Summer 2021 Virtual OTD Capstone Symposium

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  The Role of Occupational Therapy: Military Dependents Transitioning into Motherhood

  Ria Allen, Becki Cohill, Susan MacDermott, and Karen Park

  Background: Motherhood is a time of adjustments and changes. Mothers are learning how to balance taking care of a newborn, household responsibilities, and self-care. Adjustments of routine in everyday occupations can change quickly as the baby's needs evolve over time and established routines are disrupted and new routines are created. For military spouses, military culture and lifestyle can affect adjustments to motherhood as well including deployments, frequent moves, and reestablishing support systems. An in-depth literature review revealed that there is limited occupational therapy research, programming, and resources available to military dependent mothers

  Purpose: The purpose of this study was to further understand the roles, occupations, and routine challenges that new mothers face who are married to an active-duty service member and to create an educational program to help in this adjustment period of motherhood.

  Methods: Phenomenological mixed methods study consisted of a survey and interview using Likert scale and open- ended questions. The data was analyzed using Braun and Clarke’s thematic analysis method.

  Results: There were 67 participants who completed the survey and 12 participants who participated in the semi-structured interview. From the data, 5 themes were identified which were Shift in Focus on Relationships, Shift in Self Identity, Establishing Support Systems, Routine Disruption, and Mental Health Challenges and Disappointments.

  Conclusion: The findings support for an increased role of occupational therapists for new mothers married to active-duty service members. Adjustment to motherhood can become increasingly challenging when combined with the influence of military lifestyle and culture. Occupations can be disrupted at any time due to a spouse’s work schedule, deployment, or recent PCS move. The sooner a mother can balance time with themselves and others, feel grounded in their self-identity, establish their support system and routine, and address mental health needs, the easier it is for them normalize their experiences and adjust more smoothly into motherhood. By understanding a mother's needs and collaborating with them on what is important, occupational therapists can assess and understand their environment to optimize their participation in meaningful occupations and help ease their role transition into motherhood.

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  An Exploratory Study of Individuals’ Transition to Adoptive Parenthood

  Emily Brandt, Karen Park, Susan MacDermott, and Becki Cohill

  The purpose of this study was to explore individuals’ transition to adoptive parenthood through an occupational therapy lens. More specifically, this study aimed to investigate how individuals’ performance patterns and daily occupations change through this transition. Ultimately, the purpose of this study was to gain insight into this population’s lived experience to inform occupational therapy services in order to meet the specific needs of the adoptive parent population.

  A mix-method study was created using both surveys and semi-structured interviews. The survey contained both open and closed ended questions, as well as Likert Scale questions. There were forty survey participants and six interview participants recruited. Data was analyzed using Braun and Clarke’s thematic analysis method (2006), yielding three overarching themes.

  The three themes include: (1) Centered on Child, (2) Increased Realistic Information and Education, and (3) Advocate for Child. Other data collected included information about participants’ background and adoption process, participants’ preparation for parenthood, and the challenges associated with the arrival of a child in the home.

  This capstone project attempted to investigate adoptive parents’ lived experiences so that the profession of occupational therapy can meet the needs of this population. This project contributes to the limited available research on this population and further progresses this emerging practice area.

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  Occupational Therapist’s Impact in Current and Changing Roles and Routines for First-Time Foster Parents

  Kathryn Chatfield, Becki Cohill, Susan MacDermott, and Karen Park

  The purpose of this study was to understand occupational therapist’s impact in current and changing roles and routines for first-time foster parents as well as understanding how to establish, preserve and maintain such meaningful domains. This study allowed for insight into current and changing roles and routines for first-time foster parents. The results from this study allowed for further comprehension on how roles and routines were impacted, and that education and tools can be used to help decrease disruption to these domains. Understanding that taking on a new role as a foster parent means routines will be impacted in one way or another. Education on resources and support available and data from interviews and surveys may help to decrease such disruption and allow for roles and routines to be established, preserved, and maintained to improve the transition and overall quality of life.

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  Promoting Leisure and Social Participation for Seniors in an Assisted Living Facility

  Macy Clark, Becki Cohill, Susan MacDermott, and Karen Park

  Seniors in assisted living facilities (ALF) experience a decrease in leisure activity participation (Knecht-Sabres et al., 2020). This decrease could be due to the changes in the social, cultural, and physical environments and the loss of daily roles and routines (Lamarre et al., 2019). Participation in social group activities improves quality of life and provides many physical, cognitive, and socio-emotional benefits (Barnes et al., 2008; Horowitz & Vanner, 2010). Participation in group activities offers seniors a sense of community, purpose, belonging, and friendship (Dare et al., 2018). However, group activities offered in ALF may be generic and not individualized to resident interests and functional abilities (Lamarre et al., 2019). An occupational therapist (OT) has a distinct role in facilitating engagement in meaningful, social group activities by analyzing the activity demands and maximizing the fit between the person, occupation, and the environment (Knecht-Sabres et al., 2020; Lohman et al., 2017). This role could enhance resident participation in personally meaningful occupations while promoting social inclusion within an assisted living community.

  The purpose of this project was to create an individualized and occupation-based group activity program for seniors in an ALF and to educate and assist activities directors and staff in individualizing the activities to improve social participation and engagement in group activities. A needs assessment was conducted at an assisted living facility and involved observations of current group activity programming and the environment, semi-structured interviews with activities staff and residents, and the utilization of the Visual Activity Sort (VAS). The VAS is an occupation-based assessment tool that was used to evaluate the residents’ motivation and interest in different activities (O’Day, 2020).

  Based on the information gained from the needs assessment, an occupation-based program was created and conducted at an assisted living facility and a program manual was developed as a method to sustain the program long-term. This project aimed to advocate for the role of OT as a consultant in assisted living by collaborating with staff and developing occupation-based group activity programs that promote resident engagement in meaningful occupations.

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  Promoting Partner-Inflicted Brain Injury Awareness Within the Domestic Violence Community

  Christina Debowski, Heather Javaherian, and Karen Park

  Background: Brain injury has been shown in research to decrease individuals’ ability to participate in their meaningful activities by negatively impacting their cognitive, emotional, and physical systems. Recent research has begun to indicate that survivors of domestic violence (DV) are at extreme risk for experiencing partner inflicted brain injury (PIBI)--brain injury that results from the physical violence of a survivor's intimate partner. However, despite the prevalence of PIBI within the DV community, research shows that survivors and DV service providers alike are not aware of how PIBI can impact survivors' daily life and wellbeing.

  Purpose: The purpose of this project was to utilize occupational therapy principles to create a trauma-informed, and sustainable educational program that would increase PIBI awareness within the domestic violence community.

  Program Implementation: To accomplish this, the Ecology of Human Performance (EHP) model and an occupation focus was applied to an existing trauma-informed framework that was created to guide DV service providers working with survivors of trauma, mental health challenges and brain injury. DV support services participated in one, online, synchronous in-service that introduced the etiology and occupational performance impact of PIBI, and how providers could implement appropriate accommodations to further support survivors.

  Results: By the end of the program, providers reported that their awareness and confidence addressing PIBI had improved. They either “agreed” or “strongly agreed” that they were now aware of PIBI’s impact, accommodations they could implement, and community or online resources they could refer to to further support survivors. They also “agreed” or “strongly agreed” that they were confident in starting a conversation about PIBI, educating survivors, and implementing appropriate accommodations.

  Conclusions: These outcomes indicate that the incorporation of occupational therapy principles to existing and future PIBI education is feasible, has the potential to benefit service providers, and could be expanded upon by stakeholders.

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  Exploration of Aerial Arts as an Occupation

  Kristine De Guzman, Susan MacDermott, Becki Cohill, and Karen Park

  Introduction: Aerial arts is a performance art with acrobatic and dance principles that includes a variety of apparatuses, such as silks, hammock, and lyra. Aerial arts has been transforming over the years; it was once a form of entertainment and is now utilized in occupational therapy interventions. Occupational science, the academic discipline of studying occupations, has emerged to inform occupational therapy practice. Understanding the occupation of aerial arts through an occupational science framework, Doing, Being, Becoming, and Belonging, and Model of Human Occupation offered an in-depth description of the occupation that can provide more knowledge on how to use occupations more therapeutically.

  Methods: A descriptive qualitative study that used semi-structured interviews (modified version of the Occupational Performance History Interview-II) with a photo-elicitation prompt and observations. Seven aerial students completed the semi-structured interviews. Data from the semi-structured interviews and observations were analyzed with Braun and Clarke (2006) thematic analysis guidelines and were deciphered into the constructs of Doing, Being, Becoming, and Belonging.

  Results: Nine themes were identified to describe the occupation. The multidimensional concepts provided insight of the general impacts of engaging in aerial arts and illustrated how value and meaning of the occupation has been shaped with the consideration of COVID-19.

  Conclusion: The research contributes to the body of knowledge of occupational science through the example of aerial arts. The discoveries provided foundational insights of aerial arts in a holistic approach that still merits further research, especially with the impacts of COVID-19, to enhance understanding of the occupation.

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  Exploring the Occupation of Rest

  Emilee Eckhart, Susan MacDermott, Becki Cohill, and Karen Park

  Rest is an occupation that encompasses many aspects of the human experience. It is an occupation that looks different for everyone. The field of occupational therapy has always emphasized the importance and relevance of the occupation of rest. After a review of literature on the topic, there was little information about how rest and restful occupations are addressed in occupational therapy practice. This capstone project explored the occupation of rest and how it was understood and addressed in occupational therapy practice. This was a qualitative research design, where a survey was produced for occupational therapy practitioners (OTP). The survey questions were different depending on if the OTP said they addressed rest or not. The results of the survey lead to key findings, the formation of three themes, and the creation of a proposed assessment for rest.

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  The Occupational Impact of Mass Shootings

  Ashley Ellsworth, Susan MacDermott, Becki Cohill, and Karen Park

  Background: As mass shootings continue to persist in the United States, their occupational impact on victims needs to be understood. The psychosocial and physical tolls of mass shootings have been investigated, but research related to the occupational impact was not found.

  Objective: The purpose of this study was to examine stories shared by survivors of mass shootings to determine whether changes in occupational participation, performance, and fulfillment of meaningful roles and performance patterns occurred following the incident.

  Methods: The question "What is the occupational impact of mass shootings on exposed individuals in the United States?" was asked. A qualitative research design employing unobtrusive methods was used to collect and analyze publicly accessible audiovisual and written records containing stories from victims of mass shootings. Themes were developed through thematic analysis.

  Results: Victims at varying degrees of association to the event experienced changes in their occupational performance, participation, and fulfillment of performance patterns. Eight themes encapsulated the common areas of concern expressed by individuals.

  Conclusion: Occupational therapists need to be aware of victims of mass shootings' needs to ensure their receipt of appropriate care. Future research on occupational therapy practitioners’ role in working with this population is needed.

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  The Development and Implementation of an Inclusive Community Sports League for Children with Disabilities

  Delnai Filip and Angela Blackwell

  Many developed sports leagues are tailored toward non-disabled children and adults, even though, in the United States, about 26 percent of the population live with a disability and one out of every three people within this population want to participate in sports (Centers for Disease Control and Prevention [CDC], 2020a; Activity Alliance, 2018). This ultimately leads to decreased sporting opportunities for individuals with disabilities. This higher rate of development of sports leagues for children without disabilities is due to the competitive environment of sports. This competitive environment leads to the marginalization of children with disabilities who want to participate in sports, due to individuals with a disability being considered not suitable to participate. However, inclusion is one of the many factors that the profession of occupational therapy strives to implement within their practice. Especially due to the American Occupational Therapy Association’s (AOTA) vision for 2025 being the commitment to diversity, equity, and inclusion (AOTA, 2020a). Therefore, developing community sports leagues that are inclusive is one step towards treating all children impartially and creating a diverse community in which all members can flourish and function (AOTA, 2020a).

  The purpose of this project was to create an inclusive sports league for all children (5-18 years old) living in Matagorda County, to improve health and wellness, increase leisure participation, experience occupational justice, and enhance quality of life. Creation of this inclusive sports league provided the opportunity to increase inclusion within the community and social interactions by raising awareness of the barriers and benefits of sport participation. Currently, there is only one baseball team available within Matagorda County for individuals with disabilities to participate in, which portrays the lack of opportunities for these children to participate in their leisure occupation of sport participation. This also highlights the significance of this project due to the critical importance of mitigating the occupational injustice adolescents with disabilities experience. With the development of this program the intended objectives of increased participation and quality of life will be achieved, as well as promoting health and wellness and occupational justice.

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  Exploring the Form, Function, and Meaning of Esports

  Kyle Fitzstevens, Susan MacDermott, Becki Cohill, and Karen Park

  Esports has become an internationally recognized occupation that is continuing to grow in popularity. The discipline of occupational science with a qualitative, phenomenological approach was used to study the occupation of esports. Larson, Wood, and Clark’s (2003) framework of form, function, and meaning was applied to study to explore the occupational experience of esports with five participants. Form, function, and meaning guided the methods utilized through semi-structured interviews and observation. Eight sub-themes were extracted from the data and embodied the personal occupational experiences of esports. The findings support the importance of understanding the complexities of occupations such as personal experience and community. The exploration of esports through form, function, and meaning further promotes the need to study occupations. Future research would benefit from continuing to explore the complexities of esports such as gender, age, socio-economic status, and cultural identity.

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  A Scoping Review on the Role of Occupational Therapy with Breast Cancer Survivors

  Ellen Langlinais and Steven M. Gerardi

  BACKGROUND: Breast cancer survivors (BCS) suffer from treatment side effects that adversely impact occupation. Occupational therapy (OT) plays a role in the treatment of BCS, however, the literature has not clearly defined the role of OT with this population.

  OBJECTIVE: The purpose of this capstone project was to conduct a scoping review of the literature to clearly define the role of OT in addressing the occupational needs of BCS.

  METHODS: The scoping review methodology was based upon the 5-stage framework outlined by Arksey and O’Malley (2005). The EBSCOhost search engine was utilized for access to CINAHL Complete, MEDLINE, and OpenDissertation electronic databases. The final inclusion was 34 articles. The search results were recorded via PRISMA diagram. Data was extracted via summary table.

  RESULTS: The majority of intervention implementation included education and application of compensatory strategies, adapting new lifestyle habits, and physical exercise. Additionally, the majority of the interventions provided educational material and applicable activities to address the physical, cognitive, and emotional dysfunction experienced during breast cancer survivorship.

  CONCLUSION: The current interventions being implemented by occupational therapy practitioners address a limited range of occupational deficits within breast cancer survivorship. Due to the limitations of interventions and barriers being addressed, BCS faced with specific areas of occupational dysfunction are left untreated.

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  Supporting Children with Neurodevelopmental Disorders: Routines and Environmental Factors Affecting Sleep Quality

  Constance Lew, Susan MacDermott, Karen Park, and Becki Cohill

  Background: Sleep difficulties are more common among children with neurodevelopmental disorders (NDDs). There is limited research on sleep strategies used by parents of children with NDDs or resources written by occupational therapists. The study examines current sleep concerns and strategies used by parents of children with NDDs, including those affecting time it takes to fall asleep, duration of sleep, routines, and environmental factors that influence sleep.

  Method: Parents and caregivers of children with NDDs (n=22) and with no diagnosis (n=6) participated in a survey and optional interview to assess current concerns and strategies used to address sleep. Data gathered included sleep quality, bedtime routines, and sleep strategies. The survey and interview were part of an IRB approved mixed methods study.

  Results: Participants listed activities that are part of their child’s bedtime routine and strategies that work and do not work to address their child’s sleep. Strategies focused on environmental factors such as lighting, noise, and temperature. Participants who reported poorer sleep quality for their child rated poorer sleep quality for themselves.

  Conclusion: These results support a consistent bedtime routine along with environmental factors for better sleep quality. Further education and research, especially by occupational therapists, is needed.

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  An Educational Resource for Young Adults with Disabilities, Their Caregivers, and Clinicians in the Driver Learning Environment

  Destinee Logan, Missy Bell, and Angela Labrie Blackwell

  Driving and community mobility are essential occupations for growing independence and identity. Young adults who are transitioning into adulthood have a desire to engage in their community, and it is at this time that an interest in driving begins. Driving is a complex occupation that requires in-depth education and experience to safely participate in.

  Learning to drive can be challenging, especially for a person with a disability. Young adults with disabilities confront several community concerns that limit their ability to participate in the meaningful activity of driving. Those with disabilities often rely on their support systems to help guide their decision-making and learning. Caregivers, specifically, play a significant role as a primary support system by preparing their young adults for this occupation. Unfortunately, there is an absence of educational resources on driver education that highlights the role of the caregiver. As a result, there is a lack of awareness on the caregiver’s role in driver education and a feeling of unpreparedness when creating a supportive learning environment for their young adult.

  For this capstone project, an online advocacy and educational resource was developed for caregivers responsible for young adults with disabilities who are interested in learning the occupation of driving.

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  Transitional Vocational Program for Persons with Low Vision and Other Visual Impairments

  Andria Lubben, Karen Park, Susan MacDermott, and Becki Cohill

  Background: Low Vision is a life-altering visual disability (CDC, 2015). OTs work with individuals with low vision and work in the workplace and education, however, there is no research on OTs working with individuals with low vision in work or post educational settings (Butler, 2016). Vocational and educational needs are often not being met for individuals with low vision (Barbieri et al., 2019).

  Problem: OTs have a limited role in adolescent transition to the workplace and higher education in individuals with low vision and other visual impairments.

  Purpose: To understand transitional programs that support vocational and educational development of individuals with a visual impairment and OT could enhance them.

  Theoretical Model:The Model of Human Occupation (MOHO) influenced this project. Utilizing the MOHO theory during the needs assessment helped to not only identify what the participants learned, but also their confidence and volition following the programming. MOHO’s focus on this connection is key to understanding what motivates and shapes engagement (Kielhofner, 2002).

  Needs Assessment: A needs assessment was created and conducted which included a survey, observations, and interviews to assess the transitional programs at SALB. Observations of transitional program classes were observed through Zoom as well as in person. Interactions with staff & class participants including activity engagement and impromptu questioning occurred during observation hours. The survey included open-ended and closed-ended questions with Likert scale, multiple choice, and short answers. There were a total of 30 questions on the survey. Surveys were conducted verbally. Topics covered:(1.)Career Exploration, (2.) Accommodations, (3.) Assistive Technology Education, (4.) Interview Practice, (5.) Self-Advocacy Training, (6.) Resumes & Applications, (7.) State/Federally Funded Edu/Employment Supports. Review of the Transitional programs units of study was also part of the needs assessment and included reading outcome assessments and daily activities.

  Results: Following the needs assessment, strengths as well as areas of improvement were found for the transitional programs at SALB. SALB programs covered relevant topics, had interactive and engaging activities, and the flow of topics was supportive of preparing for college and employment. Areas where the program could improve included assistive technology education, accessibility and accommodations of activities, accommodation education, as well as self-advocacy training

  Project Impact: Overall, many important employment and post-secondary education topics were covered; however, the subject could have been provided in a more holistic and client-centered way. Participants reported learning the importance of many topics but did not have strong confidence or self-efficacy in the skills discussed. Not all activities accessible to individuals with visual impairment. SALB had access to assistive technology, but it was not often utilized.

  Occupational Therapy could support a more holistic and client-centered programing. Utilizing MOHO model can help to increase vocational engagement, participation, and support for individuals with a visual impairment. Self-advocacy is an important component that could improve confidence and engagement in employment and post-secondary education for individuals with visual impairments. Making programs at SALB more client-centered by providing exploration into assistive technology and practice in self-advocacy in the workplace and school can enhance programs at SALB.

  Discussion: Occupational therapists working in the vocational setting add value to vocational rehabilitation by providing occupational assessment and analyzing activities. Occupation is the foundation of the occupational therapy profession (AOTA, 2020). Occupational Therapists assess, treat and rehabilitate individuals with a disability, illness or injury to increase independence or function in the worker role (The OT Practice, 2021).

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  Exploring the Form, Function, and Meaning of Brazilian Jiu-Jitsu

  Alvin Ma, Susan MacDermott, Becki Cohill, and Karen Park

  Brazilian Jiu-Jitsu (BJJ) is a grappling martial art derived from Judo and primarily uses chokeholds and joint locks to incapacitate an attacker. These techniques require little strength and can apply tremendous amounts of force to anatomically weaker areas of the body. BJJ is a growing martial art due to its popularity in self-defense and its effectiveness in sports like mixed martial arts (MMA). This study uses a phenomenological approach and aims to increase the understanding of the form, function, and meaning of BJJ through the lived experiences of BJJ practitioners from different experience levels. Participants will be recruited and interviewed from one BJJ academy either in person or through Zoom and transcripts will be coded. Themes will be later identified. Implications include understanding of BJJ on a deeper level. Human beings express themselves through their participation in their selected occupations which also correlates with their overall health and quality of life. Occupational science is the study of occupations, and it allows occupational therapists to understand occupations on a deeper level which then helps create meaningful interventions.

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  Exploring Sensory Processing & Inclusivity within a Fitness Gym Environment

  Deveshma Maharaj, Karen Park, Becki Cohill, and Susan MacDermott

  An individual’s sensory processing involves the reception, modulation, integration, and organization of sensory stimuli, as well as behavioral responses to sensory input (Dunn, 2001). Adults with sensory processing challenges may come across troubles with completing routines and tasks for work, social participation, and leisure (STAR Institute for SPD, n.d.). Since most individuals with these sensory processing challenges have struggled with symptoms continuously, they are likely to encounter secondary effects such as depression, underachievement, and social isolation (STAR Institute for SPD, n.d.). Adults with sensory processing deficits may experience difficulties with establishing their role in society, maintaining social support systems, and pursuing higher education (Clince et al., 2016). Sensory processing challenges can potentially hinder an individual’s ability to participate in meaningful occupations, including gym participation. OTs are professionals who understand the dynamic interaction between individuals, environments, and the occupations in which they wish to partake in, and OTs specialize in promoting greater accessibility (AOTA, 2020). However, OTs have yet to create programming or recommendations to enhance the experience and participation individuals in a fitness gym context. This project helped uncover the current needs in terms of sensory processing and inclusivity within Crunch Fitness, San Marcos. The program was designed based on the common themes found in the needs assessment regarding sensory preferences and inclusion. It was intended to optimize gym participation and feelings of inclusion within the facility by providing guidance and options for self-regulation regarding incoming sensory stimuli.

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  Occupational Therapy’s Role in Reducing Barriers for Team-Based Sports Participation for Adolescents

  Dennis Nguyen, Karen Park, Becki Cohill, and Susan MacDermott

  Participating in team-based sports has numerous benefits that includes not only increased physical fitness, but also cognitive abilities and academic performance. With the many benefits of participating in team sports can provide, it will be significant to understand adolescents' specific barriers and assist in reducing the barriers for successful participation. The purpose of the capstone project was to identify and understand adolescent barriers to bridge the gap between conventional rehabilitation and team sports participation. Multiple barriers and motivators were identified including financial management, time management, and physical/athletic skill. Facing these determinants may possibly support in increasing team sports participation and be a guidance to overcome barriers. Results from this capstone project supported the literature that there are barriers to team sports participation and engagement in team sports is beneficial. This capstone project presented knowledge in the role that occupational therapy can implement in team sports participation and the importance of reducing barriers for participation in team sports.

  Participating in team-based sports has numerous benefits that includes not only increased physical fitness, but also cognitive abilities and academic performance. With the many benefits of participating in team sports can provide, it will be significant to understand adolescent's specific barriers and assist in reducing the barriers for successful participation. The purpose of the capstone project was to identify and understand adolescent barriers to bridge the gap between conventional rehabilitation and team sports participation. Multiple barriers and motivators were identified including financial management, time management, and physical/athletic skill. Facing these determinants may possibly support in increasing team sports participation and be a guidance to overcome barriers. Results from this capstone project supported the literature that there are barriers to team sports participation and engagement in team sports is beneficial. This capstone project presented knowledge in the role that occupational therapy can implement in team sports participation and the importance of reducing barriers for participation in team sports."

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  An Occupational Therapy Practice Guide for Sport-Related Concussion in Student Athletes

  Jenny Park, Steven M. Gerardi, and Mary Ann Smith

  Sport-related concussion (SRC) is a prevalent injury that affects millions of youth and young adults every year (McKeithan et al., 2019). The sequelae associated with an SRC can interfere with a student athletes’ ability to participate in school, return to play, and perform daily tasks (DeMatteo et al., 2018). Common practice in concussion management highlights the significance of getting individuals back to engaging in all areas of their lives; and this is consistent with the emphasis on participation by occupational therapy (OT) practitioners (DeMatteo et al., 2018). Despite the beneficial role that OT may offer, not only is there limited literature supporting the role of OT in concussion management, but the literature has not been organized in a way that is easily accessible for OT practitioners to utilize in practice. This paper will provide a detailed overview and guidelines for OT intervention in the management of SRC in student athletes.

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  The Role of Occupational Therapy with People Living with Epilepsy: A Scoping Review

  Paige Peeples and Steven M. Gerardi

  Objective: The aim of this scoping review is to systematically examine and organize current literature describing the current roles of occupational therapists with people living with epilepsy, including assessments, interventions, and other behaviors. This will help identify current gaps in the literature to facilitate future research.

  Methods: Using scoping review methodology, an electronic database search was conducted using the search terms “occupational therapy and epilepsy”. Data was extracted and charted independently by the investigator by way of finding themes and codes through analysis.

  Results: The total number of studies included was 12. The primary methodology noted were case studies. Per the data, the most common behaviors of OT practitioners when working with individuals living with epilepsy are evaluation and intervention. The assessments and interventions greatly varied due to the vast differences in the way epilepsy presents and affects people, including potential comorbidity involvement.

  Discussion: The primary limitations of this study include studies only published in English, limited access to literature, and lack of current published literature specifically addressing occupational therapy intervention and epilepsy.

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  The Role of Occupational Therapy in Addressing Community Mobility in Children to Young Adults with Disabilities: A Scoping Review

  Shelby Reid and Steven M. Gerardi

  Objective: This study aims to systematically examine and organize current literature describing the assessments, interventions, and other behaviors of occupational therapists used to treat children to young adults with community mobility needs. Gaps in the knowledge will be highlighted to impact future research.

  Methods: An electronic database search, searching within found literature, contact with driving and community mobility networks and organization were used to identify the relevant literature. Data was extracted and analyzed independently by the investigator by way of finding themes and codes and producing charted data.

  Results: The total number of studies included in this work was 28. The average number of participants in each study was 50. The data showed that the most common behaviors of OT practitioners in addressing community mobility needs of young people with disabilities were assessment and then intervention. The most common assessment was a driving simulator, and the most common intervention was on-road training.

  Discussion: The study was limited to studies published in English, lack of published literature on the population and occupation, and access to literature being limited. This study did not require funding.

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  The Role of OT with Individuals Living with Eating Disorders: A Scoping Review

  Claudia Ritchey and Steven M. Gerardi

  Background: Eating disorders (ED) are mental and physical illnesses that affect an individual globally, disrupting their ability to function and participate in daily life.

  Objectives: The objective of this capstone project was to conduct a scoping review of the literature to define the role of OT in the treatment of clients with ED.

  Methods: A database search was performed using the following electronic databases: CINAHL Complete, Medline, APA PsycInfo, and OpenDissertations, using the search terms “occupational therapist or occupational therapy” and “eating disorders or anorexia nervosa or bulimia or disordered eating”. Articles were screened and reviewed for the following inclusion criteria: (a) addresses OT intervention; (b) intervention must be for clients with ED; (c) must be published in the English language; (d) must have been published between the years (2000-2021); (e) must be available in full text; (f) must be from a refereed journal. Data was extracted and charted using tables to identify themes through data analysis according to the OT process.

  Results: The behaviors of OT practitioners were variable, with sparse evidence-base. Evaluations and assessments were client-centered and collaborative. The most common interventions included occupation-based meal cookery groups, and education and training throughout occupational interventions.

  Conclusion: This scoping review organized the current OT literature to define a role for OT practitioners with the ED population. Implications for future research include similar meal cookery studies completed with a larger sample size, screening of cognition and attention, consideration of family/caregiver perspectives and goals during evaluation, needs assessment/research tailored to the adolescent population, and research using The Role Checklist outcomes in greater detail.

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  Enhancing Eating Routines to Support Occupational Functioning

  Annamarie Sughair, Karen Park, Susan MacDermott, and Becki Cohill

  As the prevalence of serious mental illness becomes more widespread annually, eating habits have become more recognized as a modifiable risk factor on worsening mental health symptoms (Godos et al., 2020). Eating routines are food-based activities that occur daily, weekly, monthly, and across the lifespan (Green et al., 2021). Food-based activities include obtaining food, preparing food, eating food, and more. Challenges with eating routines are prevalent in individuals in the earlier stages of mental illness (Teasdale et al., 2020). Evidence shows gaps in graduating occupational therapy students and comfortability with addressing eating routines (Wingo et al., 2018).

  The purpose of this capstone project was to develop a program based on current literature and relevant theory to enhance eating routines for individuals impacted by mental health concerns. The program aimed to promote healthy eating habits and provide insight on how to create sustainable and meaningful lifestyle changes that are accessible to individuals impacted by mental health concerns. The project also explored the role of occupational therapy in addressing eating routines in the mental health setting. The theoretical frameworks used throughout the development and implementation of the program were Lifestyle Redesign®, the Social Ecological Model, the Health Belief Model, and the Transtheoretical Model of Behavior Change.

  The program took place at Kickstart San Diego. Kickstart is a mental health prevention and early intervention program that serves individuals ages ten to twenty-five who have experienced or may be at risk for experiencing symptoms of psychosis. A mixed methods needs assessment survey and structured observations were completed at this site. The “Eating for Occupation” program was developed to focused on increasing health literacy and promoting occupational functioning. The program consisted of two components: a 4-week group and one on one sessions. The groups and individualized sessions covered different topics and interventions such as general health education, food and mood logging, cooking skills, food handling skills, cooking safety, food exploration, meal preparation, meal planning, self-motivation, mindful eating, and more. Outcomes were measured with Pre and Post Test at the start and end of each group session. Client reports were also recorded for one-on-one sessions. Outcomes included increased health literacy and awareness of eating routines with improved confidence in skills such as cooking, meal planning, and meal preparation.

  Occupational therapists (OTs) have the skills and abilities to increase health literacy in mental health settings. OT's role can expand in this area of practice. Separate from dietetics and nutritionists, OTs can use theories and practice frameworks when developing sustainable and meaningful eating routines that are unique and individualized. Group sessions and individualized sessions are both effective ways for OTs to address improving eating routines for individuals 16 to 25 with a mental health diagnosis. A long-term outcome would be improvements in mental health and quality of life, which was not possible to measure during this short period of time. The short-term outcomes of this project hold value and should be considered by the field of occupational therapy.

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  Returning to Our Roots: Re-Introducing Art Back into Occupational Therapy

  Vivi Trinh

  The usage of arts and crafts played a significant role in the fruition of the profession, but as it adopted more medically- and evidence-based treatment methods, most practitioners steered away from arts and crafts. The overall purpose of this project was to promote the use of art in OT as well as learn about the current use of art in OT through discussions held with practicing and retired occupational therapists and OT students with fieldwork experience. A portion of the project includes conducting a needs assessment at Urban Street Angels (USA), a community-based facility in downtown San Diego, CA that houses and provides OT services to homeless Transition Aged Youths (TAY) aged 18 to 25 years who may benefit from engaging in arts-and-crafts based occupations, as well as designing a sustainable OT art workshop for the youth. An overall theme identified within the needs assessment was that engaging in artistic occupations or being creative provided these TAY as a mode of self-expression, emotional expression, or communication when their feelings cannot be verbalized.

  Following the needs assessment at USA, an artistic workshop, Urban Street Artists, was created for the youths to increase exposure and promote the utilization of artistic occupations as leisure tasks. A total of 8 sessions were created for the workshop, with sessions 1-4 and 8 focused on creative occupations and sessions 5-7 based on teaching the youths how to initiate their own art business and maintaining it on social media platforms.

  A second needs assessment was completed by contacting practicing and retired occupational therapists and OT students with fieldwork experience to discuss their familiarity with artistic occupations in their personal and professional lives. Discussions were held with over 25 OT practitioners and students and the most prominent theme identified is that unless the OT practitioner or student has had previous and positive experiences with artistic occupations, then they are less likely to think of them during treatment sessions with patients. Additionally, when asked who and where they believe would benefit from artistic occupations, most of the participants stated that all populations, ages, diagnoses, and settings would benefit from utilizing artistic occupations. The main barrier was primarily funding for materials or lack of storage space. Most settings who typically utilize artistic occupations are generally mental health, pediatric or geriatric settings. Skilled nursing facilities were identified as a setting that many occupational therapists believed would benefit most from utilizing artistic occupations especially with the recent COVID-19 restrictions and patients were limited to their rooms. All populations were believed to benefit from artistic occupations because of the variety of skills that can be worked on, strengthened, or maintained through artistic occupations, such as motor coordination, visual scanning, sequencing, recall, motor planning, among more.

  The overall purpose of the capstone project was to understand the current use of art within the field of OT by practitioners and students with fieldwork experience. The needs assessment results determined that artistic occupations still hold value, although engagement is not as common as it once was. Art allows for a person to tap into their creativity, which in turn allows for progress and growth by providing a different outlook within environments.

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  Occupational Therapy’s Role in Community Reintegration for Individuals Living with Addiction

  Jennifer Van Woy, Susan MacDermott, Becki Cohill, and Karen Park

  Community reintegration for individuals living with addiction and other co-occurring mental health concerns has been shown to be a difficult time. Occupational therapy transition services can positively affect a client’s ability to successfully reintegrate into the community. Providing clients with life skills education and assisting with the development of healthy habits, rituals, and routines, is necessary. This capstone project aims to assess the needs of homeless transition aged youth (ages 18-25) living with a serious mental illness with their transition from the Just Be U housing program to living independently in the community. Through identification of occupational areas of concern, program enhancement was created and implemented to meet the needs of this population during this challenging transition.

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  Enhancing Discharge Preparation for Adults With Substance Use Disorder Within a Residential Treatment Facility

  Piper Virva, Susan MacDermott, Becki Cohill, and Karen Park

  The community reintegration process is a vital aspect of the recovery journey, which requires sufficient planning and preparation prior to discharge from treatment (Read & Stoffel, 2019). Individuals enrolled in a residential treatment program for SUD indicated that higher levels of assistance and preparation during the transition to community living and involvement in comprehensive discharge planning would better prepare them for community reintegration (Manuel et al., 2017). Historically, the role of occupational therapy (OT) with this population has been to facilitate the resumption of meaningful roles, identify supportive habits and routines, and address executive functioning deficits related to SUD (Champagne & Gray, 2016; Rojo-Mota et al., 2017).

  The purpose of this capstone project was to conduct a research study in order to determine OT interventions utilized with adults with SUD and the perceived effectiveness of those interventions, to evaluate the discharge needs of adults with SUD receiving residential treatment, and to develop programming to enhance discharge preparation and utilize the preliminary findings of the research study to advocate for the role of OT at a SUD treatment facility.

  A qualitative research study was designed and conducted with occupational therapy practitioners (OTP) from across the country to examine the question: “which OT interventions are utilized with adults with SUD and what are practitioners’ perceptions of their effectiveness?” There were a total of 15 OTP who participated in the 24-question online survey and two who participated in an interview via Zoom. Data was analyzed using Braun and Clarke’s (2006) thematic analysis and three overarching themes emerged: variety of interventions utilized, awareness of recovery supports and barriers, and continuum of care transitions. A needs assessment was conducted with adults receiving residential treatment for SUD at Gateway Foundation in Aurora, Illinois to determine discharge needs for community reentry. Interviews were conducted with 29 clients, which yielded the following needs: the importance of routines to support recovery and structure time, the establishment of sleep hygiene routines to improve sleep quality, opportunities to engage in meaningful roles, integration of skill application and practice, and stress management and self-advocacy skills for the workplace. Observation conducted at Gateway Foundation indicated the need for a framework for clients to utilize in order to write measurable goals and structured free time to promote the exploration of meaningful and purposeful activities while still in the treatment environment.

  Programming recommendations were given to Gateway Foundation in the form of enhancements to the current program and the development of a new group in order to meet the identified needs of the clients. The recommendations include a goal writing and setting workshop, suggested implementation of structured free time, opportunities for skill application, and integration of the routines and time management group developed. The preliminary results of the research study were incorporated into programming recommendations, used to articulate the value of OT when working with the SUD population, and advocate for the inclusion of an occupational therapist on the team at Gateway Foundation.