Approaches for building community participation: A qualitative case study of Canadian food security programs

Occupational therapy's contributions to combating climate change and lifestyle diseases

BACKGROUND

The interdependence between human occupations, lifestyle diseases and climate change provides an opportunity to address them simultaneously. Occupational therapists' training in lifestyle modification and knowledge about the impact of the physical environment on daily occupations puts them in a unique position to contribute to global efforts of combating climate change and lifestyle diseases through the promotion of sustainable occupations.

AIM

To illustrate how occupational therapists can contribute to global efforts of combating climate change and lifestyle diseases by framing climate change from a personal and public health perspective.

METHOD

In this discussion paper we argue that occupational therapists can use education and lifestyle modification to support individuals in the prevention and management of lifestyle diseases and that they can help design and advocate for environments that promote sustainable occupations.

RESULT

This discussion paper highlights the contributions that occupational therapists can make to how we understand and address climate change and lifestyle diseases.

CONCLUSIONS AND SIGNIFICANCE

We argue that by framing the climate change discourse from a health perspective, occupational therapists can contribute to global efforts of combating climate change and lifestyle diseases by supporting individuals to engage in sustainable occupations and communities to facilitate this engagement.

"Justice Becomes Our Agency." Occupational Therapists in Germany Reflect on Their Practice Processes in and with Communities

Community development and population-oriented approaches are emphasized to advance the occupational therapy profession's scope of practice to meet the increasing demands created by socio-cultural-political and economic changes. This study explored the practice processes of occupational therapists in community settings outside existing health care structures in Germany. Data was gathered through five individual qualitative interviews and one focus group and analyzed using thematic analysis. Three main themes were identified: navigating parallel processes within the larger context or system; building community connections through occupation; growing professional identity. The utilization of occupational science concepts was essential to work successfully on a community level.

Promoting active transport in rural communities through infrastructural modifications: the PABEM needs assessment tool

The design of the built environment in communities influences active transport and physical activity levels of citizens. Existing instruments for quantitatively assessing built environments were developed for use in urban areas and mainly by experts. Participative assessment of built environment modifications (PABEM) is a needs assessment tool that involves citizens and community decision-makers within a structured process for identifying needed changes to promote walking and cycling in rural areas. This article describes the development of the PABEM process and evaluates its initial use in three rural towns in Austria. PABEM consists of the following seven steps: (i) qualitative interviews; (ii) expert assessment of the built environment; (iii) citizen assessment of the built environment; (iv) social media interaction; (v) household questionnaire; (vi) participatory workshop; and (vii) evaluation and scoring workshop. The main modifications identified as necessary in rural towns were the revitalization of existing walking and cycling facilities and the construction of new barrier-free and safe sidewalks. In addition cycling routes to schools, to public transport facilities and to central public places as well as cleaner and inviting seating, a car-free school environment, speed reduction in town centres, more crosswalks and improved cleanliness in public places were also deemed necessary modifications. PABEM's provisions to ensure collaborative participation of citizens and local decision-makers fostered a continuous dialogue about the requirements of the built environment, user needs and opportunities for realization throughout the whole process.

Eating Experiences of People with Disabilities: A Qualitative Study in Spain

Background: Disability causes changes in the eating process, which is central to the definition of each individual’s social and psychological spaces. Methods: This is a qualitative study based on grounded theory. Interviews were carried out in clinical hospital settings and headquarters of several disability organisations. The study included 27 individuals, aged between 18–75 years. All participants had a disability that caused a functional deficiency in the occupational aspects of the eating process. Results: The respondents’ narratives were analysed through observations made in different contexts, allowing us to describe and understand the significance attributed by the participants to their reality and experiences. Three key themes emerged from the analysis: (1) waning bodies (assumption of a diminished corporality); (2) redefinition of food-related social spaces; and (3) perceived burdensomeness, shame, and loneliness. Conclusions: Assisted feeding tends to prioritise the nutritional component of food ingestion. However, cultural, social, and contextual factors have a critical impact on an individual’s well-being and quality of life. This study stresses the importance of re-addressing intervention models affecting differently-abled people and incorporating approaches that take into account the contextual aspects of occupational therapy.