Background: Foster youth endure traumatic adversities, which can lead to obstacles when transitioning to young adulthood and pursuing postsecondary education. This vulnerable population is required to navigate independent living while also managing stress that commonly arises from postsecondary education. Method: A pre test, post test pilot design was employed to determine the potential impact and feasibility of an evidenced-based multi-factorial stress management program in reducing foster youth’s perceived stress during postsecondary education. Participants (n = 3) received one, 90-min individual occupational therapy session weekly over 6 weeks. Author-generated stress management surveys along with the Perceived Stress Scale were administered pre and post intervention. Results: Outcomes reveal this cost-effective program may be feasible in decreasing foster youth’s perceived stress. All participants’ individual Perceived Stress Scale scores decreased over the course of the intervention. Two out of three participants demonstrated a decrease in perceived academic stress while one participant’s perceived academic stress remained the same from pre to post intervention. Conclusion: Considerations for future programs include flexibility in scheduling, addressing time management challenges with this population, and integration of trauma-informed care principles.

Purpose: A repeated measures single-group feasibility study was used to investigate the potential success and feasibility of an adaptive climbing program including group social skills activities to positively impact social skills in children with developmental delays. Methods: A convenience sample of 10 children aged 4 to 12 years participated in six social skills activity groups and adaptive climbing sessions at a rock-climbing facility in North Carolina. Trained observers measured targeted social skills via an author-generated social skills tracking form. Results: A paired t-test indicates a statistically significant improvement in social skills from session 1 to session 6 (pConclusions: Outcomes suggest participation in a community-based adaptive climbing program that involves group social skills activities may be beneficial for promoting social skill development in children with developmental delays. Opportunities exist for occupational therapists to partner with climbing gyms or other organizations to develop and tailor programming specific to each child’s developmental level and needs.

Background: The Kawa model, a framework to guide culturally relevant occupational therapy, has gained recognition and become more widely used in practice. Research on the model thus far, while still relatively sparse, provides guidance for the model’s use, including its strengths and facets that require further exploration to support its use and effectiveness in dynamic ways. Method: A scoping review was completed to gather, organize, appraise, and synthesize the current research evidence on use of the model. Results: Findings support the Kawa model’s culturally flexible application and its capacity to garner client-centered qualitative information, as well as to build therapeutic relationships in a variety of settings. Challenges to the model’s use include therapists’ inexperience limiting effectiveness and the need for additional quantitative assessment measures to supplement the qualitative findings gathered during use of the Kawa. Limitations to this review include author preconceptions, homogeneity among the authors, and inclusion of non-peer-reviewed theses. Conclusion: The Kawa model is an adaptable tool to examine and enhance well-being. It may be most effective when used by experienced therapists and in conjunction with other relevant tools. Further research is recommended to continue to evaluate its dynamic use.

Aim To investigate the feasibility of occupational therapy-led multidisciplinary delirium management interventions in a long-term acute care hospital to decrease incidence of delirium and increase independence for self-care.Methods Convenience sampling was used to recruit eight patients in a long-term acute care hospital for a pretest/posttest delirium management pilot study. Interventions included mobility, functional cognition, sensory deficit correction, self-care, and sleep interventions. Delirium was assessed using the ICDSC and the CAM-ICU; self-care outcomes were measured using the AM-PAC “6 clicks” Daily Activities Short Form.Results One participant decreased delirium incidence and increased self-care independence following the intervention. However, participants in aggregate had a 25% decrease in delirium incidence.Conclusion Occupational therapy interventions may positively impact delirium incidence in long-term acute care hospital patients, but interdisciplinary team management with collaborative team interventions may be necessary to extend the impact to patient functional outcomes.

Fine motor performance skills are essential for children's successful educational participation. Kindergarten curriculums are increasingly academic with less emphasis on play-based learning. Increased expectations for kindergarten readiness do not align with developmental milestones. Occupational therapists are uniquely positioned to support students and teachers with preparing for kindergarten. This six-week collaborative intervention utilized fine motor and sensory activity centers, integrated within the classroom, to promote kindergarten readiness for 16 preschool students. Pre- and post-testing indicated clinically significant gains in readiness skills. Results of this pilot study support the effectiveness of integrating occupational therapy within the preschool classroom to improve kindergarten readiness skills.

The quadruple aim of health care focuses on enhancing health care systems through improving quality patient care, improving the health of populations, providing care in cost-efficient ways, and improving the experience of providing health care by decreasing provider and caregiver stress and burnout. The purpose of this retrospective review is to share how the curricular design and doctoral capstone process from one postprofessional occupational therapy doctorate program have been designed to support students in recognizing occupational therapy’s distinct value in creating sustainable practice changes to move their respective health care systems forward. The postprofessional occupational therapy doctorate curriculum over 12 years has supported over 250 students in creating sustainable practice change projects in various work settings across the US. Doctoral capstone projects can be an effective platform for illustrating occupational therapy’s distinct value by showing how occupational therapy services are unique and valuable in health care institutions. A strong curricular design with supports related to focusing on all aspects of the quadruple aim is an effective mechanism for enhancing care.

Home health care agencies are restructuring service delivery models to address quality of care and client satisfaction while containing costs. New regulatory changes and the public health emergency due to the COVID-19 pandemic precipitated an immediate need for alternative care models. Telehealth has been recognized as a feasible delivery model to provide health care. This quasi-experimental pretest-posttest study examined the feasibility of performing occupational therapy telehealth visits as an adjunct to on-site visits for homebound clients (N=9). The Outcomes and Assessment Information Set (OASIS) data collection set, Canadian Occupational Performance Measure (COPM), and a survey were used to collect data. This combination of visits resulted in clinically and statistically significant improvements in client perception of performance and satisfaction with activities of daily living. Findings showed that participants favorably perceived this service delivery model met their therapy needs and they would recommend it to others. Results of this study warrant a larger study involving physical and speech therapy services.

Purpose: Parents often experience moderate to severe levels of stress due to the challenges of raising a child with special needs. Previous research has proven that excessive parental stress negatively impacts both the parent and child’s health. However, few organizations have been identified which offer intervention programs focusing directly on decreasing parental stress. This pilot study investigates the effectiveness of a 6-week online mindfulness-based course in reducing stress experienced by parents of children with special needs. Method: A pre-test, post-test pilot design, as well as a participatory action approach, were employed to determine the impact of the online mindfulness-based course in reducing perceived stress experienced by parents of children with special needs. Eleven parents participated in the pilot study. The course was facilitated by an occupational therapist (the first author) trained and experienced in mindfulness practices and a parent of two children with special needs. The Depression Anxiety Stress Scale - Stress subscale (DASS-SS), The Perceived Stress Scale (PSS), The Five Facet Mindfulness Questionnaire-15 (FFMQ-15), and author-generated measures were administered pre- and post-intervention to determine changes in perceived stress levels, as well as, the impact and application of mindfulness practices. Results: The DASS-SS measuring the parents’ perceived stress level revealed a 30% mean reduction in stress when comparing pre-and post-intervention scores. The PSS revealed a 21% mean reduction in perceived stress score post-intervention. The FFMQ-15 (used to measure changes in the integration of mindfulness practices into the parent’s daily routine) indicated a 4% increase in the groups’ mindfulness practices comparing pre- and post-intervention scores. Responses to the author-generated measure revealed that 82% of parents believed they could better handle challenging situations post-intervention; 100% of the parents agreed that the course made them more mindful of their thoughts. Conclusion: Results indicate that an introductory online mindfulness-based parenting program can be an effective intervention for reducing the stress experienced by parents of children with special needs.

Many current students studying in health care professions lack skills in communication, socialization, and decision-making that can lead to an inability to recognize and manage emotions, indicating a need for emotional intelligence training in university health field curricula. This article presents an evidence-based study that used a new approach to education using online emotional intelligence modules within a graduate occupational therapy program to supplement the program’s curriculum. The study was completed over six and one-half weeks and included 28 second-year graduate occupational therapy students. A pre/post-survey design was used to determine participants’ knowledge and their perceptions of their own emotional intelligence skills before and after the completion of six online educational modules and five reflective online activities. Students reported improved perceptions of their own emotional intelligence skills as well as increased knowledge of the key components of emotional intelligence after participation in the online education. The greatest perceived changes were reported in self-awareness (+14.1%) and social awareness (+12.2%), followed by relationship management (+10.0%) and self-management (+8.3%). Additionally, in response to open-ended questions, students identified the perceived benefits of improved emotional intelligence as leading to future success in the classroom and clinical fieldwork affiliations. The emotional intelligence modules and reflective online activities may provide a new approach to the delivery of emotional intelligence education, appealing to today’s students.

Purpose: Effective healthcare team collaboration is imperative for quality client-centered care, job satisfaction, and overall morale. Rehabilitation team collaboration can be impacted by high productivity demands, differing backgrounds of individual team members, and the unpredictable healthcare environment. The Kawa (river) model, a culturally-neutral model of occupational therapy practice, has been shown to improve communication and collaboration with its use of metaphors, but its utility in various contexts to enhance collaborative practice is still being explored. The purpose of this study was to implement an evidence-based teambuilding intervention with use of the Kawa model to investigate the impact on acute care rehabilitation team collaboration. Method: A 5-week pretest-posttest study was completed with a group of eight rehabilitation team members, consisting of occupational therapists, physical therapists, and a speech language pathologist, in an acute care setting. Pre and post-surveys were utilized to gather quantitative and qualitative data on perceptions of team collaboration, knowledge of the Kawa model, and the model’s utility for collaboration. Results: Outcomes showed overall mean improvements in agreement that the Kawa model provides a common method of communication, and 100% of the participants agreed or strongly agreed that use of the Kawa model can improve acute care rehabilitation team collaboration. Qualitative post-survey responses indicated an enhanced understanding of the components of effective team collaboration. Conclusions & Recommendations: Team collaboration was cultivated with use of the Kawa model. The model provided a successful method for the acute care team to openly discuss and collaboratively problem-solve how to maximize their team flow. Further study of the Kawa model’s utility to improve collaboration in various contexts with broader participant groups is recommended, as well as study of longitudinal effects of a teambuilding intervention with use of the Kawa model.

A pre-test post-test design was used to deliver the Size Matters Handwriting Program to 19 second-grade students using an occupational therapist-teacher collaborative teaching model. Outcomes from the Minnesota Handwriting Assessment indicate statistically and clinically significant gains for students in legibility, form, alignment, size, and spacing. Students' perceptions of self-monitoring, collected via a brief self-report measure, reveal that most students agreed that self-monitoring played an important role in their learning by understanding the rules of handwriting and learning proper spacing strategies when writing. These results support the effectiveness of employing the Size Matters Handwriting Program and teaching self-monitoring strategies.

Background/AimThe purpose of this pre-test, post-test study was to determine if caregivers of patients diagnosed with a mild brain injury feel better prepared for the caregiving role following a single, individualised education session in the acute care hospital setting.MethodsA total of 17 patients and 21 caregivers were recruited. A pre-intervention survey was used to gather baseline perceptions on preparedness, worry, and brain injury knowledge. The intervention included a review of a mild brain injury educational booklet and a caregiver handout with the patient and caregiver during a 45–60-minute session. A post-intervention survey was used to assess caregivers' perceptions following the educational session.FindingsThe mean Likert survey responses of the caregivers indicated an improvement in the areas of worry, preparedness for caregiving, and understanding of brain injury post-intervention. Caregivers unanimously agreed that their understanding of brain injury and ability to manage the patients' symptoms was a direct result of the intervention.ConclusionsThe findings from this pilot study demonstrate the benefits of a single educational session with caregivers in the hospital setting. Exploring if the educational material was used by caregivers post-discharge is warranted to further support the results.

Purpose: The Kawa (river in Japanese) model uses the metaphor of a river to view one’s life from a metaphysical perspective, with consideration given to the interaction between social and physical environments, life circumstances, assets, and liabilities. Preliminary research suggests that the Kawa model may be an effective tool for interprofessional collaboration, but studies employing the model with diverse groups of healthcare professionals have not been undertaken. The purpose of this pilot study was to determine if the Kawa model could serve as an effective collaboration tool for a diverse healthcare team within a skilled nursing facility. Method: A pilot study using survey methodology was conducted with an interprofessional team (N=10) involving rehabilitation, nursing, administration, social work, and activities personnel. Education on the Kawa model and its components was provided to the team, followed by their participation in an interactive activity involving application of the model to a case study. An author-generated survey was administered before and after the study to elicit views about the Kawa model’s potential use as a team collaboration tool. Results: All 10/10 participants agreed or strongly agreed the Kawa model provides a common language for interprofessional collaboration, and 9/10 felt it would be an effective tool to increase collaboration in their facility. Conclusions: Healthcare professionals from a variety of fields must collaborate effectively for quality client care. Using a tool, such as the Kawa model, may provide a common ground for interprofessional discussions when making decisions about a client’s care. Recommendations include replication of this study with larger, more diverse healthcare teams, incorporation of an actual client and his or her family in the team, and comparison of other collaborative practices with those employing the Kawa model.

Despite the effectiveness of occupational therapy home modification interventions, persons with disabilities may not receive them due to service delivery costs, limited number of therapists, and expansive geographic service areas. The need for occupational therapy home modification interventions will increase with the rising U.S. aging population, incidence of chronic illness, and shift toward community-based care. This study examined the feasibility of telehealth occupational therapy home modification interventions using participant owned smart phones, tablets, or computers. A pretest posttest design (n=4) demonstrated improvement in home safety and perception of performance of daily activities. Participants reported satisfaction with the mode of intervention citing ease of use and reduction in client and caregiver burden. Two key implementation challenges were (1) inconsistent quality of synchronous audio and video and (2) limited funding for home modification interventions. A large-scale telehealth occupational therapy home modification interventions pilot study is warranted.

Purpose: Fall prevention is an ongoing concern in long-term care. Self-efficacy of nursing staff affects their performance levels related to fall prevention. Research concerning falls in the elderly is plentiful but there are no published studies addressing self-efficacy of nursing staff for implementation of fall prevention strategies in long-term care. The authors hypothesize that fall prevention education by an occupational therapist would be effective to improve the self-efficacy of nursing staff for implementation of fall prevention strategies and self-efficacy to prevent resident falls. Method: A pre-test post-test pilot study implementing a five-week, multifaceted, fall prevention education course was conducted by an occupational therapist. The SEPF-A and SEPF-N were administered to the nursing staff respective of their professional licensure to assess falls self-efficacy before and after the course. Results: Eight participants (6 certified nursing assistants & 2 nurses) completed the course. A statistically significant improvement (p = .043, a = .05) in falls self-efficacy was noted for the nursing assistants. Following training, there was a 40% increase in the SEPF-A and a 67% increase in the SEPF-N indicating an improvement in self-efficacy related to falls. Conclusion: Fall prevention training by a licensed expert may be an effective approach to increase self-efficacy of nursing staff for implementation of fall prevention strategies and for prevention of resident falls in long-term care.

Background: Executive functions are higher order cognitive processes occurring in the frontal lobe that influence cognitive, emotional, and behavioral functions. Adolescents with executive functioning deficits are at risk for difficulties in all domains of occupational functioning. Parents of these adolescents often live in a persistent state of stress that leads to highly reactive exchanges with their children. Studies have shown that a mindful approach to parenting can enhance a parent’s caregiving ability and self-awareness in the family unit. Methods: A pretest/posttest study evaluated the effectiveness of a 6-week mindful parenting program. Four parents of adolescents with executive function deficits participated in six consecutive group sessions for 1.5 hr each, one time per week, to learn mindful strategies. Results: Although most results were not found to be statistically significant, findings demonstrated promising trends for three of the parents. Statistically significant results indicated that one parent experienced improved communication with his or her adolescent, two had fewer concerns at school for their adolescent, three showed increased ability to problem-solve, one decreased his or her perfectionistic parenting skills, and one was more likely to be in the middle between the other parent and their adolescent. Conclusions: Support for parents after program conclusion may be necessary to promote lasting change. Further research is needed with larger groups and longer periods to determine the effectiveness of mindfulness programs for parents with adolescents with executive functioning deficits.

Purpose: The KAWA model, a culturally-sensitive model of occupational therapy practice, can enhance patient-provider collaboration, but its use as a tool for teambuilding and collaboration among an interprofessional group has not been studied. Teambuilding has been positively correlated with job satisfaction, and quality of client care. The purpose of this exploratory qualitative study was to identify potential uses of the KAWA model and areas for future research related to teambuilding. Method: Trainings on the model, including a review of model components, its potential utility with clients, and an interactive activity, were provided to two rehabilitative teams (N=26) within two skilled nursing facilities. Results: Focus groups were conducted and analysis of the discussions revealed 4 potential applications of the model: (1) as a teambuilding tool to build team cohesiveness/morale; (2) as a tool to address performance issues with individual team members; (3) as a tool for conflict resolution among multiple team members; and (4) as a means to address workplace challenges external to the team itself. Conclusions & Recommendations: Teambuilding in healthcare settings can benefit both clients and rehab professionals, and the KAWA model may be an effective tool for this purpose. Limitations include a modest sample, and interpreter bias; however, this study provides a foundation for future research on the KAWA model related to teambuilding and interprofessional collaboration.