and recreational activities. Additionally, evidence of the effectiveness of social skills programs is strong for children requiring services at the intensive level (e.g., those with autism spectrum disorder, diagnosed mental illness, serious behavior disorders) to improve social behavior and self-management.

A multi-tiered approach to addressing the mental health issues surrounding obesity in children and youth.

Obesity in children and youth is a major public health concern known to have a significant impact on physical and mental health. Although traditional approaches to obesity have emphasized diet and exercise at the individual level, broader attention to the mental health consequences of obesity is crucial. Individuals who are obese live in a world where they are often less accepted resulting in social exclusion and discrimination. A public health multi-tiered approach to obesity focusing on mental health promotion, prevention, and individualized intervention is presented.

Service learning: the process of doing and becoming an occupational therapist.

ABSTRACT The purpose of this phenomenological study was to explore the perceptions and experiences of entry-level occupational therapy students participating in a service-learning experience designed to provide preventive occupation-based social skills groups to low-income urban youth attending after-school care. Reflective journals and focus groups were used to study how the students made sense of their experience. Qualitative data analysis resulted in six major themes revealing the process of professional growth over the eight-weeks. Professional reasoning progressed from mechanical procedural reasoning to flexible forms of conditioning reasoning. Findings emphasize the critical role of active participation in real-life contexts on learning how to become an occupational therapist. Study findings provide a discussion about the possibilities of preparing future occupational therapy practitioners to address society's occupational needs in emerging practice areas.

Integrating occupational therapy services in a kindergarten curriculum: a look at the outcomes.

PURPOSE: We measured fine motor and emergent literacy outcomes in kindergarteners enrolled in two integrated kindergarten classrooms. The students received fully integrated occupational therapy services. Most occupational therapy services focused on planning and teacher consultation versus direct intervention. METHOD: A one-group pretest-posttest descriptive design was used to measure occupational therapy and emergent literacy outcomes in a convenience sample of 37 kindergarten-age children with and without disabilities. Four fine motor and two emergent literacy assessments were administered at the beginning and end of the school year. Data on the amount and type of occupational therapy services were documented over 7 months. RESULTS: Children without disabilities made statistically significant changes in all areas. Children with disabilities made significant changes in two of the fine motor and three of the emergent literacy assessments. CONCLUSION: Findings demonstrated that for this sample of children, significant improvements in fine motor and emergent literacy function were made.

Meaning of occupation-based groups for low-income urban youths attending after-school care.

The purpose of this phenomenological study was to describe the meaning of occupational therapy groups focusing on occupational engagement, group process, and social-emotional learning for a purposeful sample of low-income urban youths attending after-school care. Interviews and participant observation were used to study how the children made sense of their experience. Qualitative data analysis resulted in two thematic descriptions of the experience. First, the groups were fun because of engagement in novel and challenging leisure occupations within a supportive group context. Participation in creative activities that allowed choice transformed mood--children experienced happiness and wanted more of these experiences. Second, the participants valued being able to talk about feelings and learn strategies for dealing with anger. Findings provide a glimpse into the possibilities of enhancing occupational balance by engaging children in occupations they find to be fun.

Women's work in Guatemala.

OBJECTIVE: The purpose of this paper is to describe women's work in Maya communities in the Guatemala Highlands, along with some of the trends accompanying the rapid societal change there. METHOD: Over the course of six years, observations and interviews focused on two specific groups of women. The first were traditional, home-based women, the second, teachers in a primary school. Resulting transcripts and field notes were analyzed by the researchers to identify themes related to the women's perspectives on work, the patterns of their work activities, and the importance of work in their lives. Women who had been interviewed were asked to reflect on the themes identified. RESULTS: All the women engaged in paid work activities and were responsible for obligatory tasks in the home. The traditional group preserved the tradition of weaving, but remained largely illiterate, while the emerging group was literate, but did not learn to weave. CONCLUSION: Cultural change is both positive and negative, as described by these women. It is important to understand the particular values of the culture, and to recognize that these may not conform to Western (that is to say U.S.) beliefs and practices.

Exploring the development of meaningful work for children and youth in Western contexts.

Through a literature review, this paper explores current issues influencing the transition to meaningful adult work for youth living in Western contexts. Historical and contemporary perspectives of children's work are discussed. With the current emphasis on finding meaningful work, youth face greater challenges because the transition to adult work is more complex, offering additional options without structured pathways. Today's youth are required to invest more energy into developing the skills and self-knowledge needed to make meaningful decisions about future work. Given this challenge, a number of key factors associated with the successful transition to adult work are identified and discussed including social origin, time orientation, parental influence, work experience, and participation in structured leisure pursuits. For each key factor, implications for practice are offered to help parents, teachers, youth workers, and other significant adults foster interactions and experiences that may assist today's youth in successfully transitioning to meaningful adult work.

Play in Mayan children.

OBJECTIVE: The purpose of this study was to describe the characteristics of play activities and playfulness in a group of Mayan children in southern Belize. METHOD: This qualitative study involved participant observation in the daily occupations of 20 children from five Mayan families over a 2-week period. Analysis of the field notes, using open and closed coding, revealed themes specific to customs of child rearing, play activities, and playfulness. FINDINGS: The primacy of adult work is a major cultural principle that influences Mayan children's daily occupations. Parents did not encourage play but permitted play if it did not interfere with work. Children found ways to integrate play activities and playfulness into their daily occupations. CONCLUSION: The statement, "play is a child's major occupation," may not be a universally held belief. Parental values and customs of child rearing should be considered in order to provide culturally sensitive and relevant services.