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Wasmuth S, Belkiewitz J, Miech E, Li CY, Harris A, Hernandez J, Horsford C, Smith C, Bravata D. A Hybrid Type III Analysis of a Filmed Story-Telling Intervention's Impact on Provider Stigma. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241260022. [PMID: 39086138 DOI: 10.1177/15394492241260022] [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: 08/02/2024]
Abstract
Identity Development Evolution and Sharing (IDEAS) reduces provider stigma, but few have been trained to implement IDEAS, highlighting a need for implementation strategies that facilitate uptake. We evaluated whether external facilitation successfully supported IDEAS implementation and whether IDEAS reduced provider stigma within and across sites irrespective of implementation barriers and facilitators. Key informants from 10 sites completed interviews and surveys of appropriateness, acceptability, and feasibility. Interviews were analyzed using the Consolidated Framework for Implementation Research guidelines. Intervention effectiveness was measured via paired t tests of pre-/post-quantitative data on provider stigma completed by practitioners who attended the training. Ten sites successfully implemented IDEAS via external facilitation; 58 practitioners from nine sites completed pre- and post-surveys. Data showed significant decreases in stigma after the intervention. IDEAS, supported by external facilitation, is a feasible, acceptable, and appropriate means of reducing stigma among occupational therapy practitioners.
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Affiliation(s)
| | | | | | - Chih-Ying Li
- University of Texas Medical Branch, Galveston, USA
| | - Alex Harris
- Indiana University Health, Indianapolis, USA
| | | | | | | | - Dawn Bravata
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
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Wasmuth S, Milton C, Pritchard K, Johnson KR, Wakeford L, Caldwell B, Peak K, Briggeman L, Johnson K. Narrative Theater to Examine and Mitigate Anti-Black Racism Within Occupational Therapy. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:81-89. [PMID: 35266428 PMCID: PMC9729967 DOI: 10.1177/15394492221078190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Theater has long-standing roots in social justice and holds promise for reducing racist attitudes and behaviors. Objectives of this study were to (a) collect and theatrically portray narratives from Black occupational therapy students and practitioners to a national audience and (b) examine the impact of the theatrical performance on anti-Black racism among attendees. The Identity Development Evolution and Sharing (IDEAS) model guided translation of narratives into a filmed performance. Paired t-test of pre/post administration of the Acceptance and Action Questionnaire-Stigma (AAQ-S) measured changes in stigma beliefs. Qualitative thematic analysis of an open-ended post-survey question elucidated experiences of the performance. The performance engendered significant decreases in stigma; qualitative data elucidated potential mechanisms of change. This study provides insight into experiences of anti-Black racism within occupational therapy and offers a promising means for occupational therapists to engage in anti-Black racism.
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Affiliation(s)
- Sally Wasmuth
- Indiana University, Indianapolis, USA,Sally Wasmuth, Department of Occupational Therapy, School of Health and Human Sciences, Indiana University, 1140 West Michigan Street, Coleman Hall 306, Indianapolis, IN 46202-5143, USA.
| | | | | | | | - Linn Wakeford
- The University of North Carolina at Chapel Hill, USA
| | | | - Kierra Peak
- The University of North Carolina at Chapel Hill, USA
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Wasmuth S, Belkiewitz J, Bravata D, Horsford C, Harris A, Smith C, Austin C, Miech E. Protocol for evaluating external facilitation as a strategy to nationally implement a novel stigma reduction training tool for healthcare providers. Implement Sci Commun 2022; 3:88. [PMID: 35962426 PMCID: PMC9372956 DOI: 10.1186/s43058-022-00332-z] [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: 03/10/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Identity Development Evolution and Sharing (IDEAS) is a theatre-based intervention for reducing healthcare provider stigma. IDEAS films are created by collecting narratives from people who have experienced discrimination and healthcare inequity, partnering with professional playwrights to create theatrical scripts that maintain the words of the narratives while arranging them into compelling storylines involving several interviews, and hiring professional actors to perform and record scenes. IDEAS implementation requires a moderator to establish a respectful learning environment, play the filmed performance, set ground rules for discussion, and moderate a discussion between healthcare providers who viewed the film and invited panelists who are members of the minoritized population being discussed. IDEAS’ impact on provider stigma is measured via pre/post Acceptance and Action Questionnaire – Stigma (AAQ-S) data collected from participating providers. The objectives of this manuscript are to provide narrative review of how provider stigma may lead to healthcare inequity and health disparities, describe the conceptual frameworks underpinning the IDEAS intervention, and outline methods for IDEAS implementation and implementation evaluation.
Methods
This manuscript describes a hybrid type 3 design study protocol that uses the Consolidated Framework for Implementation Research (CFIR) to evaluate external facilitation, used as an implementation strategy to expand the reach of IDEAS. CFIR is also used to assess the impact of characteristics of the intervention and implementation climate on implementation success. Implementation success is defined by intervention feasibility and acceptability as well as self-efficacy of internal facilitators. This manuscript details the protocol for collection and evaluation of implementation data alongside that of effectiveness data. The manuscript provides new information about the use of configurational analysis, which uses Boolean algebra to analyze pathways to implementation success considering each variable, within and across diverse clinical sites across the USA.
Discussion
The significance of this protocol is that it outlines important information for future hybrid type 3 designs wishing to incorporate configurational analyses and/or studies using behavioral or atypical, complex, innovative interventions. The current lack of evidence supporting occupational justice-focused interventions and the strong evidence of stigma influencing health inequities underscore the necessity for the IDEAS intervention.
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Reynolds S. State of the Journal, 2021. Am J Occup Ther 2021; 75:23094. [PMID: 34842912 DOI: 10.5014/ajot.2021.756004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The American Journal of Occupational Therapy (AJOT) retains its ranking as the top-rated occupational therapy journal in North America by maintaining its commitment to publishing high-quality research aimed at occupational therapy professionals. As the needs and scope of the profession continue to expand, AJOT will continue to serve as a resource to practitioners, academics, and administrators to help guide best practices. Communication and engagement with readers will be facilitated through the new AJOT website as well as the new AJOT: Authors and Issues series. The journal seeks to expand its scope through its website, manuscript submission platform, and new ways to engage readers.
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Affiliation(s)
- Stacey Reynolds
- Stacey Reynolds, PhD, OTR/L, FAOTA, is Editor-in-Chief, American Journal of Occupational Therapy, and Associate Professor, Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA;
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Reynolds S. State of the Journal, 2021. Am J Occup Ther 2021; 75:23082. [PMID: 34817598 DOI: 10.5014/ajot.2021.56004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The American Journal of Occupational Therapy (AJOT) retains its ranking as the top-rated occupational therapy journal in North America by maintaining its commitment to publishing high-quality research aimed at occupational therapy professionals. As the needs and scope of the profession continue to expand, AJOT will continue to serve as a resource to practitioners, academics, and administrators to help guide best practices. Communication and engagement with readers will be facilitated through the new AJOT website as well as the new AJOT: Authors and Issues series. The journal seeks to expand its scope through its website, manuscript submission platform, and new ways to engage readers.
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Affiliation(s)
- Stacey Reynolds
- Stacey Reynolds, PhD, OTR/L, FAOTA, is Editor-in-Chief, American Journal of Occupational Therapy, and Associate Professor, Department of Occupational Therapy, Virginia Commonwealth University, Richmond, VA;
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Harrison EA, Sheth AJ, Kish J, VanPuymbrouck LH, Heffron JL, Lee D, Mahaffey L. Disability Studies and Occupational Therapy: Renewing the Call for Change. Am J Occup Ther 2021; 75:12524. [PMID: 34780612 DOI: 10.5014/ajot.2021.754002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Disability studies (DS) is an interdisciplinary field grounded in a minority studies philosophy that approaches disability as a socially constructed phenomenon. The first special issue of the American Journal of Occupational Therapy on DS was published in 2005. The present issue serves as a follow-up to highlight opportunities for and examples of DS integration into occupational therapy education, research, and practice. Studies in this special issue reflect a DS approach to research that prioritizes lived experiences, critical approaches, and participatory methodologies. Reported interventions focus on changing societal barriers rather than remediating individual impairments and acknowledge instrumental activities of daily living often neglected by traditional research. Studies on educational practices in occupational therapy have found persistent issues around negative attitudes toward disability and many opportunities to better infuse disabilities studies into curricula. Revisiting DS as it applies to occupational therapy has shown that many of the issues and considerations raised in 2005 remain in the field today. Recommendations across articles in this special issue highlight that advocacy and working for broader social change are essential for occupational therapy practitioners, given ongoing occupational injustices for people with disabilities. Infusing DS ideas into occupational therapy can promote greater alignment with priorities of disability communities and spur professional change to dismantle oppressive structures and ideologies.
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Affiliation(s)
- Elizabeth A Harrison
- Elizabeth A. Harrison, OTD, OTR/L, is PhD Candidate, Department of Disability and Human Development, University of Illinois at Chicago
| | - Alisa Jordan Sheth
- Alisa Jordan Sheth, PhD, OTR/L, is Assistant Professor, School of Occupational Therapy, Pacific University, Hillsboro, OR
| | - Jacqueline Kish
- Jacqueline Kish, MS, OTR/L, is PhD Candidate, Department of Disability and Human Development, University of Illinois at Chicago
| | - Laura H VanPuymbrouck
- Laura H. VanPuymbrouck, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Rush University, Chicago, IL
| | - Jenna L Heffron
- Jenna L. Heffron, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Ithaca College, Ithaca, NY
| | - Danbi Lee
- Danbi Lee, PhD, OTD, OTR/L, is Assistant Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle;
| | - Lisa Mahaffey
- Lisa Mahaffey, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, Midwestern University, Downers Grove, IL
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