Spring 2020 Virtual OTD Capstone Symposium

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  Perceived Impact of Non-contact Boxing on Daily Life and Occupational Participation at Home Among Individuals with Parkinson’s Disease

  Kristen E. Bignal, Susan MacDermott, and Becki Cohill

  The aim of this project was to determine whether individuals with Parkinson's disease perceive an impact on their daily life and occupational participation at home secondary to participation in non-contact boxing.

  Semi-structured open-ended interview questions were conducted with 17 participants (3 female) who have been diagnosed with Parkinson's disease for(i.e., self-care, home and health maintenance, sleep, intimacy, social and leisure interests, etc.) in the home environment. Interviews were transcribed and analyzed utilizing thematic analysis.

  Data analysis derived three overarching themes including psychological benefits, sense of community, and framework to develop routines. Subsequent research exploring how non-contact boxing directly impacts specific occupations completed in the home environment would further support this study.

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  Exploring the Concurrent Validity of the Indoor Mobility Pre-driving Screen (IMPS): A Comparison of the IMPS and EF-Car Motion Driving Simulator

  Nicholas T. Bolen, Kayla Collins, Mary P. Shotwell, and Kaitlyn Cremer

  The purpose of this study was to evaluate the concurrent validity of the Indoor Mobility Pre-driving Screen (IMPS) in relation to assessments on the EF-Car Motion Driving Simulator. Data was gathered from a convenience sample of 36 participants ages 18 and older who possessed an active driver’s license. To answer the primary research question, is there a correlation between scores on the IMPS and the EF-Car Motion Driving Simulator, statistical analyses were performed in the form of Pearson r correlations. Results of these statistical tests showed scores on the IMPS correlate with some scores on the driving simulator. While some correlations were present, there was not a high level of correlation found between these measures.

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  A Non-Pharmaceutical Approach to Chronic Pain: An OT’s Perspective

  Alison L. Brown, Kayla Collins, and Mary P. Shotwell

  The following project was created for advocacy and education of occupational therapy's role in chronic pain management. This project focuses on occupational therapist's ability to utilize non-pharmaceutical interventions to manage chronic pain symptoms. The capstone outlines fitness-based exercises, aquatic therapy, ergonomics, adaptive equipment, and adaptive strategies by supporting their efficacy in recent literature. Occupational therapists possess invaluable skills that can impact the chronic pain community for the better. They can aid in the reduction of pain while increasing overall quality of life and independence. Occupational therapists are a much needed resource in chronic pain management.

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  Exploring the Occupation-Based Needs of Older Adults with Alzheimer’s Disease at a Reminiscence Therapy Adult Day Center

  Kendra C. Gillio, Susan MacDermott, and Becki Cohill

  Alzheimer’s disease is the most common form of dementia, affecting approximately 60% to 70% of the older adult population aged 65 and older (Santos da Silva, de Oliveira Alves, Barros Leite Slagueiro & Bezerra Barbosa, 2018). Reminiscence therapy prompts an individual’s memory by stimulating their sense – sight, smell, hearing, taste, and touch, and provides an opportunity for them to revisit and relive their past through their surrounding environment (Swann, 2013). For individuals with Alzheimer’s disease, occupational therapy focuses on adapting the environment in order to promote their ability to engage in meaningful occupations, increase quality of life, and social participation; ultimately optimizing occupational performance (Letts, et. al, 2011). Activities of daily living, instrumental activities of daily living, leisure activities and social activities are reported as problematic areas for individuals Alzheimer’s disease and dementia (Padilla, 2011). Reminiscence therapy shows the potential to improve occupational functioning for an individual with Alzheimer’s disease, however occupational therapy is not currently involved.

  The objectives of this project were to complete a needs assessment identifying the occupation-based activity related needs of individuals with Alzheimer’s disease and dementia at an adult day reminiscence therapy program, and then propose program recommendations to the staff on adapting activities to meet the identified population needs. Identified behaviors from the observation of the Alzheimer’s disease and dementia population at Glenner Town Square were connected to an overall decrease in activity engagement and participation. Current staff discussed their experiences with lack of participation, disengagement, and the ongoing barriers to redirect or reengage participants in activities. Caregivers expressed their day to day concerns and challenges living with and caring for an individual with Alzheimer’s disease or dementia. The needs assessment ultimately supported the limited research currently available on the role occupational therapy and reminiscence therapy play on activity engagement and occupational performance in individuals with Alzheimer’s disease and dementia.

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  Exploring Occupational Disruption in Newly Diagnosed Individuals with Cancer with Minor (Dependent) Children

  Riley S. Harrold, Susan MacDermott, and Becki Cohill

  Background: According to the American Cancer Society (2019), there were more than 1.7 million new cases of cancer in 2019 alone. Individuals are being diagnosed at a young age with 22.4% of cases occurring in individuals 22-55 years old and whom are childrearing age (Shah et al., 2017). There are an estimated 2.85 million children under the age of 18 who are living with a parent who has cancer (Shah et al., 2017). Newly diagnosed individuals face changes in daily life, the threat of possible death, and fear of dying (Compas et al., 1994). Changes in shared family roles can impact the entire family across many domains (Heiney et al., 1997; Helseth & Ulfsæt, 2005). Newly diagnosed individuals develop secondary psychosocial symptoms that impact the parenting roles and face challenges maintaining routines in the home (Kim et al., 2006; Smith et al., 2005). The purpose of this project is to further explore the impact of a cancer diagnosis and subsequent treatment on the individual and their family. This project also aims to investigate the role of occupational therapy in integrative therapy services.

  Methods: This project took place at the Knight Cancer Institute which is part of a large hospital: Oregon Health and Science University (OHSU) in Portland, Oregon. Needs assessment consisted of three parts: a survey to intended population, in-depth interviews with two participants using a modified version of the Occupational Circumstance Assessment and Rating Form (OCAIRS), and in-depth interviews with current instructors of the integrative therapy program.

  Results: Of the 10 survey respondents, eight were pre-treatment or in treatment. Of those participants, 87.5 reported their daily routine impacted by pain or fatigue. OCAIRS interviews revealed three common themes: Roles in the family became blended, independently sought additional care, and mindfulness as a strong coping tool. In-depth interviews with instructors developed common themes: Impact of cancer diagnosis and treatment, need to provide education on integrative therapies, programs typically accessed after treatment, and the value of in-home services.

  Discussion: Results from the survey suggest psychosocial symptoms develop at diagnosis and continue through treatment. There is a need to provide services in the home environment for parents to address psychosocial symptoms during their cancer treatment and additional resources to support their roles and responsibilities as parents of minor (dependent) children. Occupational therapists have an important role in integrative medicine within the home environment. To address psychosocial symptoms secondary to cancer, an occupation-based home program will be offered to the newly diagnosed parents at the Knight Cancer Institute. “Healing at Home” is a program guided by the occupational therapist in the natural setting of the family.

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  An Occupational Therapy Approach to Education for Foster Parents

  Alexandra E. Judd, Susan MacDermott, and Becki Cohill

  The focus of this project is to enhance current programming for foster parent pre-licensure education courses in San Diego, California. This capstone project focused on the preferred learning styles of foster parents and utilized adult learning theories to create suggestions to enhance the current pre-licensure class curriculum. Data collected during verbal interviews with foster parents helped guide the suggestions to enhance the current curriculum. Utilizing specific occupational therapy group strategies, occupational therapists can help enhance education for foster parents by increasing the saliency of the learning material. The increased saliency facilitates a deeper understanding of the material and increases the retention of knowledge amongst participants. The capstone project will explore how occupational therapists can help enhance the current pre-licensure curriculum for foster parents to be more inclusive of different learning styles.

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  Introduction to Adaptive Surfing: A Pool Program to Promote Engagement, Safety, and Confidence

  Madison McBride, Susan MacDermott, and Becki Cohill

  This poster delves into a needs assessment done on the international community of adaptive surfers with spinal cord injuries to determine the interest in creating a pool-based program as a prerequisite for adaptive surfing. This was done through a survey which inquired about their experiences with learning how to adaptive surf, as well as important skills necessary for adaptive surfing. Results of the survey were used to inform curriculum design for an introduction to adaptive surfing pool program.

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  Developing Educational Resources to Support the Use of the Hippotherapy Evaluation and Assessment Tool

  Emily Peoples, Kayla Collins, and Mary P. Shotwell

  The Hippotherapy Evaluation and Assessment Tool (HEAT) was created in 2011 with the goal of creating an assessment specific to this therapeutic intervention and effectively tracking client progress. Based on the current literature of client progress during hippotherapy intervention, four domains of scoring were created: Static Posture, Dynamic Motor Behavior, Sensory Processing, and Psychosocial/Behavioral. Over the years, many thesis studies have been conducted to confirm the reliability and validity of the HEAT. However, further dissemination was required as many therapists had not yet heard of the tool. A doctoral capstone project was completed in 2019-2020 to create a training program for educating therapists on the use of the HEAT, as well as supplemental materials for further ease of use. The training program includes video modules including demonstrations of the HEAT being conducted with clients, a written administration manual, and multiple formats of the supplemental materials. The purpose of the poster presentation would be to review the creation of the HEAT and the appropriate literature regarding hippotherapy, review the assessment and administration, as well as answer questions for therapists interested in incorporating it into their practice.

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  Leadership Roles in the Field of Occupational Therapy

  Christina Pitts, Kayla Collins, and Mary P. Shotwell

  The purpose of this capstone project was to learn about leadership through expertise and experience. The first portion of the project consisted of reviewing the literature and interviewing four occupational therapists that currently had a leadership role within the healthcare industry to gain insight into leadership qualities. The second potion included me being at a facility (Advent Therapy in Richmond Hill, G.A.) for 14 weeks where I observed and learned about current programs, and with the guidance of the therapists and management of the facility, developed and implemented a program that was deemed to be beneficial to the client population.

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  Occupational Therapy’s Role in Pain Management using Virtual Reality

  Johnathan Quach, Becki Cohill, and Susan MacDermott

  Pain is a complex phenomenon that affects millions every day and is frequently associated with activity restriction and decreases in psycho-social health. Studies have shown that opioids alone cannot eliminate all the difficulties that are associated with chronic pain, demonstrating a dire need to consider safer and more effective alternatives. Furthermore, given the impact of chronic pain on an individual’s ability to perform valued activities, and therefore overall well-being and quality of life, occupational therapy must be considered an essential member of any pain management team. Thus, there may be potential benefits to reviewing the use of virtual reality (VR) in conjunction with occupational therapy services for individuals with chronic pain. The purpose of this capstone project is to determine the appropriate and potential role of VR for pain management within the scope of occupational therapy practice.

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  Occupational Therapy in Veterans Treatment Court

  Lauren T. Rodriguez, Kayla Collins, Mary Shotwell, and Suny Faradj-Bakht

  Veterans may face difficulty transitioning back into a civilian lifestyle. Their difficulties may be attributed to PTSD, TBI, sexual trauma, anxiety, depression, unemployment, and more. Due to these obstacles, veterans may commit crimes that place them in the Veterans Treatment Court (VTC). It was noted in October of 2018 that there were possible gaps in service for our veterans. The purpose of this project was to create an occupational therapy-based curriculum that will reduce the recidivism rate in St. Johns County VTC. The OT-based manual is intended to replace negative habits, roles, and routines with positive ones in order to increase quality of life, health, and well-being of the veterans. This program is theory-driven and evidence-derived. The needs of the veterans were identified through the utilization of the AOTA Occupational Profile Template and therapeutic interviewing. Evaluation and intervention of the veterans regarding roles, habits, routines that support or detract from recovery, life skills, cognitive, sensory, and motor factors have been included as well.

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  Mental Health in the School System: Providing Tools and Resources For Teachers

  Hannah Skinner, Kayla Collins, and Mary P. Shotwell

  Mental health is an important part of our everyday life. For many school aged students, mental health issues are on the rise and our roles as occupational therapists are becoming more vital. Educators also have a vital role in the mental health of their students, however their is a gap between their knowledge of mental health practices and their comfort and confidence with implementing such practices.

  This project aimed to bridge this gap for 5 educators in the Lake Stevens School District in Washington state. The project was comprised of a Mindfulness Toolkit that walked teachers through implementing a total of 6 different mindfulness activities with their classrooms.

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  Occupational Therapy’s Role in Spirituality: Partnering with a Special Needs Ministry

  Kelsey Stockton, Kayla Collins, and Mary P. Shotwell

  Children with special needs frequently face obstacles and barriers to inclusive participation in various activities among their peers; most commonly due to mental, physical, and/or social limitations and deficits (Mathur & Koradia, 2018). One activity in particular impacted by such barriers is participation in spiritual activities within a church (Jacober, 2007; Lee, 2010).

  While several highly successful special needs ministries have been established globally, many churches currently either lack appropriate evidence-based volunteer and staff training, adequate resources and accommodations to meet each child’s needs and functional capabilities or are unable to provide any accommodation services. (Avis, 2019; Jacober, 2007; Lee, 2010). This then impacts not only successful inclusion into spiritual health activities and overall effectiveness of the ministry, but the quality of life of both the child and their family (Avis, 2019).

  The purpose of this project was to aid in the overall provision and development of special needs ministries nationwide through partnership with a pre-existing special needs ministry. This program aimed at enhancing and revising the special needs ministry for increased accommodation and effectiveness through evidence-based volunteer training/education, enhancement of the classroom curriculum, development and implementation of youth community gatherings, and provision of occupational therapy resources to edify accessibility and inclusion within the ministry.

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  Improving Awareness and Access to Adaptive Sports

  Alison S. Takagaki, Becki Cohill, and Susan MacDermott

  Adaptive sports can be defined as a recreational activity that allows individuals to improve their overall quality of life through an occupation they enjoy (Aytur et al., 2018). Barriers to participation in adaptive sports programs include a lack of resources, limited programs identified, and difficulty in finding the best program to fit the athletes’ needs (Lape et al., 2018). Adaptive sports have been seen as a holistic rehabilitative care plan that helps to improve self-esteem, build self-identity, increase confidence, and provide higher life satisfaction (DiVincenzo, 2013). Occupational therapists can play a role in helping enhance participation in adaptive sports by looking at different programs in a holistic manner to understand the program, the athletes, the volunteers and staff, and the environment (AOTA, 2019). Occupational therapy can be a significant contributor to adaptive sports through activity analysis, adaptive equipment, and helping to better understand the impact of client factors, psychosocial factors, environment, and performance (AOTA, 2019).

  The purpose of this capstone project is to evaluate the needs regarding access and awareness to adaptive sports and concerns of participants, volunteers, and others conducting adaptive sports programs to provide a better understanding of what is needed and how to bridge the gap to help sustain participation. This capstone project used observation, surveys, and semi-structured interviews in order to gain a deeper understanding of the needs of each participant.

  The findings from this capstone project indicated that participants experienced a lack of awareness of programs available and difficulties with transportation, but found a great opportunity through sports for competition and social engagement. These findings support other studies and literature reviews that report benefits to participation in adaptive sports such as building self-identity, increasing confidence, and providing higher life satisfaction, and barriers to participation such as lack of resources, limited programs identified, and difficulty in finding the best program to fit the athletes’ needs (Aytur et al., 2018; DiVincenzo, 2013; Gossett & Tingstrom, 2017). With the data found through this capstone project and with the support of other literature, there is a need for an increase in awareness, advocacy, and a role that occupational therapy can provide through activity analysis and role identification to help support and increase participation in adaptive sports.

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  Occupational Therapy’s Role in Adapting Residential Youth Camps for Increased Inclusion

  Brittany Tate, Susan MacDermott, and Becki Cohill

  Each year, summer camps serve more than 11 million youth in the United States (US) (Wilson, Sibthorp, & Brusseau, 2017). Summer camps provide children with new experiences and give them opportunities to build confidence, social skills, and peer relationships (Wilson et al., 2017). Occupational therapy (OT) is an emerging area of practice throughout summer camps in the US (Hanscom & Schoen, 2014). Hanscom and Schoen (2014) recommend strategically combining OT with traditional camp programming to create an emotionally, physically, and spiritually safe environment that promotes optimal attending and task follow through. Summer camp has been shown to enhance positive youth development, as it meets motivational needs and promotes intrinsic engagement (Halsall, Kendellen, Bean, & Forneris, 2016). However, not all youth have an equal opportunity to partake in the experience (Shefter, Uhrman, Tobin, & Kress, 2017). McCarthy (2015) states that two percent of American Camp Association camps exclusively serve youth with special medical needs. Further, only seven percent are inclusive (Hall, Dunlap, Causton-Theoharis, & Theohari, 2019). The purpose of this capstone project is to explore the populations served within a residential youth camp, identify barriers to participation, and recommend adaptations to the environment to promote a more inclusive setting.

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  Occupational Therapy’s Role in Matching Handlers and Assistance Dogs

  Jyoti K. Tatla, Becki Cohill, and Susan MacDermott

  The purpose of this project was to assess and observe the matching process and to identify the role of an occupational therapist in aiding the evaluation process with potential handlers and assistance dogs. Three sites were explored within California: Canine Support Teams, Canine Companions for Independence, and Guide Dogs for the Blind. Interviews were conducted with twenty-five participants about roles, routines, physical environment, need for an assistance dog, and additional support.

  Key findings from this project revealed a need for occupational therapy within the evaluation process and two-week team training. Therapists could aid with adapting learning material, addressing performance patterns, conducting home evaluations, and educating staff about a range of clients who have different disabilities.

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  Animal-Assisted Therapy and Quality of Life of Patients with Dementia

  Karissa D. Thomson, Kayla Collins, and Mary P. Shotwell

  The aim of this quantitative study was to examine the effects animal-assisted therapy (AAT) had on people diagnosed with dementia living in a nursing home. The study examined the effects AAT had on depression, blood pressure, social interaction and how these factors impact quality of life (QOL). The study was conducted once a week for one hour on Thursdays for 6 weeks. 7 participants were included in the study and further broken down into two groups based upon their level of cognition as measured by the Mini Mental State Examination. The Beck’s depression inventory (BDI) and the World Health Organization quality of life- BREF (WHOQOL-BREF) were administered pre and post AAT sessions to measure depression and QOL. Additionally, blood pressure recordings were taken pre and post AAT sessions.

  The results from the BDI and WHOQOL-BREF did not produce statistically significant data which could be attributed to the small sample size and short duration of the study. On the other hand, blood pressure recordings did produce significant data meaning AAT did have an impact on blood pressure. Additionally, clinical observations were recorded throughout the study of the participants' behaviors when interacting with the therapy dog. This study showed AAT had a positive impact on blood pressure and behaviors as witnessed by blood pressure recordings and clinical observations. Further studies should be conducted to determine how AAT impacts depression and QOL using alternative assessments that do not include self-reports such as physiological assessments.

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  Occupational Therapy Student Pro Bono Clinic: Creating a Sustainable Model

  Shane Tong, Kayla Collins, and Mary P. Shotwell

  The purpose of this project was to create a model for a sustainable student pro bono clinic with a clear mission and vision that aligned with that of the occupational therapy (OT) profession. This project consisted of interviewing founding members of similar programs, conducting an indirect needs assessment, and performing a strengths, weaknesses, opportunities, and threats (SWOT) analysis (Blayney, 2008) of current pro bono clinic operations at the University of St. Augustine College for Health Sciences (USAHS). These results, combined with input from key stakeholders, were used to develop a strategic plan to support the development of future pro bono clinics by OT programs across the nation.

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  Occupational Therapy’s Role in College and Career Readiness for Adolescents

  Chelsea Van Gorder, Becki Cohill, and Susan MacDermott

  The transition to life after high school leads to many possibilities including post-secondary education, employment, and independent living. Of the youth aged 16-24 who graduated high school in 2018, 69.1% enrolled in college, and 79.1% of the remaining graduates either were employed or participated in employment searches (United States Bureau of Labor Statistics, 2019). With a considerable number of high school graduates entering the workforce and college, the education system needs to equip students with skills necessary for post-secondary success. Transition planning for adolescents incorporates College and Career Readiness (CCR) which consists of academic and non-academic factors (Lombardi, Freeman, & Rifenbark, 2018). The Individuals with Disabilities Education Act (IDEA) requires that eligible students receive transition planning to prepare them for their transition into adulthood. School-based occupational therapy (OT) is a service that addresses transition planning for eligible adolescent students; however, the disconnect is that less than 10% of interviewed school-based occupational therapists understand their role in transition planning (Mankey, 2011). The purpose of this program was to develop a holistic and comprehensive transition program that addresses non-academic skills and is inclusive of all adolescent students, regardless of disability, to prepare them for participation in post-secondary activities (e.g., education and employment). The expansion and identification of occupational therapy’s role in college and career readiness for adolescents occurred in addition to program development.

  The program was designed for a non-public school that needed to address the transitional needs of their diverse student population (i.e., students with and without disabilities). Utilizing the Person Environment and Occupation model (PEO) and principles of OT, college and career readiness units were developed, resulting in an all-inclusive program for transitioning adolescents. Occupation-based lessons and targeted experiences enhanced the CCR curriculum and were vital in exposing students to the demands of post-secondary occupations (e.g., employment and education). Overall, students reported an increase in knowledge on career readiness topics as determined by increased ratings on Likert-scaled post-survey questions (i.e., students agreed more with the knowledge statement after the CCR lessons). All students found the targeted experiences to be beneficial and reflected on what they found meaningful (e.g., gaining experience, increasing confidence, changing expectations, etc.).

  Occupational therapists provide valuable insight into preparing adolescents for post-secondary transitions and assisting them in becoming college and career ready. Through the use of activity analysis and occupation-based activities, students gain experience, create realistic expectations, and identify areas of improvement as they prepare to transition out of high school. The comprehensive, client-centered, holistic approach representative of OT is paramount in designing a CCR curriculum that encompasses the elements necessary for success in the occupations of post-secondary education and employment. The expansion of OT services to include extensive transition focused interventions is beneficial not only for eligible students who receive OT services, but also for the neurotypical adolescent student population.

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  Occupational Therapy’s Role in the Transition to Employment

  Jeanne M. Ventura and Kayla Collins

  Employment rates for persons with disabilities are shockingly low at 30%, while 70% remain unemployed. Some of the reasons for this disparity found in the research include a lack of preparation during high school, a lack of occupational therapy involvement in the transition to work process, and limited transition resources in rural communities resulting in students with disabilities graduating from high school without the skills necessary to secure employment. The goal of this project was to create a pre-employment course at a local YMCA in Warsaw, IN with occupational therapy-based curriculum for youth and young adults with disabilities to help mitigate these disparities and provide a resource where one did not already exist. Through a needs assessment of Warsaw, IN, curriculum development, and recruitment of nine participants, a seven-week, occupational therapy-based pre-employment course was created and implemented at the local YMCA. A pre and post-test were administered at the beginning and end of the class cycle to gauge effectiveness and student understanding. Comparing the results showed a mean increase of 6 points overall supporting occupational therapy involvement in the transition to work programs. Occupational therapy has much to offer the population with disabilities during their transition to work period, and occupational therapists have a responsibility to stake a claim in working in this area of practice.

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  Supporting the Role and Transition to Motherhood Through the Occupation of Feeding

  BethAnne N. Vidmar, Becki Cohill, and Susan MacDermott

  The purpose of this project was to assess and explore the occupational needs of mothers who are feeding their infants in a variety of ways to then identify psychosocial and occupational barriers affecting women's’ choices in feeding options for their infant through survey and interviews and opportunities for occupational therapists to become more involved in the occupation of breastfeeding.

  Data analysis for this capstone project consisted of running a needs assessment in Santa Barbara County. The needs assessment consisted of written or online surveys and semi-structured in-depth interviews. Of the 95 women who filled out the hard-copy or online survey, 25 were expectant mothers and 70 were postpartum mothers with a 0-12-month-old. Of the 95 women who participated in the survey, 48 consented to be contacted further by the student for an interview. Of the 48 women who consented to an interview, 21 total mothers were interviewed due to their availability. The student reviewed both the survey answers and the detailed notes from the phone interviews in order to identify mothers' common responses and organize them into themes.

  This capstone project suggests that occupational therapists have a large role to play in maternal mental health and the lactation community. Occupational therapists can change the promotion of breastfeeding to benefit the population of new mothers by applying their unique perspective and knowledge of routines and role transitions associated with the occupation of breastfeeding and help enhance the psychosocial and occupational lives of mothers.

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  Inclusion in Religion and Spirituality for Children with Special Needs

  MacKinzie C. Weiss, Kayla Collins, and Mary P. Shotwell

  The purpose of this capstone project will focus on using occupational therapy interventions to help a local church be more inclusive to children and families with special needs. This project partners with a pre-existing special needs program to develop evidence-based volunteer training, implement a parent respite program, and introduce a movement-based program for children with special needs.