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Balog EJ, Figueiredo S, Vause-Earland T, Ragusa E, Van der Wees PJ. Nurturing the Seeds of Participation: Unveiling the Foundational Path for Understanding Aging in Place Barriers and Facilitators From the Perspective of Older Adults Using Mixed Methods and Translational Science. J Appl Gerontol 2024; 43:881-898. [PMID: 38298083 DOI: 10.1177/07334648231225336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Participation in society is a cornerstone for quality of life, active aging, and aging in place. While the majority of older adults prefer aging in place, health and financial challenges can hinder this vision. Conducted in suburban South Jersey, this study utilized mixed methods, including surveys and interviews with older adult participants. Surveys indicated that satisfaction with participation in the community is influenced by functional ability, healthcare service availability, and information access. Interviewees identified suggestions to overcome barriers (e.g., improve access to community and address ageism). Combined results provide a theory of change which suggests older adults' empowerment in community participation hinges on home living support, participation options aligning with ability and interest, and accessible information on community events. This person-centered planning approach emphasizes the importance of older adult and stakeholder participation in foundational community planning, offering translational foundational tools for evidence-based strategies to engage them in future community action plans (CAPs).
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Affiliation(s)
- Emily J Balog
- Occupational Therapy Doctorate Program, Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA
- PhD in Translational Health Sciences, Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Sabrina Figueiredo
- PhD in Translational Health Sciences, Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Tracey Vause-Earland
- Jefferson College of Rehabilitation Sciences, Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Philip J Van der Wees
- PhD in Translational Health Sciences, Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
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Tierney-Hendricks C, Schliep ME, Vallila-Rohter S. Barriers and facilitators to outcome measurement and treatment practices in aphasia rehabilitation in the USA: a mixed methods approach using the Theoretical Domains Framework. Disabil Rehabil 2023:1-16. [PMID: 38053357 DOI: 10.1080/09638288.2023.2288221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/22/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE To identify clinician-perceived barriers and facilitators to the delivery of outcome measurement and evidence-based treatment practices and integration of these practices in aphasia rehabilitation. MATERIALS AND METHODS Using a convergent mixed methods design, aphasia clinicians (n = 87) across care settings in the United States completed an online survey designed within the Theoretical Domains Framework (TDF). Participants responded to open-ended questions and rated Likert scale statements. Qualitative data were analyzed using content analysis and quantitative data were summarized using descriptive statistics. RESULTS Factors related to the TDF domain of "environmental context and resources" (priority and productivity demands; characteristics of resources) were cited as primary barriers in 70% of qualitative responses for both outcome and treatment practices and were consistent with Likert rating statements. Facilitators were associated with TDF domains of "memory, attention, decision-making" (decision-making processes), "knowledge" (awareness of evidence) and "social influences" (client and caregiver preferences). CONCLUSIONS Organizational-level factors and the misalignment of the research evidence with clinical needs are barriers to delivering evidence-based care in aphasia rehabilitation. Theoretically informed strategies such as establishing organizational infrastructure for practice change, developing clinically relevant evidence through research-practice partnerships, and implementing algorithms to support clinical decision-making can address barriers and leverage facilitators.
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Affiliation(s)
| | - Megan E Schliep
- Spaulding Rehabilitation Hospital, Boston, MA, USA
- MGH Institute of Health Professions, Boston, MA, USA
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Cocreation from Emerging Opportunities: Occupational Therapists’ Perspectives on Supporting Older Persons, in Japan. Occup Ther Int 2022; 2022:5495055. [PMID: 35936830 PMCID: PMC9334041 DOI: 10.1155/2022/5495055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/28/2022] [Accepted: 07/04/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Practices of occupational therapists, particularly those supporting older persons with physical impairments, remain overly focused on remediating impairments, and implementation of occupation-centered practices remains fraught with difficulties. In Japan, this issue exists across the continuum from acute care to rehabilitation settings and into the community. This is despite the existence of international models and frameworks that place occupation at the core of the profession. Accordingly, there is a need to better understand how occupational therapists respond to the call for occupation-centered practices across the said continuum of care with this population. The aim of this study was at exploring and understanding occupational therapists' experiences of supporting the resumption of occupations among older persons with physical impairments, in Japan. Methods Embedded in a constructivist world view, this was a qualitative focus group study. Four focus groups (two in urban areas and one each in rural and semirural areas), consisting of seven or eight occupational therapists with at least three years of relevant practice experience, convened twice to narrate and explore their support of older persons. All were participating voluntarily with confidentiality of their participation being guaranteed by the researchers. They met for a third time to verify emerging analytic results. Data were analysed using a reflective thematic analysis. Results Identified were three themes, namely, calling forth powers of occupations, imagining client's future, and cocreating plots, which we synthesized into recurring cocreations from emerging opportunities. Discussion. Supporting the resumption of occupations among older persons with physical impairments hinges on repeated processes of identifying possibilities for occupation, followed by actions to bring these (e.g., images of clients' future) into reality. Occupations' healing properties (i.e., occupations' powers) can be used to assist clients in experiencing health and well-being. The results suggest a reframing of occupational therapy practices as recurring processes of recognizing opportunities for occupation, followed by actions whereby these possibilities are turned into reality. Occupational therapy effectiveness might be enhanced when goals and methods are repeatedly and creatively aligned with the evolving plots cocreated between the client, therapist, and stakeholders.
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McQuaid L, Thomson K, Bannigan K. Case study research: Building the occupational therapy evidence base one case at a time. Scand J Occup Ther 2022; 30:435-443. [PMID: 35171068 DOI: 10.1080/11038128.2022.2039758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is growing recognition in healthcare that evidence from randomised controlled trials may not be appropriate to answer the full spectrum of practice-based questions and a more pluralistic approach is needed. AIM To consider the use of case study research in contributing to the occupational therapy evidence base. MATERIAL AND METHODS A critical discussion of the current state of evidence-based practice in occupational therapy and exploration of a viable approach to case study research is used. RESULTS Case study research can capture the context and complexity of occupational therapy practice. Cases can then be pooled to make a substantial contribution to the evidence base. CONCLUSIONS Occupational therapists should consider the use of case study research to produce practice related, meaningful research. Journal editorial boards need to be mindful of the value of high-quality case study research when considering publication priorities in occupational therapy literature. SIGNIFICANCE Highlights a changing landscape in the literature about how best to conduct research in health and social care, particularly for complex interventions and describes a pragmatic approach to case study research for occupational therapy.
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Affiliation(s)
- Leona McQuaid
- Department of Occupational Therapy Human Nutrition and Dietetics, Glasgow Caledonian University, Glasgow, Scotland
| | - Katie Thomson
- Department of Occupational Therapy Human Nutrition and Dietetics, Glasgow Caledonian University, Glasgow, Scotland
| | - Katrina Bannigan
- Department of Occupational Therapy Human Nutrition and Dietetics, Glasgow Caledonian University, Glasgow, Scotland
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Murrell JE, Pisegna JL, Juckett LA. Implementation strategies and outcomes for occupational therapy in adult stroke rehabilitation: a scoping review. Implement Sci 2021; 16:105. [PMID: 34922568 PMCID: PMC8684217 DOI: 10.1186/s13012-021-01178-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Stroke survivors often encounter occupational therapy practitioners in rehabilitation practice settings. Occupational therapy researchers have recently begun to examine the implementation strategies that promote the use of evidence-based occupational therapy practices in stroke rehabilitation; however, the heterogeneity in how occupational therapy research is reported has led to confusion about the types of implementation strategies used in occupational therapy and their association with implementation outcomes. This review presents these strategies and corresponding outcomes using uniform language and identifies the extent to which strategy selection has been guided by theories, models, and frameworks (TMFs). METHODS A scoping review protocol was developed to assess the breadth and depth of occupational therapy literature examining implementation strategies, outcomes, and TMFs in the stroke rehabilitation field. Five electronic databases and two peer-reviewed implementation science journals were searched to identify studies meeting the inclusion criteria. Two reviewers applied the inclusion parameters and consulted with a third reviewer to achieve consensus. The 73-item Expert Recommendations for Implementing Change (ERIC) implementation strategy taxonomy guided the synthesis of implementation strategies. The Implementation Outcomes Framework guided the analysis of measured outcomes. RESULTS The initial search yielded 1219 studies, and 26 were included in the final review. A total of 48 out of 73 discrete implementation strategies were described in the included studies. The most used implementation strategies were "distribute educational materials" (n = 11), "assess for readiness and identify barriers and facilitators" (n = 11), and "conduct educational outreach visits" (n = 10). "Adoption" was the most frequently measured implementation outcome, while "cost" was not measured in any included studies. Eleven studies reported findings supporting the effectiveness of their implementation strategy or strategies; eleven reported inconclusive findings, and four found that their strategies did not lead to improved implementation outcomes. In twelve studies, at least partially beneficial outcomes were reported, corresponding with researchers using TMFs to guide implementation strategies. CONCLUSIONS This scoping review synthesized implementation strategies and outcomes that have been examined in occupational therapy and stroke rehabilitation. With the growth of the stroke survivor population, the occupational therapy profession must identify effective strategies that promote the use of evidence-based practices in routine stroke care and describe those strategies, as well as associated outcomes, using uniform nomenclature. Doing so could advance the occupational therapy field's ability to draw conclusions about effective implementation strategies across diverse practice settings.
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Affiliation(s)
- J Edward Murrell
- Department of Health Services Administration, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Janell L Pisegna
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Lisa A Juckett
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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Juckett LA, Lee K, Bunger AC, Brostow DP. Implementing Nutrition Education Programs in Congregate Dining Service Settings: A Scoping Review. THE GERONTOLOGIST 2020; 62:e82-e96. [PMID: 32833007 DOI: 10.1093/geront/gnaa109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Nutrition education programs implemented in congregate dining service (CDS) settings have the potential to improve healthy eating behaviors among older adult populations. However, little is understood about the types of nutrition education programs that are implemented at CDS sites and the factors that impede or promote implementation efforts. The purpose of this scoping review was to examine the characteristics of CDS nutrition education programs, barriers and supports to program implementation, and opportunities to enhance implementation of programming. RESEARCH DESIGN AND METHODS We adopted a scoping review methodology to assess the relevant literature published January 2000 - January 2020 by accessing CINAHL, SocINDEX, MEDLINE, AgeLine, and Academic Search Complete. RESULTS We identified 18 studies that met our inclusion criteria. The majority of nutrition education programs were led by trained facilitators, included the use of interactive activities, and also incorporated written or video materials. Programs that were adapted to the needs of older participants were perceived as supports to implementation whereas participants' needs and resources (e.g., lack of resources, lower health literacy) were occasionally found to limit effective implementation of programming. DISCUSSION AND IMPLICATIONS As the older adult population continues to access CDS sites to address their health and nutritional needs, purposeful efforts are needed to examine the specific approaches that can support nutrition education program implementation. Future research is needed to assess strategies that are effective for mitigating barriers to implementing nutrition education programming in the CDS setting.
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Affiliation(s)
- Lisa A Juckett
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Kathy Lee
- School of Social Work, University of Texas at Arlington
| | | | - Diana P Brostow
- Department of Veterans Affairs, Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, Colorado
- School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora
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Juckett LA, Wengerd LR, Faieta J, Griffin CE. Evidence-Based Practice Implementation in Stroke Rehabilitation: A Scoping Review of Barriers and Facilitators. Am J Occup Ther 2020; 74:7401205050p1-7401205050p14. [PMID: 32078516 PMCID: PMC7018459 DOI: 10.5014/ajot.2020.035485] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Despite advancements in stroke rehabilitation research, occupational therapy practitioners still face challenges with implementing research into routine practice. Although the development of evidence-based practices (EBPs) is one critical step along the knowledge translation continuum for the population of people with stroke, research is also needed to identify the most effective strategies for implementing EBPs with stroke survivors who are receiving occupational therapy services. OBJECTIVE To synthesize research related to occupational therapy practitioners' implementation of EBPs in adult stroke rehabilitation. DATA SOURCES We searched four electronic databases-CINAHL, MEDLINE, PubMed, and Academic Search Complete-and the peer-reviewed journal Implementation Science to identify relevant research studies. STUDY SELECTION AND DATA COLLECTION Studies that met the following inclusion criteria were included in the scoping review: published between January 2003 and January 2018, addressed the adult stroke population, and examined the implementation of occupational therapy interventions. Data were abstracted on the basis of recommendations from the seminal review framework established by Arksey and O'Malley (2005). Thematic analysis identified themes that emerged from the included studies. FINDINGS Twenty-five articles satisfied our inclusion parameters. Our analyses yielded three overarching themes: barriers to implementation, facilitators of implementation, and implementation strategies. Implementation strategies often consisted of multimodal knowledge translation training programs. CONCLUSION AND RELEVANCE Although the stroke rehabilitation literature appears to have established the barriers to and facilitators of EBP implementation, greater attention to the identification of effective implementation strategies that promote the uptake of EBPs by occupational therapy practitioners is needed. WHAT THIS ARTICLE ADDS This article summarizes the contextual factors and effective strategies that may influence practitioners' implementation of stroke research findings in real-world practice.
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Affiliation(s)
- Lisa A Juckett
- Lisa A. Juckett, MOT, OTR/L, CHT, is Instructor, Occupational Therapy Division, The Ohio State University, Columbus;
| | - Lauren R Wengerd
- Lauren R. Wengerd, MS, OTR/L, is Lecturer, Occupational Therapy Division, The Ohio State University, Columbus
| | - Julie Faieta
- Julie Faieta, MOT, OTR/L, is Lecturer, Occupational Therapy Division, The Ohio State University, Columbus
| | - Christine E Griffin
- Christine E. Griffin, MS, OTR/L, BCPR, is Clinical Instructor, Occupational Therapy Division, The Ohio State University, Columbus
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Lombard K, Desmond L, Phelan C, Brangan J. Irish occupational therapists use of evidenced-based falls prevention programmes. IRISH JOURNAL OF OCCUPATIONAL THERAPY 2019. [DOI: 10.1108/ijot-02-2019-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland.
Design/methodology/approach
A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively.
Findings
In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland.
Originality/value
In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.
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Juckett LA, Robinson ML, Wengerd LR. Narrowing the Gap: An Implementation Science Research Agenda for the Occupational Therapy Profession. Am J Occup Ther 2019; 73:7305347010p1-7305347010p6. [PMID: 31484036 DOI: 10.5014/ajot.2019.033902] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite advancements in occupational therapy research, the widespread research-to-practice gap continues to delay how quickly evidence-based practices are implemented in real-world clinical settings. Implementing research in practice is a complex process that mandates attention from all occupational therapy stakeholders; however, researchers are uniquely positioned to help minimize the 17-yr lag between scientific discovery and the implementation of research findings into practice. Our article serves as a response to Marr's (2017) Centennial Topics article, which proposed that purposeful efforts are needed to advocate for implementation research in occupational therapy. We provide an implementation science research agenda informed by concepts from the implementation science literature and suggest how researchers can structure methodologies to examine implementation-related outcomes and strategies. We provide explanations of gold-standard implementation outcomes and offer several recommendations for how researchers can report and disseminate implementation research findings to occupational therapy stakeholders.
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Affiliation(s)
- Lisa A Juckett
- Lisa A. Juckett, MOT, OTR/L, CHT, is Clinical Instructor, Occupational Therapy Division, The Ohio State University, Columbus;
| | - Monica L Robinson
- Monica L. Robinson, OTD, OT/L, FAOTA, is Associate Professor-Clinical, Occupational Therapy Division, The Ohio State University, Columbus
| | - Lauren R Wengerd
- Lauren R. Wengerd, MS, OTR/L, is Lecturer, Occupational Therapy Division, The Ohio State University, Columbus
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Liu CJC. Functional Ability in the Changing Demographic Landscape: Evidence and Opportunities for Occupational Therapy. Am J Occup Ther 2019; 72:7204170010p1-7204170010p5. [PMID: 29953824 DOI: 10.5014/ajot.2018.724002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The growing number of older adults is changing the demographic landscape. Occupational therapy can better serve the older adult population by helping them maintain their functional ability, which is the ability to engage in occupations. This special issue includes both studies of interventions to evaluate and support functional ability in community-dwelling older adults and systematic reviews of such studies. This editorial highlights the six systematic reviews, which were completed in collaboration with the American Occupational Therapy Association's Evidence-Based Practice Project. These reviews compile evidence for the effectiveness of interventions within the scope of occupational therapy practice to promote occupational performance in community-dwelling older adults. The distinct value of occupational therapy in supporting the functional ability of community-dwelling older adults with stable or declining health is discussed using the World Health Organization's framework for healthy aging.
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Affiliation(s)
- Chiung-Ju Cj Liu
- Chiung-ju (CJ) Liu, PhD, OTR, FGSA, is Associate Professor, Indiana University Department of Occupational Therapy, School of Health and Human Sciences, Indiana University, Indianapolis;
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