American Journal of Occupational Therapy最新文献

Importance: Belonging is a dynamic contextual construct valued within occupational therapy and connected with students' academic success and career transitions. Although belonging has been measured in higher education, there is no specific tool to measure it in occupational therapy education.

Objective: To create the Professional Belonging Scale for Occupational Therapy Students (PBSOTS) and assess its validity and internal consistency reliability for measuring belonging among occupational therapy and occupational therapy assistant students.

Design: Scale development and preliminary psychometric study.

Setting: Academic programs.

Participants: The study took place in three phases from 2022 to 2023. Phases 1 and 2 involved occupational therapy experts in diversity, equity, inclusion, belonging, and assessment. Phase 3 included 162 students from accredited occupational therapy education programs in the United States.

Outcomes and measures: Scale items were developed on the basis of the literature, expert interviews, and a student focus group and were revised based on calculated content validity index ratings (cutoff = .78) and expert feedback. Next, student data were analyzed for an exploratory factor analysis and to determine internal consistency reliability.

Results: Of an initial 24 items, 5 were removed, 5 were revised, and 1 was added, resulting in a 20-item scale with an α value of .92. Four factors had eigenvalues greater than Kaiser's criteria of 1 and explained 61.13% of the variance.

Conclusions and relevance: On the basis of preliminary validity and internal consistency reliability testing, the authors suggest further developing and researching the PBSOTS. Plain-Language Summary: Belonging is valued within occupational therapy and is connected to students' academic success and career transitions. However, there is no specific tool to measure belonging in occupational therapy education. This study used the Professional Belonging Scale for Occupational Therapy Students (PBSOTS), a self-assessment that was created by the authors to measure students' sense of belonging in occupational therapy education programs. The authors recommend further developing and researching the PBSOTS so that the self-assessment can be used to inform occupational therapy education programs about students' sense of belonging.

The occupational therapy profession faces critical workforce shortages, and the demand for services to meet the needs of diverse communities continues to rise. Underdocumented individuals represent a diverse pool of potential practitioners who face barriers to licensure if they pursue a career in occupational therapy. Despite being eligible for occupational therapy education and the National Board for Certification in Occupational Therapy exam, inconsistent state licensure requirements, which often mandate a Social Security number (SSN), pose a significant barrier to licensure and employment. We examine the challenges underdocumented individuals encounter in pursuing occupational therapy education and careers and argue for removing such barriers to enable them to become licensed practitioners. Addressing these barriers could diversify the workforce, enhance access to culturally responsive care, and alleviate shortages in underserved areas. We propose six actionable steps for the profession: (1) investigating and clarifying state licensure requirements; (2) ensuring accurate information dissemination to the public and students; (3) advocating for inclusive licensure policies, such as accepting Individual Taxpayer Identification Numbers instead of SSNs; (4) addressing inconsistencies in reciprocity agreements across states; (5) funding research to better understand workforce demographics and needs; and (6) advocating for increased tuition equity and scholarship opportunities. By fostering an inclusive pathway to licensure and embracing diversity in cultural backgrounds, languages, and life experiences, the occupational therapy profession can become a meaningful career option for underdocumented individuals who can contribute to the development of a more resilient and representative workforce to effectively serve diverse populations and address health disparities.

In this editorial, AJOT Editor-in-Chief Stacey Reynolds shares how the special issue on Diversity, Equity, Inclusion, Justice, Accessibility, and Belonging in Occupational Therapy Practice and Education was developed. From the establishment of the journal's first-ever Diversity, Equity, and Inclusion (DEI) Committee to the creation of a robust collection of research focused on DEI, Dr. Reynolds reflects on lessons learned and how the process of developing the special issue has helped shape the future of the American Journal of Occupational Therapy.

Importance: Occupational therapy students need preparation to provide culturally effective pediatric care that addresses the needs of Hispanic families.

Objective: To implement and evaluate a curriculum module aimed at improving occupational therapy students' cultural awareness, cultural knowledge, and cultural skills for working with Hispanic families.

Design: Mixed-methods, pre-post interventional study.

Setting: An entry-level occupational therapy master's program.

Participants: Convenience sample of 30 occupational therapy master's students.

Intervention: A 2-hr cognitive behavioral-based intervention module on culturally effective care for Hispanic families.

Outcomes and measures: Cultural Competence Self-Assessment Checklist-Revised (CCSACR) administered pre- and postintervention as well as a qualitative questionnaire on self-perceived changes.

Results: Significant improvements were found in cultural awareness (p = .013) and cultural skills (p = .038) on the CCSACR. Qualitative data indicated self-perceived improvements in awareness, knowledge, and preparedness for culturally effective practice.

Conclusions and relevance: A brief educational module can significantly improve occupational therapy students' cultural awareness and skills for working with Hispanic families. Curriculum-based cultural training can help prepare students to provide more equitable care. Plain-Language Summary: This study demonstrates the effectiveness of a targeted educational module for improving culturally effective care for occupational therapy students working with Hispanic families. The study found significant improvements in students' cultural awareness and cultural skills. Curriculum-based cultural training can help prepare students to provide more equitable and culturally effective care. Positionality Statement: The authors' perspectives are rooted in their social positions, which shape their approach to this research. They both identify as female; one identifies as Black, and one identifies as Hispanic. The authors' experiences have instilled a deep understanding of the systemic barriers and historical injustices that have shaped health care access and outcomes for marginalized communities.

Importance: The transgender and gender-diverse (TGD) community faces significant health care disparities, including elevated rates of mental health issues, poverty, and barriers to accessing affirming care. Occupational therapy practitioners are ethically obligated to provide gender-affirming care, yet there are no practice guidelines for such care.

Objective: To examine the landscape of gender-affirming care within occupational therapy practice, aiming to identify gaps for future research and guidelines.

Data sources: Six databases (MEDLINE, EMBASE, Scopus, PsycINFO, CINAHL, Web of Science). Search dates ranged from database inception to September 19, 2023.

Study selection and data collection: We followed Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute guidelines for all methodologies. Studies were included if they described gender-affirming care, included language related to the transgender and gender-diverse community, and mentioned occupational therapy. Studies were excluded if they were not peer-reviewed or did not include an intervention.

Findings: A total of 614 studies were identified, and 17 were included. Of the included studies, the majority were qualitative (n = 9) and from the United States or Canada. Published research highlighted clinicians' need for more training in gender-affirming care and suggested diverse modalities to bridge gaps in working with TGD individuals.

Conclusions and relevance: This review underscores the urgent need for targeted research to address TGD individuals' specific needs in occupational therapy practice. Future efforts should focus on developing and evaluating gender-affirming care interventions, expanding training modalities, and promoting inclusive care within occupational therapy. Plain-Language Summary: The transgender and gender-diverse (TGD) community often encounters obstacles in accessing health care, including mental health issues and barriers to affirming care. Occupational therapy practitioners play a crucial role in providing gender-affirming care, yet there is a lack of clear guidelines for doing so. This study aimed to examine the current state of gender-affirming care in occupational therapy and identify areas for improvement, ultimately benefiting both practitioners and clients. Future research should focus on developing and evaluating gender-affirming care interventions, expanding training modalities, and promoting inclusive care within occupational therapy. Positionality Statement: The authorship team represents one individual who identifies as nonbinary and four who identify as cisgender. Most of the authors identify as White. Three authors identify as LGBTQ+. Two authors have prior experience writing scoping reviews.

Importance: Research on the factors contributing to low academic performance of first-generation students studying occupational therapy is limited, and how these factors affect the students' academic performance is insufficiently described.

Objective: To explore how first-generation students in occupational therapy perceive their academic self-efficacy, academic engagement, and social integration.

Design: Explanatory sequential mixed-methods design.

Setting: Occupational therapy program on the East Coast of the United States.

Participants: The total sample included 18 first-generation students in occupational therapy through purposeful sampling. Eighteen participants completed the survey, and 5 participants participated in the interview.

Outcomes and measures: Measures included a demographic questionnaire, the Self-Efficacy for Learning Form-Abridged, the Survey of Student Engagement, the Social Integration Scale, and semistructured interviews.

Results: Participants reported a low level of academic self-efficacy, academic engagement, and social integration.

Conclusions and relevance: This study fills the gap in research regarding factors contributing to low academic performance of first-generation students in occupational therapy and how the identified barriers of academic self-efficacy, academic engagement, and social integration can be addressed for these students. Plain-Language Summary: This study explored how first-generation occupational therapy students think about their academic performance, engagement, and social integration. Students reported a low level of academic performance, engagement, and social integration. Identifying and understanding the factors that affect the academic performance of first-generation students can improve the support and services provided by occupational therapy programs to first-generation students. Positionality Statement: Positionality is described as the location of the researcher in their research (Milner, 2007). It influences the researcher's assumptions, findings, and interpretations (Banks, 2015). As a first-generation doctoral student, I identify with the unique challenges faced by many first-generation students. As Milner (2007) suggested, it is important to be introspective during research and acknowledge any internal biases to maintain objectivity during the research process. I aimed to be reflexive by taking notes about my thoughts throughout the study to actively reflect on my understanding of how my positionality may affect my data collection and analysis.