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Importance: With the increasing use of telehealth, it is imperative to synthesize the existing evidence to examine the effectiveness of telehealth interventions and inform practitioners and reimbursement entities. Objective: To examine the effectiveness of telehealth occupational therapy interventions across the lifespan, delivered either independently or as part of an interdisciplinary team. Data Sources: MEDLINE, CINAHL, SAGE, PsycInfo, Cochrane Database of Systematic Reviews, OTseeker, and OT Search and hand searches of systematic reviews, relevant journals, and known occupational therapy telehealth research. Study Selection and Data Collection: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we screened and appraised articles that included an occupational therapy intervention delivered via telehealth and that were peer reviewed, written in English, published between 2009 and 2019, and Levels 1b to 3b evidence. Findings: Twenty full-text articles (8 Level 1b, 9 Level 2b, and 3 Level 3b) met the inclusion criteria. Strong strength of evidence supports the use of telehealth approaches for occupational therapy interventions for people with neurological and pain conditions. Moderate strength of evidence supports the use of telehealth interventions to support education outcomes. Low strength of evidence was found for other outcomes for children with developmental disorders and additional conditions. Conclusions and Relevance: There is evidence to support that occupational therapy interventions delivered via telehealth are similarly effective as those delivered face-to-face, especially for neurological and pain conditions. What This Article Adds: The findings include an updated synthesis of telehealth occupational therapy interventions provided separately and with interdisciplinary health care teams. They expand occupational therapy’s scope of practice to include interventions provided across the lifespan for rehabilitation and habilitation needs and include effectiveness by conditions.

Aims: The purpose of this study was to understand the frequency of reflex retention as well as the correlation between primitive reflex activity and scholastic performance. This quantitative correl...

Knowledge of social determinants of health (SDH) can help students reduce health disparities and advance health equity and quality of life. This pilot study aimed to assess the effectiveness of Strategies for Health, an interprofessional game, in improving student knowledge regarding SDH as well as attitudes toward interprofessional collaboration when compared to or combined with didactic coursework. A mixed methods approach was utilized. Participants (N = 42) were divided into one of four groups: Control (A), gameplay (B), didactic module (C), and a combined didactic module followed by gameplay (D). Data was collected using a knowledge base test of SDH, the Interprofessional Attitudes Scale (IPAS), and qualitative feedback during gameplay and debriefing. SDH results indicated no significant differences within groups, but a combined pre-post indicated a significant improvement among Group D (p = .04). IPAS results indicated a statistically significant improvement in interprofessional attitudes of teamwork, roles, and responsibilities among Groups B and D. A combination of didactic learning and gameplay was the most effective approach to improving and maintaining SDH knowledge and attitudes toward IPE over time. These findings inform the need for interprofessional curricula that aim to improve health outcomes and advance health equity.

We investigated the internal structure, internal consistency reliability, and convergent validity of the Meaningful and Psychologically Rewarding Occupation Rating Scale (MPRORS). The American Occu...

Importance: Interventions that promote function, medication reconciliation, and skin integrity assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing health care costs. Objective: In this systematic review, we focus on three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: functional status, medication reconciliation, and skin integrity. Data Sources: We conducted a search of the literature published between 2009 and 2019 in CINAHL, Cochrane, MEDLINE, PsycINFO, OTseeker, and Scopus. We also hand searched the systematic reviews and meta-analyses in our search results for articles that met our inclusion criteria. Study Selection and Data Collection: This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings: We found 47 articles that address the three outcome areas. Regarding functional status, low strength of evidence is available for cognition and functional mobility interventions to support functional performance, moderate strength of evidence supports interventions for vision, and moderate evidence supports task-oriented and individualized interventions to promote activities of daily living (ADL) outcomes among people with neurological conditions. Strong strength of evidence supports individualized occupational therapy interventions focusing on medication adherence. Low strength of evidence was found for occupational therapy interventions to reduce pressure ulcers and promote skin integrity. Conclusion and Relevance: The evidence supports occupational therapy interventions to improve functional status in ADLs and medication management. Additional research is needed that examines the outcomes of occupational therapy interventions for other areas of function and skin integrity. What This Article Adds: We found evidence to support occupational therapy interventions that align with value-based measures in the three outcome areas of interest. The effectiveness of these interventions highlights the viability of occupational therapy as an essential profession and the worth of occupational therapy to the public, potential clients, and payers.

Importance: Interventions that prevent falls, facilitate discharge after hospitalization, and reduce hospital readmissions assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing costs. Objective: In this systematic review, we address three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: prevention and reduction of falls, facilitation of community discharge and reintegration, and prevention of hospital readmission. Data Sources: We conducted a search of the literature published between 2009 and 2019. Study Selection and Data Collection: We developed operational definitions to help us identify articles that answered the search question for each outcome area. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings: We found 53 articles that address the three outcome areas. Regarding the prevention and reduction of falls, low strength of evidence is available for interventions focusing on a single fall risk and for customized interventions addressing multiple risks. Moderate strength of evidence supports structured community fall risk prevention interventions. Low strength of evidence was found for community discharge and reintegration interventions that include physical activity and educational programming. Low to moderate strength of evidence was found for readmission prevention interventions for patients with four types of condition. Conclusion and Relevance: Several intervention themes in the three outcome areas of interest are supported by few studies or by studies with a moderate risk of bias. Additional research is needed that supports the value of occupational therapy interventions in these outcome areas. What This Article Adds: Our study provides important insights into the state of the evidence related to occupational therapy interventions to address three outcome areas of the IMPACT Act.

Accredited occupational therapy education programs are required to include telehealth technology in their curricula as outlined by the Accreditation Council for Occupational Therapy Education. An innovative Doctor of Occupational Therapy program piloted a telehealth module with first- and second-year students. Both dynamic lecture content and active learning lab exercises were created to advance student knowledge in the use of telehealth technology and to inform occupational therapy telehealth education. The teaching approaches in lecture and lab were assessed using a mixed methods approach. A quantitative pre and posttest assessment of student self-efficacy and knowledge was collected at three time points. At the final timepoint, a post survey was also completed to collect qualitative perspectives of student experiences after the lecture content and lab exercise, to further explain quantitative findings. Results indicated that the students’ knowledge significantly improved after the module. In addition, engaging in lab after lecture did add a significant improvement in self-efficacy of students’ perception of their knowledge regarding telehealth as well as confidence in their ability to use telehealth. The outcomes of this study assist and inform occupational therapy education programs in determining an effective teaching format for instruction on the use of telehealth technology in practice.

The purpose of this paper is to describe a newly developed set of guidelines for use of meaningful and psychologically rewarding occupations as therapeutic media in occupational therapy interventions for better therapy outcomes among occupational therapy service users. We begin with a report of the results from meta-analyses indicating that participation in and/or interventions based on meaningful and psychologically rewarding occupations have a positive effect on perceived health and well-being. Using these findings from meta-analysis as a foundation, we present step-by-step guidelines regarding how to evaluate a service user in order to identify personally meaningful and psychologically rewarding occupations; assess the occupational performance issues that are a priority for the service user; plan and implement evidence-based and theory-based interventions that are centered on personally meaningful and psychologically rewarding occupations; and evaluate therapeutic outcomes. Finally, we provide a case example to illustrate application of the intervention guidelines. We recommend that the guidelines be tested through clinical trials in order to determine their clinical effectiveness in typical occupational therapy practice settings.

In this chapter, authors explore interrelated and multidimensional factors that influence health, well-being, and quality of life. Teaching well-being in public health requires thoughtful planning and pedagogy that moves beyond traditional didactic instruction. Using the social ecological model of health as an organizing framework, authors describe an innovative and integrated approach to teaching that aims to create quality learning experiences. Through applying Fink’s taxonomy of significant learning to public health education across health science disciplines, instructors can guide the process of active learning through incorporating each phase of the taxonomy: learning how to learn, foundational knowledge, application, integration, caring, and human dimension constructs. Creating significant learning experiences involves engaging students in multiple ways and incorporating strategies and activities that encourage lasting change in the life of the learner. In this chapter authors discuss active learning, technology utilization, reflective dialogue, and rich discussion as methods of teaching health, quality of life, and well-being within each level of the social ecological model of health: intrapersonal, interpersonal, institutional, community, and public policy. Learners explore factors related to quality of life and well-being as authors describe how influences of context, social determinants of health, contextual factors, culture, and engagement in meaningful activities relate to health. Assignment descriptions and case examples are timely and serve to equip students to meet the demands placed upon health professionals in our modern, globally connected society. Sustainable improvements in health often include a series of complementary interventions that target multiple levels of the social ecological model. The chapter culminates with examples of direct and indirect learning experiences, in which course objectives align with Fink’s taxonomy of significant learning and related activities target each level of the social ecological model. These examples illustrate the importance of engaging health science students in innovative and interprofessional learning experiences as a way to promote and sustain health, quality of life, and well-being.

Children are occupational beings and as such are born with an innate desire to experience learning, control, and mastery. This intrinsic motivation and ability to engage in occupations or everyday life activities is what establishes purpose and fulfillment, enables physical and emotional health and well-being, organizes behavior, and improves quality of life. In childhood, these occupations include education, play and leisure, social participation, activities of daily living (ADLs) and instrumental activities of daily living (IADLs), rest and sleep, and work. Development and competence in these areas as children and youth influence success, interests, and values in adult occupations.

Date Presented 04/06/19 Collaboration during provision of low-vision services is paramount to comprehensive service delivery. Despite rural practitioners having decreased access to other members of the rehabilitation team, professional collaboration occurred similarly among OTs working in rural, micropolitan, and urban settings. Methods of collaboration, including online technology, should be explored as a means of increasing interprofessional collaboration to foster improved client outcomes. Primary Author and Speaker: Whitney Lucas Molitor Additional Authors and Speakers: Diana Feldhacker