Summer Akbar, Susan MacDermott, and Karen Park
Consistent caregiver involvement in therapy services is a necessity for an increase in therapeutic outcomes for children and caregiver confidence. A caregiver’s cultural background plays a significant role in choices made on behalf of their child and the amount of caregiver engagement that is involved in their child’s therapy services. When cultural factors and needs are unacknowledged or unmet by therapists, this can lead to a decrease in motivation for caregivers and their children to participate in therapeutic interventions. Due to the essential need for a caregiver to be involved in their child’s pediatric therapy services, pediatric OTs must learn to deliver services effectively, while practicing cultural competency in the caregiver-therapist relationship. There is a current lack of research on identification of specific cultural factors that impact family-centered care, further causing health disparities and cultural inequity in pediatric therapy.
This capstone is aimed to identify which cultural factors impact family-centered care, specifically pediatric occupational therapist’s therapeutic use of self and caregiver engagement in pediatric occupational therapy services. Results on how current family-centered care is carried out and areas where therapists and caregivers can improve to build a healthy caregiver-therapist relationship were found.
Culture Change for Occupational Therapists on Safe Patient Handling and Mobility (SPHM): Advocacy for SPHM Policies for a National Organization.
Guldana Alizakhova, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
Safe patient handling and mobility is an ergonomic approach consisting of policies, programs, and equipment to reduce WMSD and facilitate a culture of safety among patients and healthcare practitioners. Due to occupational therapy’s established role in ergonomics, practitioners are skilled to utilize SPHM to provide evaluative, consultative, preventative, and therapeutic services to patients while preventing WMSDs to healthcare practitioners. Despite OT’s contributions to SPHM, occupational therapy practitioners are not recognized as leaders in SPHM. To address this problem, in the Spring 2021 meeting, the AOTA Representative Assembly was presented a request for action by a taskforce that also recognized this problem. They moved that a position statement a be written and made available for members and external audiences. A position statement was created to present the current position of a national organization, AOTA, on occupation therapy’s role in SPHM. In this statement SPHM is defined, and the components of SPHM are presented. SPHM on an individual, group, and organizational level will be applied to occupational therapy. The current state and national legislation of SPHM was discussed. As well as a look into inclusion of SPHM into the curriculum, and implications for occupational therapy.
Sadé Barnswell, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
Unique challenges and differences surround the population of African American crossover youth and how they successfully transition into adulthood once aged out of foster care as compared to same-aged peers (Kim et al., 2019). The problem is that African American crossover youth aging out of the foster care system, are not receiving occupation-based transitional services focusing on IADLs required for adulthood independence resulting in increased prevalence of homelessness (Armstrong-Heimsoth et al., 2020; Flores et al., 2018; Kelly, 2020; Paul-Ward & Lambdin-Pattavina, 2016; Pérez et al., 2019). The purpose of this program development type project is to develop and implement an occupation-based transitional program for African American crossover youth aging out of the foster care system focused on IADLs required for adulthood independence, decreasing the prevalence of homelessness. An occupation-based program is essential in providing more programs for youth during those transitional ages to increase self-sufficiency into adulthood. The occupation-based program focusing on IADLs and health management, #Adulting, was successful based on the positive feedback from each activity.
Maryam Binaei and Susan MacDermott
Despite the presence and popularity of dating cultures in the media, the occupation of dating is highly complex and still prematurely understood through research. Recent research has found autistic adults to experience increased variety in their gender and sexual identity as well as challenges to achieving dating goals. A doctoral capstone project was completed to explore current approaches to resources and programs to address their dating needs, as well as understand their experiences in more depth. A needs assessment was carried out through an occupational therapist working with autistic adults in a day program. The need’s assessment revealed that autistic adults would benefit from occupation-based interventions where they are able to safely investigate and discuss their dating-related needs and goals and receive guidance on social and cultural subtleties and the unspoken rules of dating. Based on literature findings and the needs assessment results, a program manuscript was developed to serve as a foundational protocol for an occupational therapist to facilitate dating-related, self-exploration, and skill development. The program includes 11 modules that explore various aspects related to the occupation of dating. A website for the private and personal use of occupational therapy-related activities was additionally created as a resource for autistic adults to utilize OT-based resources independently.
Taylor Borin, Susan MacDermott, and Karen Park
Background: The purpose of this project is to advocate for occupational therapy’s presence in chronic pain programs. In a chronic pain setting occupational therapy currently focuses on enabling individuals to achieve satisfying performance in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) despite pain and fatigue (Hill, 2016). Treatment interventions focus on activity management, problem solving, activity adaptation, planning/pacing, stress management, relaxation training, and coping skills training (Hill, 2016). Occupational therapy can provide individuals with chronic pain a more diverse and unique perspective on pain management. They can utilize their consideration of psychosocial factors and occupation focused background, to engage clients in more meaningful therapeutic sessions.
Objectives: The objectives of this project are to complete a needs assessment to identify where OT is currently not represented in this setting, identify the needs of those living with chronic pain and how OT can fulfill those needs, assess current chronic pain programs with and without OT, advocate for OT in chronic pain, and learn more about the ways in which occupational therapists contribute to the interdisciplinary pain team.
Methods: The methods in this study include a literature review of chronic pain conditions, involvement in chronic pain affiliated groups, learning more about advocacy and its components, completing a needs assessment for individuals living with chronic pain, interviewing both patients and healthcare professionals about their experience with or treating chronic pain, site observations, and involvement in advocacy groups and collaborative efforts.
Results: After the above methods were complete numerous themes appeared that highlighted the needs of individuals living with chronic pain and the systematic adjustments that need to be made in order to provide better care to these individuals. These themes included, a lack of occupation-based interventions, a limited number of holistic and client-centered pain management programs, barriers to occupational performance, limitations or loss of independence, limited knowledge of chronic pain interventions by healthcare professionals, and improvement in patient/caregiver education, with a focus on pain neuroscience.
Conclusion: These findings support occupational therapy’s distinct role in chronic pain management and demonstrate the need for continued advocacy in this setting. Through advocacy efforts, the increased use of the interdisciplinary collaboration framework, and updating current OT curriculum to include pain and pain management, occupational therapy is sure to increase its presence in the chronic pain setting.
Victoria Bui, Karen Park, Susan MacDermott, and Becki Cohill
The focus of this project was to enhance currently existing foster youth programming to promote engagement and participation in independent living skills (ILS) development. Research shows that although such programming exists to support foster youth transitioning into independent living, services are underutilized and may greatly benefit from a more personalized and holistic approach to engage participants. The process of this project included conduction of a needs assessment to understand site-specific areas of concern impacting occupational performance. Findings from the needs assessment informed development of a manual containing occupational therapy strategies for program staff to address concerns and promote engagement and participation. In addition to program enhancement recommendations, the manual also provided education on occupational therapy’s scope of practice and role in supporting foster youth and childhood trauma. In doing so, the aim of the project was also to advocate for the inclusion of occupational therapy in community-based practice supporting foster youth’s transition into adulthood and independent living.
Occupational Therapy’s Role in Emergency and Disaster Preparation for the Population of Physically Disabled Individuals
Aldin Cerillo, Susan MacDermott, and Karen Park
Emergencies and disasters may occur anywhere in the world, with no population immune to their effects. Vulnerable populations, including individuals with physical disabilities, are more at risk and lose the ability to maintain crucial occupations in the event of an emergency or disaster (Rutkow et al., 2015). Currently occupational therapy services have a strong presence in post emergency situations, in a recovery capacity. Despite Safety and Emergency Maintenance being an Instrumental Activity of Daily Living, a gap exists in the literature regarding what occupational therapists may do when engaging in emergency and disaster preparation with individuals who have a physical disability.
The purpose of this capstone was to expand the literature of occupational therapy’s involvement in emergency preparation with the population of individuals with a physical disability. To gain a holistic end product a needs assessment, which included observations and informal interviews, was used to support the findings of an Internal Review Board approved research survey given to occupational therapists. The results produced educational material to help guide occupational therapists when participating in emergency preparation with individuals with a physical disability.
Michelle Chavez and Karen Park
Background: The transition of moving to an assisted living facility as an older adult can be accompanied by many physical and psychological challenges affecting adjustment to such a facility. Occupational therapists assist clients as they prepare for and cope with major life transitions, however this role is most often seen in childhood and early adulthood transitions. Occupational therapists are skilled at facilitating the re-establishment of roles, habits, routines, and rituals and are knowledgeable in how the environment serves as a major influence on this. Because of this, it would be ideal for occupational therapists to have a role in facilitating older adult transitions into assisted living facilities.
Purpose: The purpose of this project was to ease the transition into assisted living for older adults through staff training and education. The intent of these trainings was to decrease negative outcomes post transition into ALFs. The purpose was also to advocate for a role for occupational therapists in this transition process.
Methods: A needs assessment was conducted to determine the specific needs of one assisted living facility using interviews and observations. From this assessment themes were developed using a SWOT analysis to inform the creation of a staff training program and to identify specific roles for an occupational therapist in this transition.
Results: It was revealed that there were deficits in staff knowledge in areas such as transition processes and influences, cognition strategies and approaches, caregiver burnout and compassion fatigue and its influence on transition, and how to facilitate stress management strategies. Because of this, a staff educational training program was created to address each of these areas as well as three educational handouts as educational resources for new residents and families beginning the transition process.
Madison Coker Cox, Becki Cohill, and Karen Park
Background: Cerebrovascular Accident (CVA), or stroke, is a leading cause of death and a major source of disability in the United States (Centers for Disease Control and Prevention [CDC], 2017). Stroke is classically characterized as a neurological deficit attributed to an acute focal injury of the central nervous system (CNS) by a vascular cause de (Sacco, et al., 2013). Vascular causes include cerebral infarction, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). and is a major cause of disability and death worldwide (Sacco, et al., 2013). Stroke and transient ischemic attack (TIA) patients are at a high risk for a subsequent event. Each year, 15 million people worldwide will have a stroke. In America, the number of people who will have a stroke this year is approximately 795,000. Of that large number, 25% of stroke patients will have a secondary stroke within 5 years (Flach, 2020). A high number of secondary stroke events presents a need to develop interventions and strategies to decrease the prevalence.
Purpose: The purpose of the capstone project is to define the role of occupational therapy in secondary stroke prevention. Occupational therapists are an integral part of the rehabilitation process and can offer a holistic approach to prevent second strokes. Identifying the role of occupational therapy within secondary stroke prevention will help to bring an occupation-based approach to secondary stroke prevention to increase participant’s volition and create/modify habits. This will foster a healthier lifestyle and ultimately reduce the likelihood of a second stroke. Awareness of the role of an occupational therapist will also help to educate the interdisciplinary team working within the stroke care continuum. This paper will also help advocate for the role of occupational therapy in secondary stroke prevention by clearly defining the role.
Methods and Results: Qualitative data was obtained through a needs assessment that included interviews, observations and survey completions of 15 stroke patients and 20 occupational therapy practitioners over the course of 12 weeks. The results from the needs assessment, along with the thorough literature review allowed the student investigator to define the role of occupational therapy in secondary stroke prevention.
Conclusion: The qualitative study identifies the unique role of occupational therapy within secondary stroke prevention. Occupational therapy practitioners have the expertise to provide stroke patients with client-centered education, health promotion, self-care skills, fine and gross motor skills, functional mobility, core strength, sensory processing, visual-motor skills, praxis, range of motion, strength, cognition, behavioral health and more. All of these occupation-based interventions work to reduce the likelihood of a secondary stroke event. Advocacy for occupational therapy in secondary stroke prevention is needed, as there is limited literature outlining the role and expertise. Occupational therapy has an impactful and unique role in secondary stroke prevention.
Luke Drohan and Susan MacDermott
This capstone outlines a jobs training program for transition-aged youth (TAY), ages 18 – 25, currently residing at Urban Street Angels, a transitional housing facility for youth experiencing homelessness located in San Diego, California. The purpose of this project was to incorporate occupational therapy services into the site’s dormant social enterprise program, 8West. 8West produces a line of artisanal hand soaps created in-house by the youth living at Urban Street Angels. Through experiential and didactic learning, youth developed integral skills in customer service, communication, sales, marketing, professionalism, and production. The project addressed an unmet need for job skills training and development for TAY youth experiencing homelessness.
Understanding OT’s Role in Fall Prevention and Analyzing the Perceived Barriers from Nurses and Occupational Therapists in an Inpatient Setting
Kyle B. Esguerra, Becki Cohill, and Susan MacDermott
The aim of this project was to analyze current fall prevention strategies, work and environmental-related barriers, and OT’s role in fall prevention in a hospital setting. Two online surveys consisting of quantitative questions (multiple-choice, select-all-that-apply, and Likert scale) with the option for open-ended answers were given to OT practitioners and nurses with inpatient experience. A total of 341 OT practitioners and 21 nurses completed the survey. The results were transferred to a password-protected Microsoft Excel document in preparation for analysis. Data analysis derived several themes including lack of resources, lack of training, inter-professional collaboration, workload, work culture, cognitive and physical deficits, and OT's involvement with fall prevention. An informative handout was created to educate nurses, OT practitioners, and hospital managers on the collected survey data and current fall prevention strategies used in a hospital setting.
An Occupation-Based Program for Formerly Incarcerated Youth and Staff in an Employment Re-integration Program
Heather Fierros, Angela Blackwell, and Leslie Khan-Farooqi
One of the most vulnerable and growing populations within the United States (U.S.) are youth involved in the juvenile justice system. Each day, approximately 60,000 youth are currently incarcerated in the U.S., signifying a necessary demand for community re-entry success. Having been incarcerated makes it more challenging for youth to attend school, obtain a license, find public housing, and attain public benefits. Furthermore, because of the effects following being a part of the juvenile justice system, the youth exemplify a lack of social interaction skills, hindered relationship patterns, altered values and beliefs. These underdeveloped skills and patterns interfere with the youth's occupational participation as they re-integrate into their communities. As such, this paper elaborates the creation of a doctoral capstone project to address this population's needs. This capstone project aimed to create an occupation-based program geared towards community reintegration to address the youth's underdeveloped skills and patterns to improve their participation in occupations. The methods of this program included 5 phases the strengths and needs assessment phase, program development phase, program implementation phase, program evaluation phase, sustainability and partnership phase. During the 14-week capstone experience, a self-regulation program to facilitate the youth and staff's occupational performance was developed at an employment reintegration center. The results are intended to highlight the role of occupational therapy in this emerging practice setting.
Crystal Garcia, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
There are an estimated 11 million individuals who identify as LGBTQ+ in the United States (Rosendale et al., 2019). With this number steadily increasing, it is important that occupational therapists continue to become culturally competent and educated on different strategies to transform the way individuals who identify as LGBTQ+ are given and receive treatment. The problem is that there is a gap in the literature supporting occupational therapist cultural competence to integrate occupational roles of the LGBTQ+ population into their evaluation and intervention. Without culturally competent educational opportunities, the health care system is inadequately prepared to provide responsive health care (Singer, 2015).
The purpose of this quantitative research type capstone project will be to analyze the evaluation and intervention strategies occupational therapists can use to better serve the LGBTQ+ population. This paper supports the beneficial role occupational therapy has in addressing the needs of the LGBTQ+ population. The author believes that occupational therapists have the expertise and competence to improve OT services in the LGBTQ+ population and play a big role in the quality of life of individuals who identify as LGBTQ+.
Hannah Hardeman, Steven M. Gerardi, and Emily Frank
Informal (family) caregivers providing care to loved ones experiencing symptoms of dementia and Alzheimer’s Disease navigate multiple challenges. Caregivers observe and respond to changes in their loved ones related to physical, emotional and social skills. While providing care to their loved ones, caregivers must be aware of their own needs and the importance of maintaining a balance between the responsibilities of being a caregiver and the responsibilities in other areas of their life. Maintenance of positive emotional and physical health is crucial to providing effective and safe care. Identification of methods to promote the positive health of informal caregivers becomes increasingly important as their loved one demonstrates progression towards the next stage of dementia, changing the amount and type of care required. Each individual caregiver has different needs, routines, values and responsibilities which require a personalized approach and adoption of different coping mechanisms. Identifying individual goals, challenges and interests allows for educational programs, such as “Providing Care to People with Dementia: An Educational Workshop”, to be tailored and modified to fit the need for caregiver education within multiple populations and settings. Inclusion of interactive components and peer support is also beneficial to the learning process and implementation in a caregivers’ daily life. Acknowledgement of the amount of care being provided and experience level of each caregiver ensures that the proper information and guidance is being provided with the goal of increasing the quality of life for both the caregiver and individual receiving care.
Rajaé Jones and Susan MacDermott
The first portion of this project involved conducting original research to answer the question: What is the current knowledge, attitudes, and application of haircare (grooming & styling) as an intervention in occupational therapy? There is currently a lack in occupational therapy-based literature that addresses the occupation.
The dissimilarities amongst client and the plethora of occupations they engage in are multidimensional. Values attached to occupations often depend on cultural and sociopolitical factors (Wilcock & Townsend, 2019). OTs are currently lacking knowledge regarding the cultural importance of hairstyling within different communities and the impact on occupational identity.
Most people outside of the Black community have little to no education about Black hair. At present, there are no educational programs that inform OTs of the needs of Black hair. The purpose of this project was to develop an educational program for OTs on the cultural importance of hairstyling for women within the Black community and the effects it plays on their occupational identity and ultimately occupational performance throughout their different life stages. Data gained from the first portion of the capstone experience was used to inform the creation the educational course. The program aimed to provide education to assist practitioners in better providing client-centered interventions for Black women regarding haircare.
A Quantitative Exploration of Relationships Between Severity of Infant Congenital Muscular Torticollis and Caregiver Understanding of Positioning and Handling During Occupations of Infancy
Dalton J. Krencik, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
Congenital muscular torticollis (CMT) is a musculoskeletal disorder typically presenting in newborns/infants that is characterized by unilateral shortening and increased tone in the upper cervical muscle called the sternocleidomastoid. (Hardgrib, 2017) This increased tone and shortening of the musculature causes the infant to present in a higher degree of lateral flexion on the ipsilateral side, and higher degree of cervical rotation on the contralateral side. (Ellwood et al., 2020) Infants participate in occupations with their caregivers throughout daily routines, and the various impairments caused by CMT can cause an effect on occupational performance and participation of the infant. The problem is there is a lack of information and statistics on caregivers’ self-rating of their understanding on infant positioning and handling during occupations of infancy based on the severity of infant CMT.
The purpose of this quantitative research type capstone project is to collect and analyze data on caregivers’ self-rating of their understanding on infant positioning and handling during occupations based on the severity of infant CMT. The researcher created a survey including questions on rating of understanding of positioning and handling techniques and posted the link to the survey to 3 Facebook support groups for the population. It was found that there was no statistically significant relationship between severity of CMT and mean self-rating responses of caregivers of infants with CMT in regard to play and rest/sleep. There was a statistically significant relationship between Mild CMT and Moderate CMT caregivers in regard to feeding, with mild CMT scoring significantly higher. The research also found that among the 3 severities, self-rating scores were relatively low across all occupations.
Exploring Occupational Therapy’s Role in Supporting Health and Wellness in the Transition to Motherhood
Katelynn A. Lillibridge, Karen Park, and Susan MacDermott
The transition to motherhood [matrescence] is a time of major life changes. All aspects of a new mother’s life are impacted during matrescence as she assumes her new role, identity, responsibilities, and learns the occupational skills of mothering. During this time, health, wellness, and occupational balance may all be impacted. This is a sensitive time for mothers with potential implications for both short and long-term health. Using an occupation-based approach can be a way to provide comprehensive support and care to mothers during this period to promote health and wellness, enhance occupational engagement, and support meaningful co-occupations. Currently there is a lack of comprehensive occupational therapy programs to support new mothers and maternal wellness.
The purpose of this capstone project was to assess the current needs of the new mother population and develop a program to support maternal health and wellness. A needs assessment was conducted at the Child Development Institute [CDI]. The survey and interview questions were developed from extensive literature review on current publications in maternal health. The assessment included qualitative and quantitative data that was collected through online surveys and phone interviews. There were 60 survey responses and 11 completed interviews included in the analysis. The results identified needed supports in preparing for motherhood and postpartum, challenges to routines, roles, and responsibilities, self-care, mental health, physical health, and social supports. Themes were identified from the assessment including perceptions of the COVID-19 Pandemic impacts on motherhood and social support.
This data was used to enhance a current program already in place at CDI, [CDI’s CALM Baby class: content was provided on establishing routines and self-care] and to propose a new maternal wellness program. The program consisted of 5 parts: The fourth trimester recovery and mother-baby bonding, social supports, mental health, physical health, and establishing routines and self-care habits. The program was proposed and presented to the occupational therapy staff at CDI with the following program outcomes: the presentation increased knowledge base, information would be useful in practice, was presented to be understandable to professionals and the public, supporting materials reinforced the program content. The outcomes suggest the program has the potential to be a successful addition to practice for maternal healthcare and provide support of occupational therapy’s value to maternal health.
Lizbeth Mapa, Karen Park, Susan MacDermott, and Becki Cohill
Background: Food insecurity, or the “limited or uncertain availability of nutritionally adequate, safe foods, or inability to acquire personally acceptable food in socially acceptable ways,” is becoming a prevalent problem. College students are one of the susceptible groups to food insecurity, impacting many aspects of a student’s daily life. At present, there is limited OT-based programming that addresses the multiple internal and external factors of food insecurity in college students.
Purpose: The purpose of this capstone project was to develop a life skills program for college students experiencing food insecurity. The program aimed to address internal and external factors of food insecurity, such as money management, meal planning, and opportunities and knowledge of resources in the community. The theoretical frameworks used to guide the development and implementation of the program were the Model of Human Occupation and Person-Environment-Occupation model.
Methods: A survey using a combined qualitative and quantitative approach and semi-structured interviews were completed to determine the needs of students at CBD College in Los Angeles, CA. This program was developed to focus on helping students manage food insecurity using life skills. The program was a 5-week program that addressed one topic a session: time management, nutrition/healthy eating, budgeting/money management, meal planning and preparation, and stress management. Outcomes were measured with pre and post knowledge checks for each session/topic, a post-program survey, and a student satisfaction survey. Overall, students were very satisfied with the program and demonstrated improved knowledge, ability, or confidence in each of the life skills discussed.
Results: The results of this program indicate that the field of occupational therapy can contribute to supporting this population. Occupational therapists have a role in creating and implementing a life skills program to assist college students experiencing food insecurity. The sessions of the program should cater and address the needs of the students.
Cole Milkovich and Susan MacDermott
The "Hero’s Journey" is a powerful narrative therapy tool that uses the hero metaphor to help clients reframe their life circumstances (Robertson & Lawrence, 2015; Williams, 2017). However, this concept has only been utilized in the department of psychology. Occupational therapists utilize narrative reasoning to guide client-heroes through a rehabilitative rite of passage through the collaboration (Kelly, 2007). As mentors, clinicians assist client-heroes to create their stories that will be acted out to reflect their identity. Therefore, the therapeutic process aims to empower the client and enact a real positive storyline through meaningful occupation (Clark, 1993; Mattingly, 1998).
The challenge then, was to address the similarities between the "Hero’s Journey" and set forth to determine if this concept could be utilized within the scope of occupational therapy practice. The Path: Kairos pilot project was tested at a high school setting helping at-risk youth enhance their resiliency and occupational therapy.
Exploring the Role of Occupational Therapy in the Development of Behavior Management Programs for Elementary School Teachers and Staff
Lauran Minark, Becki Cohill, and Karen Park
Background: Behavior, how one acts, influences occupation, the things one needs and wants to do. When a student struggles with the ability to regulate their behavior and actions, they are more likely to exhibit behaviors in the classroom that negatively impact their overall ability to participate in academic learning in the classroom (Walls & Rauner, 2015). Examples of these student behaviors include: Eloping from the classroom, yelling, tantrums, task refusal, physical and verbal aggression, standing on furniture, throwing materials, etc. Dealing with difficult student behaviors is difficult. This can impact a teacher’s ability to perform their responsibilities required of their work-related occupations. The literature has reported a decrease in elementary teacher and staff’s overall job-satisfaction, sense of confidence/competence, and overall motivation in relation to working with students who these inappropriate or unsafe behaviors on a regular basis. This had led to a recent increase in school staff feelings of “burnout” and higher rates of leaving the career field altogether (Brouwers and Tomic, 2000). Occupational therapists work with students in elementary schools but there is little evidence in the literature to support the role of occupational therapy (OT) in behavior management program development schools (AOTA, 2014). It should be noted that any issues observed in this project were likely exaggerated by the effects of the global COVID-19 pandemic.
Purpose: The purpose of this project is to establish OT role in staff program development and increase staff and student occupational performance/participation in school-based occupations with the implementation of a behavior management skills program for staff use at Park Village Elementary School.
Methods: The needs assessment that informed the development of this pilot program was created with a Mixed-Method Approach. The needs assessment included informal classroom observations, an active classroom checklist, and an online-survey adapted from a survey used by Martin et al. (1999). Data was analyzed using coding for descriptive data and numerical data was collected and interpreted using the online platform Survey Monkey. The goal was to evaluate current behavior management methods used in the classroom as well as staff perception of their own abilities and confidence in behavior management with students in the classroom who require behavioral intervention. 11 staff members completed the online survey, 10 classrooms were observed informally, and 5 classrooms were observed using the active classroom checklist.
Preliminary Results: It was determined that there was a need for a pilot program to be developed to address the finding of the survey, observations, and interviews. It was determined that there was a need for further information and education to be provided to staff in relation to effective behavior strategies. Results of the pilot program show that it was effective in providing staff with information and resources on behavior management that met the needs of the staff at this school.
Discussion: Occupational therapists have a role in program development in beyond the typical role in the school setting. This study showed the importance of program development in for staff to increase occupational participation for both staff and students. A future program can be developed based on the success of the pilot program to deliver to the entire school staff population.
Rachel Morgan and Steven M. Gerardi
A spinal cord injury (SCI) has a serious impact on an individual’s participation in everyday life activities, leading to a high risk of a sedentary life-style. There is a paucity of research pertaining to adaptive sport participation post-injury and the role of occupational therapy (OT). Additionally, there are limited resources available that inform people with SCI on the benefits of adapted sports or where to go to engage in them. As such, this paper describes the development of a doctoral capstone project to address this need. The purpose of this capstone project was to create an educational web page that will overcome the barriers to sport participation for people in wheelchairs, by providing benefits and links to sport organizations to promote participation.The methods that were used to conduct this capstone project were survey’s, checklists, interviews, observation and a literature review to create an online educational resource. Over a 16-week capstone experience, a 10-section website was developed informed by the literature and input from key stakeholders. OT practitioners and the SCI population will benefit from the results of this capstone project.The availability of the created online resources will serve as a resource to clinicians to promote engagement in adaptive sports among their clients with SCIs. Additionally, the website will inform people with SCIs of the availability of adaptive sports for people with SCIs.
Exploring a Piloted Occupational Therapy Toolkit for Military Children and Youth in Addressing Occupational Performance
Mirely Murcio, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
In the United States (U.S.) there are more family members than military personal in the Department of Defense force with 62.8% of the 2,619,788 family members are children. Research indicates that children of active-duty service members experience unique challenges compared to same age peers due to military life and culture that create occupational disruptions. Research has shown that evidenced based interventions and assessments are needed to support the resilience of military connected children and youth to support their overall health and mental health resulting from the effects of parental deployment and military stressors.
The problem is that despite growing literature there is not an evidence-informed assessment for occupational therapists to utilize for military connected children and youth who face these social, academic, psychological, and behavioral health problems secondary to parental military service. As a result, military connected children and youth’s occupational performance may be affected, including social participation and academic roles.
The purpose of this capstone project was to explore the feasibility of an evidence-based screening tool that can be used by occupational therapists to screen for occupational performance deficits and address mental health concerns in military connected children and youth.
This qualitative study contributes to the literature of military connected children and youth and of occupational therapists in addressing mental health.
Kristen A. Ollison, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
Schools are the third largest employer of occupational therapists (OTs) in the United States (U.S. Bureau of Labor Statistics, 2021). Occupational Therapists have the distinctive ability to observe the child in their natural context of the school, a place where children participate in a variety of activities (Benson et al., 2015). The problem is that there continues to be discrepancies in the understanding and utilization of OT services in the school setting that affect the perceptions of both OTs and teachers regarding the OT role in school, and general service provision (Bolton & Plattner, 2020; Seruya & Garfinkel, 2020; Truong & Hodgetts, 2017).
The purpose of this capstone project was to analyze perceptions of both OTs and teachers regarding the OT role in school, and service provision. An interview was conducted to gather these perceptions. Participants consisted of 20 OTs. It was concluded that the roles and responsibilities are understood by school-based Occupational Therapists, but there is a lack of knowledge by some teachers on the scope of school-based OT practice. There is a need for improved OT service delivery in the school system as well as a need for more school-based OT. A broadening of the realm of school-based OT practice to include mental health and social emotional functioning would also be of benefit to the practice. In addition, there is a need for improved education of school-based OT provided to OT students while in school. Furthermore, Pull-out service were perceived to be the most effective and beneficial method of school-based Occupational Therapy service delivery.
Eung Gyeong Park, Susan MacDermott, Becki Cohill, and Karen Park
Traumatic brain injury (TBI) is a condition that occurs due to an external blow to the skull that damages the brain (Carulli et al., 2018). According to the Centers for Disease Control and Prevention, 2.5 million TBI have been reported each year. Many students with TBI face physical, cognitive, environmental, and social challenges in their transition to post-secondary education (Bedell et al., 2017). Individuals with TBI experience social and behavioral changes that interfere with their participation as they face difficulties initiating, regulating their social behaviors, and experiencing increased introversion (Bedell et al., 2017). Physical challenges include fatigue, headaches, sleep disturbances, and poor anger management that hinder their academic successes (Jacobs et al., 2017). Environmental challenges include limited transportation, time constraints, and lack of understanding from peers and teachers' misconceptions about their TBI conditions (Bedell et al., 2017).
The purpose of the project is to enhance a transition program with an OT lens to meet the student’s needs in physical, social, environmental, and/or cognitive barriers to improve their successes at postsecondary institutions.
According to the needs assessment and site observation, an occupation-based transition program was developed. This program was conducted at Mt. San Antonio College. For the program outcome, a pre-survey was given to the participants before the program implementation and the post-survey was given after the program implementation. The pre-survey and post-survey results were compared and analyzed to determine the effectiveness of the transition program.
Rajvi Patel and Karen Park
Background: Concussions or mild traumatic brain injuries are caused by a bump, blow or jolt to the head or body causing the head and brain to move rapidly back and forth inside the skull (CDC, 2019). Concussions are one of the most common sports injuries reported in the pediatric population (Browne & Lam, 2006). According to the Center for Disease Control, from 2010-2016, a yearly average of 283,000 children, aged 17 and younger, checked into an emergency department for a sports recreation related concussion (CDC, 2019).
Purpose: The purpose of this program is to better understand occupational therapy’s role in sports related concussions. This program increased awareness on returning a student safely into sports and school after a concussion. The program also aims to increase awareness of OT role within this setting through education and advocacy in the high school setting.
Program Implementation: A needs assessment was conducted at a medical clinic with a sports medicine physician and a high school with a family medicine physician and head football coach. The needs assessment results indicated a lack of knowledge on concussions and concussion protocol among all coaches including football, basketball, tennis, badminton, and volleyball and teachers. The needs assessment also indicated a lack of knowledge on OT role within this population. Therefore, this program provided educational materials that may act as a concussion guide to all staff at the high school and advocated for the role of OT within this population.
Results: Feedback was requested from staff members at a high school to determine how beneficial the educational handouts were through an online survey. Results indicated the educational handouts were useful, increased knowledge, confidence, and were easily accessible to all staff, students, and parents at the high school.
Conclusion: This program concludes there is a lack of knowledge and access to educational materials regarding concussions, concussion recovery, and post-concussion protocols in the high setting for teachers, coaches, and students. It also concludes a lack of knowledge of OT role within this population. Educational handouts on concussion protocol were delivered to the team physician and head football coach of the high school. This program advocated the role an OT may provide within this population and hopes to make OT a permanent member of the concussion management team.
Staff Perceptions on Organizational Change and Its Impact on Occupational Participation in Institutional Settings
Shelby Pearce, Susan MacDermott, and Karen Park
Background: Organizational change, primarily in institutional settings, is necessary to prevent institutionalization as well as to reach the goals of the organizations. To support these goals, institutional settings, such as correctional facilities, often use restrictive measures including occupational deprivation. As a profession, occupational therapy recognizes the importance of occupational participation for all persons in society, however there is a gap in knowledge on the importance of how to promote and/or educate other entities on successful change management in different institutional settings.
Purpose: The purpose of this study is to understand how organizational culture impacts occupational participation in institutional settings and use this data to promote successful change management in institutional setting to meet the occupational needs of individuals and goals of the organization.
Methods: This descriptive, qualitative study aimed to answer the question, “How does organizational change impact occupational participation in correctional facilities?”. The study utilized convenience sampling to recruit participants for semi-structured interviews who have a history of working in a correctional facility. Data from the interviews were analyzed using thematic analysis.
Preliminary Results: Thus far, the study consists of four participants with varying years of experience working in corrections, job positions held, and their specific associated facilities. Using thematic analysis, three themes emerged as the shared experiences and perceptions of correctional staff participants.
Discussion: Occupational therapists have a unique skillset to act as change agents and inform organizational change beyond correctional settings. This study will continue with more interviews and survey instruments with correctional staff participants to potentially further identify themes associated with organizational changes to promote successful and sustainable change.
Chad Roberts, Pam Kasyan-Howe, Kristin Domville, and Lisa Schubert
The rise in obesity among children and youth in the last 20 years is a public health concern. The prevalence of childhood obesity has multiplied worldwide in the last four decades (“The Heavy Burden of Obesity and the Economics of Prevention,” 2019). Obesity is a complex chronic disease in which abnormal or excessive accumulation of body fat impairs health (Wharton et al., 2020). Childhood obesity can profoundly affect children's physical health, social and emotional well-being, and self-esteem (Rankin et al., 2016 & Purnell et al., 2018). The problem is a lack of an occupation-based evaluation tool utilized to link occupational participation to health, well-being, and quality of life to improve occupational engagement for children and youth who are obese and overweight ages 8-16 (Benjamin Neelon et al., 2016; Gold et al., 2018., p. 308-309;J. Kugel et al., 2017; Pandita et al., 2016; Pizzi, 2016; Pizzi & Orloff, 2015; Pizzi & Vroman, 2013).
The purpose of this qualitative research capstone project is to pilot the Pizzi Healthy Weight Management Assessment PHWMA on children and youth ages 8-16 to improve health, well-being, and Quality of life, and occupational engagement for youth who are overweight and obese. This study aimed to investigate health behaviors, well-being, occupational engagement, and overall quality of life and how the PHWMA along with the Six Modules Occupation Based Program for Healthy Behaviors, can change children and youth outlook on health behaviors.
Assessing Occupational Access and Enhancing Occupational Engagement at Inpatient Psychiatric Facilities
Cristina Ruelas, Susan MacDermott, and Ingrid Leu
Many individuals at inpatient psychiatric facilities experience limited participation in activities of daily living, minimal opportunities for purposeful occupations, very few productive roles, and almost no occupational choice and autonomy (Murphy & Shiel, 2019). Many people report experiencing boredom throughout their stay (Marshall, et. al., 2020). This boredom can lead to poor patient satisfaction, frustration, aggression, or incidents of self-harm (Foye, et al., 2020). Individuals at psychiatric facilities are deprived of participation in daily occupations (Murphy & Shiel, 2019) and they experience an injustice of occupational deprivation.
Rheanne Sager, Karen Park, and Aaron Bonsall
Background: There are few resources that address the postpartum time period in fathers and the transition period of becoming a new parent specifically for males (Goldstein et al., 2020). Males experience postpartum symptoms almost as frequently as women (Madsen, 2009); however, men display different symptoms than women and are often not thought of because they did not physically carry the infant (O’Connell-Binns, 2009). The transition period for becoming a new parent is stressful on males as well as females, yet the male role is not always clear for the individuals (Asenhed et al., 2014).
Purpose: The purpose of this project is to create more opportunities and resources for males experiencing stressors associated with becoming a new father to increase occupational participation and performance. A research study can offer greater insight into the experience of males during the postpartum period and identify the occupational impact and needs from these individuals. Understanding the experience of males with postpartum symptoms of stress can help create more awareness and inform resources to support not only new fathers themselves, but also their loved ones. Occupational therapy can offer a holistic approach to better understand the different factors that have impacted the individual, in relation to the environment, roles, and occupations to promote a smoother transition. Additional education and resources can be created to investigate the impact fatherhood has on occupation with the hopes to increase occupational performance. Males have expressed a lack of resources and feeling as though they were not treated as equals to the mother during their transition to fatherhood (Baldwin et al., 2018). Furthermore, advocating for this population within other health care settings and encouraging screening and/or asking questions early on to address any concerns during the transition period.
Methods/Results: New fathers experience a decrease in occupational participation after becoming a father. There were difficulty reported with time management, a lack of overall education in regards to fatherhood, and change in daily routine and occupational participation.
Conclusion: This capstone project, the purpose of this mixed methods research project was to analyze information about new fathers transition into parenthood and the impact that has on daily occupations. With the assumption of occupations being altered with the transition into fatherhood being proven true, this project supports how occupational therapists can become more involved with new fathers. While this study shows that there is a change in daily routines and a decrease in occupational performance, there is a lack of specific interventions and what can be done to assist this population. Occupational therapy can be implemented to provide educational tools to increase overall knowledge and create a needs assessment/interest check list to provide individualistic care with the hope to increase occupational participation.
Karen M. Travis, Karen Park, and Susan MacDermott
A significant percentage of first year students in post-secondary education (PSE) do not persist through their first year and high schools continue to seek new ways of supporting students’ college and career readiness (CCR). Studies show lack of persistence derives not only from academic deficits but in non-academic skill deficits such as self-determination and executive function skills. Public school CCR programs have had limited resources to address these non-academic challenges to their students’ success whereas private high schools have significantly lower student to counselor ratio and many provide enhanced CCR programming. One small private school has provided a new semester class to prepare high school seniors, developed by OTs, that teaches non-academic skills experientially for greater impact. This project evaluates the efficacy of this CCR class using a quantitative and qualitative student survey developed to measure outcomes for self-determination, self-advocacy, and goal-setting skills. Survey questions were divided into the career exploration, PSE and employment readiness, financial literacy, and life skills units plus an overall evaluation section. Results of this survey indicate the class curriculum is meeting objectives and the students are being prepared for PSE, employment, and adult living skills. The implication for OT is that non-academic skills can be effectively taught and that OTs can support enhanced CCR programming that supports student persistence in post-secondary endeavors.
Leslie Trinh, Susan MacDermott, and Karen Park
Background: In the United States, approximately 16% of couples, or roughly five million individuals, are diagnosed with infertility (Collins, 2019). The literature demonstrates that the experience of infertility limits the ability to participate in daily occupations and fulfill occupational roles. The goal of this study was to gain a better understanding of how occupations and roles are impacted by the experience of infertility and use that information to determine whether there is a potential role for occupational therapy in providing care to this population.
Methods: This study took a qualitative approach using interviews and photo elicitation to gain a deeper understanding of the experience of infertility. Seven women, between the ages of 29 to 45 years, participated in the study. Following data collection, data analysis was completed using Braun and Clarke’s (2006) thematic analysis.
Results: Two main themes were uncovered: shift in how to participate in occupations and shift in individual role and role of others. Each main theme was also broken down into subthemes.
Conclusion: The results of this study indicated various ways in which occupations and roles were impacted by the experience of infertility, which supports a potential role for occupational therapy in providing services and support to this population.
Tiffany Truong, Susan MacDermott, and Karen Park
Background: Adaptive apparel is specially designed to make the dressing experience easier for individuals with disabilities (Azher et al., 2012). Some barriers to accessing adaptive apparel include limited retailers, limitations in design, and affordability. Though dressing is an occupation within occupational therapy’s scope of practice, there are limited research, programs, and projects defining occupational therapy’s role and presence in adaptive clothing.
Objective: The purpose of this study was to examine and understand individuals with disabilities' perceptions and experiences of fashion and apparel, and to better define occupational therapy’s role in this field.
Methods: The qualitative study used unobtrusive methods to collect and analyze publicly accessible audiovisual and written records related to dressing and apparel from individuals with disabilities, and/or their caregivers. Thematic analysis was used to derive meaningful themes from the data. The 5F framework for wearable designs was used to compile and sort the data for design considerations from a consumer perspective.
Results: From the 66 sources, 5 themes were derived: difficulty finding apparel connected to person and environment, humanizing who we are, fashion for environment expectations increase demand for varying apparel, flexibility of self-expression, and perceptions influence desire and engagement for apparel. The 5f framework contained 10 categorized conditions sorted into fit, function, fastener, fabric, and fashion from the user and/or caregiver perspective.
Conclusion: The research contributed to the literature regarding individuals with disabilities' perceptions and experiences with apparel, as well as occupational therapy’s needed presence in adaptive apparel. The information from this research provided more insights into adaptive apparel design considerations, occupational therapy’s role in this field, and a Call to Action for increasing accessibility to adaptive apparel.
Abby Vander Laan and Steven M. Gerardi
Erin Wallace and Karen Park
Background: Adaptive scuba diving is an activity that provides many therapeutic benefits to individuals living with physical, visual, and/or cognitive disabilities. Occupational therapists (OTs) specialize in using valued activities as therapeutic interventions, however, the literature supporting the profession’s value in the adaptive scuba diving industry is limited. There are no clearly defined job descriptions for OTs contributing to the adaptive scuba diving industry although evidence shows the therapeutic potential that OTs can contribute to it.
Purpose: The purpose of this project is to demonstrate OT’s value in the adaptive scuba diving industry by creating an adaptive diving reference book for dive professionals to increase readiness for assisting divers living with cognitive, physical, and/or visual disabilities; and to create 2 job descriptions for OTs working in adaptive diving settings.
Methods: Qualitative data was gathered from 2 groups who reviewed the reference book: dive professionals and healthcare professionals. The dive group was sent a draft copy of the reference book along with instructions for completing a post-review survey via Microsoft Forms. The healthcare group was sent specific chapters of the book depending on their area of expertise and returned written feedback via email. The data was analyzed using Braun and Clarke’s (2006) thematic analysis method as well as Microsoft Forms’ response analysis.
Results: There were 23 dive participants who completed the post-review survey and 7 healthcare participants who provided written feedback. From the data for the dive group, 3 themes were identified: Reader Readiness and Knowledge, Value and Awareness of Reference Book, and Filling Gaps in Resources. From the data for the healthcare group, 2 themes were identified which were Edits and Content Suggestion.
Conclusion: The findings support an increased role of occupational therapists in the adaptive scuba diving industry. Scuba diving and diving related activities provide many therapeutic benefits for those living with physical, cognitive, and/or visual challenges. Although occupational therapists are experts in task, environment, and equipment adaptations as well as using occupation-based interventions, they are not widely considered to be contributors in this setting. This project lays a foundation for the role of an adaptive scuba diving occupational therapist.
Kennedy Wischmeyer, Angela Blackwell, and Gina Benevente
This collection of SOAR@USA gathers posters presented at the Fall 2021 Virtual OTD Capstone Symposium held online, December 9-10, 2021. These posters present the capstone work of students completing their Doctor of Occupational Therapy degree at the University of St. Augustine for Health Sciences.
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