Research Projects 2018

 

 

All aboard: Users’ experiences of adapted paddling programs

Darien Merrick, Alice Wilson, Kyle Hillman

Introduction: Leisure activities in natural environments are associated with improvements in mental and physical well-being (Shanahan et al., 2016). People with disabilities may be prevented from engaging in such activities due to physical, societal, and psychological barriers (Dorsch, Richards, Swain, & Maxey, 2016). Adaptive kayaking and paddleboarding programs enable people with disabilities to engage in outdoor activities in a unique, water-based context. Little is known about how people experience these activities, but one study suggested adaptive kayaking provides a sense of freedom and equality with able-bodied paddlers (O’Broin & Collins, 2009).

Objectives: To explore paddlers’ experiences in two adaptive kayaking and paddleboarding programs: one focused on therapeutic skill-development; the other was recreational.

Methods: This ongoing ethnographic study involves participant observations and semi-structured interviews. Participants include children and adults living with a range of physical, cognitive, and/or developmental impairments. Data are being analyzed thematically (Braun & Clarke, 2006).

Results: Seven days of observations have been conducted and nine interviews have been completed with a goal of fourteen. Our preliminary analysis has identified three themes. “A Whale of a Time characterizes the meaning paddlers’ associate with their experiences. “Making a splash” describes the physical experience of being on the water. “Different strokes” explores the diversity of physical and social contexts of the programs.

Conclusions: Paddlers see adaptive paddling programs as a valuable opportunity to engage in outdoor leisure pursuits. Program coordinators, therapists, and outdoor enthusiasts may use this research to develop programs and encourage access to outdoor activities.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.

Casey, N., O’Broin, D., & Collins, B. (2009). Research article: The meaning of the experience of kayaking for persons with spinal cord injury. Irish Journal of Occupational Therapy, 37(2), 29-36.

Dorsch, T. E., Richards, K. A. R., Swain, J., & Maxey, M. (2016). The effect of an outdoor recreation program on individuals with disabilities and their family members: A case study. Therapeutic Recreation Journal, 50(2), 155-171.


A mindful OT: How Canadian occupational therapists use mindfulness-based approaches

Melissa Ferguson and TJ Isherwood

Introduction: Mindfulness-based approaches (MBAs) are used in clinical practice to support clients to increase awareness by intentionally paying attention, from moment-to-moment, non-judgmentally and compassionately. While MBAs are gaining popularity in occupational therapy (OT) and  show potential to innovate practice, there is limited understanding of the specific profile of practice for OTs using MBAs in Canadian healthcare.

Objectives: To better understand the mindfulness practice parameters, and potentially unique contributions of OTs facilitating MBAs.

Methods: This study will use a mixed-methods approach. Canadian OTs will be recruited to participate in an online survey through regulatory bodies, professional associations, educational programs, clinical network, and social media. Semi-structured interviews will be conducted with an additional 10 OTs for an in-depth understanding of clinical reasoning related to the use of MBAs. The survey and interviews will explore the education, intervention parameters, approaches and outcomes used when OTs employ MBAs. Survey data will be analyzed using SPSS software to determine trends. Interview data will be coded and thematically analyzed.

Results: Findings will help in understanding who, where and how Canadian OTs are using MBAs and what it is that OTs uniquely bring to MBAs.

Conclusions: The findings will increase collective understanding of the profession as a whole, the individuals receiving MBAs across Canada, and of the broader research community on how these innovative approaches support meaningful occupations of clients, are uniquely used by OTs, as well as how mindfulness is an inclusive occupation in and of itself.


Comparing Standardized and Parent-Reported Outcomes of Extremely Preterm Infants

Andrea Abbott and Maeve Morgan-Feir

INTRODUCTION: Extremely preterm infants are at increased risk of later motor impairment. Neonatal Follow-Up Programs in Canada conduct standardized assessments to track developmental outcomes, yet few studies have examined the relationship of standardized motor measures and parent-reported outcomes.

OBJECTIVE: Our objective is to compare 18-month motor outcomes with parent-reported functional outcomes at 3 years for preterm infants born at <29 weeks gestation.

METHODS: We will use data from the Canadian Neonatal Follow-Up Network (n=2340) to compare the proportion of infants with Bayley-III motor composite scores at 18-24 months corrected age (CA) >84, 70-84 (-1SD) and <70 (-2SD) to the proportion of participants with parent-completed 36-month Ages and Stages Questionnaire (ASQ) gross or fine motor scores in the monitoring zone and below the clinical cut-off zone using chi-square analyses. Pearson correlation coefficients will be calculated to evaluate the degree of correlation and statistical significance. A series of sensitivity and specificity calculations will assess the ability of 2 cut-off points on the Bayley-III Motor composite score to predict an abnormal or borderline ASQ-3 result in the fine motor and gross motor domains. We expect that a high proportion of infants with motor difficulties at 18-24 months CA will have functional difficulties at age 3 years and that standardized assessments and parent-reported outcomes will be moderately correlated.

RESULTS: This project will determine what proportion of extremely preterm infants scoring  >84, 70-84, and <70 on the Bayley-III composite motor score at 18-24 months have parent-reported functional motor difficulties at 3 years, and whether the Bayley-III gross and fine motor subscale scores are associated with the gross and fine motor domains of the ASQ.

CONCLUSIONS: Study results may help occupational therapists better understand the impact of Bayley-III motor findings and add to the bank of research on motor outcomes.


Developmental Coordination Disorder: Consulting with Parents

Lisa Minor & Lisa Barclay
Introduction: Developmental Coordination Disorder (DCD) is a neuromotor disorder of unknown cause that affects a child’s ability to learn motor skills and perform daily activities. Despite its prevalence, DCD is under-recognized and under-diagnosed. While research related to DCD has increased in recent years, few studies have examined parents’ perspectives of what is most valuable for future research and improving the diagnostic process.

Objectives: Our objective is to engage parents of children with DCD to better understand their experiences with the diagnostic process and determine what parents perceive as important to inform future research.

Methods: Parents of children with DCD who consented to be contacted for future research (n=~150) will be invited to participate in a focus group. We anticipate conducting 5-6 focus groups with 6-10 participants in each group. Transcripts from focus groups will be coded to identify common themes.

Results: We anticipate parents will identify a lack of support in the field of DCD, provide meaningful suggestions for future research, and identify barriers to receiving a diagnosis for their child. We believe this information will be clinically meaningful, as it will help improve the diagnostic process and direct future research towards what is most valuable for families.

Conclusions: Conducting a study which looks at the unique perspective of parents provides an invaluable point of view, which can only be understood through lived experience. This study provides a forum for parents and researchers to work collaboratively with the common goal of improving the experience for families of children with DCD.


Development of a novel Tool measuring Socio-emotional Skills among Children: Analysis of Psychometric Properties

Meredith Blinkhorn and Jessie Bears

Introduction: Autism Spectrum Disorder (ASD) is a prevalent neurodevelopmental disorder, affecting approximately 1 in 68 children. Difficulties with emotion recognition and perspective-taking are commonly observed in children with ASD and have a profound impact on their daily functioning and quality of life. Currently, there is little information on valid and reliable assessment tools that can objectively evaluate socio-emotional skills in children age 6-10 with ASD, making it difficult for occupational therapist to evaluate intervention outcomes.

Objectives: The current project aims to develop and test the psychometric properties of two tools evaluating perspective taking and emotion recognition.

Methods: In a cross-sectional exploratory study, 20 children with ASD and 20 neurotypical children, aged 6-10 years, will trial the developed evaluation tools. Researchers will meet with participants in their homes and/or research lab, where participants will complete two computer-based behavioural tasks to evaluate emotion recognition and perspective taking abilities. Test-retest reliability, criterion validity, and comparisons between group performance on the outcome measures will be analyzed between children with ASD and neurotypical children.

Practice Implications: Occupational therapists need access to valid tools in order to monitor clients’ progress. The developed tools will provide occupational therapists with two standardized tools to measure emotion recognition and perspective-taking among children with ASD.

Conclusions: The creation of standardized tools will assist with measuring intervention outcomes related to socio-emotional skills in children with ASD and potentially other developmental disorders in occupational therapy clinical practice and in future research.


Domain-Specific Strategy Use within the Cognitive Orientation to daily Occupational Performance Approach for Children with Developmental Coordination Disorder

Sarah Northrup and Sara Schwartz 

Introduction: Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder impacting motor coordination, which interferes with participation in everyday activities across the lifespan. Current best-practice for treating children with DCD is Cognitive Orientation to daily Occupational Performance (CO-OP), an individualized intervention that focuses on skill acquisition using cognitive strategies. The specific strategies that are most effective for children with DCD have not been systematically explored.

Objective: This study aims to determine the domain-specific CO-OP strategies (e.g., attention to doing, task modification/specification, verbal mnemonic) most used to enable children with DCD to achieve their self-care, productivity, and leisure motor goals.

Methods: A retrospective chart review will be conducted to explore occupational therapists’ use of domain-specific strategies within CO-OP for ~50 children with DCD (8-12 years). CO-OP effectiveness will be determined through pre- and post-intervention ratings of performance and satisfaction on the Canadian Occupational Performance Measure (COPM) using Wilcoxon Signed Rank Tests.

Results: Results thus far (N = 30) demonstrate a significant increase (p < 0.001) in COPM performance scores (pre-mean (SD): 3.01 (1.96); post: 7.02 (1.60) and in satisfaction scores (pre-mean (SD): 2.86 (2.32); post: 7.51 (1.78). Supplementing task knowledge has been identified as the most frequently used strategy and leisure as the most common goal category.

Conclusion: Identifying the most common domain-specific strategies will increase occupational therapists understanding of CO-OP’s effectiveness for child-chosen motor goals. Recognizing goals that are most important for children with DCD will provide insight for occupational therapists about the areas in which children with DCD require support.


Effectiveness of petrie hip abduction splint post hip containment surgery

Anica Villamayor and Dan Hurst

Introduction: The Petrie Abduction Splint is current standard of practice at a Children’s Hospital to maintain positioning in the hip joint after varus derotation surgery in children with Cerebral Palsy. Although use of the splint is based on biomechanical theory, little evidence has been published to support its use.

Objectives: The aim of this study is to investigate the effectiveness of the Petrie Abduction splint by measuring hip migration post-surgery through x-rays and range of motion using a goniometer. We hypothesize that the splint maintains effects of surgery, specifically decreasing hip migration and increasing hip range of motion.

Methods: Using a single subject research design, we have measured change in the hip migration and range of motion post reconstructive hip surgery for three children with Cerebral Palsy with GMFCS level 4 and 5; data collection is ongoing with a target of eight participants by May 2018. Data have been collected by the health care team pre-operatively at baseline and post-operatively at 2-4 weeks, 3 months, 6 months, and one year post-surgery.

Results: Preliminary results demonstrate maintained effects of the surgery through decreased bilateral hip migration percentage but results are inconclusive regarding range of motion.

Conclusion: Preliminary evidence suggests that use of the Petrie hip abduction splint post hip containment surgery may assist in maintaining hip migration percentage while more data are needed for conclusive effects on range of motion. Further data collection for this pilot study will determine if the Petrie hip abduction splint is effective for long-term hip positioning.


Evaluation of The Nino®: Advancement in Assistive Power Mobility Technology

Bryn Matheson and Jazzmin Tavares

Rationale: A manual wheelchair is an effective and functional means of mobility for many individuals, but may pose restrictions to participation due to diverse physical, environmental and psychosocial barriers. In recent years, novel assistive power mobility devices have emerged that aim to combat barriers manual mobility users face. However, little research exists examining the experience of the Nino in order to evaluate the effectiveness.

Objectives: The proposed study aims to explore the experience of using the Nino®, a two-wheeled Segway-technology assistive power mobility device.

Approach: This mixed-methods study will explore the skills and subjective evaluations of 12 participants who are current manual wheelchair users in order to evaluate the Nino®. Participants will complete the Wheelchair Skills Test in their manual wheelchair and in the Nino. Task-load and confidence variables will be measured in conjunction with a qualitative interview exploring experience.

Practice Implications: The proposed study will provide insight into suitability of the Nino as a wheelchair prescription option for individuals who are looking for an assistive power mobility device and are currently using a manual wheelchair.

Conclusions: Occupational therapists need to evaluate the efficacy and functional characteristics of new assistive power mobility devices in order to properly inform and educate clients around their options. Results will provide insight into the benefits and limitations of assistive power mobility devices, such as the Nino®


Experiences of Internationally Educated Occupational Therapists transitioning into Canadian practice

Jacob Colby and Natalie Carrion

Introduction: British Columbia (BC) has an increasing demand for Occupational Therapists (OTs) that is not currently being met by OTs trained in the province. One way this shortage is met is through the registration of Internationally Educated Occupational Therapists (IEOTs). Becoming a registered OT is a transition with potentially complex effects on the IEOT’s life and occupations and about which little is known from an occupational perspective.

Objectives: This study aims to: (1) understand the process, barriers and facilitators for IEOTs becoming registered OTs, (2) explore the experience of transition from an occupational perspective for IEOTs who are registered OTs, (3) appraise the fit of the Predictable Transitions from an Occupational Perspective (P-TOP) Model (Romanyk, Young, Lee Bunting & Forwell, 2016) with the experience of IEOTs who are registered OTs.

Methods: IEOTs will be recruited through the College of Occupational Therapists of British Columbia (COTBC). An online survey will address the process, barriers and facilitators for IEOTs obtaining registration with COTBC. Semi-structured interviews will be conducted to explore the transition experience of IEOTs and further refine the P-TOP model.

Results: Findings will address the current knowledge gap in understanding the transition experiences of IEOTs as they become registered OTs in BC from an occupational perspective. Results will explore how this transition affects the person, environment and occupation and inform further refinement and validation of the P-TOP model.

Conclusion: Exploring transition in the lives of IEOTs will contribute to a deeper understanding of transition from an occupational perspective.

Reference List:

1.) Romanyk, J., Young, T., Lee Bunting, K., & Forwell, S.J. (2016, October). Transition from an occupational perspective: Defining and presenting a model of life transition unrelated to health. Paper presented at the CSOS – SSO:USA 3rd joint conference. Portland, Maine, USA.


Exploring newcomer integration into Metro Vancouver from an occupational perspective 

Jin Hu, Xin Ma

Introduction: According to Bennett et al. (2012), immigrants face numerous challenges related to role changes, employment, and identity that influence their integration into the host society. Various factors such as language proficiency, inadequate policies, cultural discrepancies, and discrimination create barriers for immigrants and refugees to achieve career development, maintain routine, and engage in meaningful daily occupations. This paper will use an occupation-based perspective to examine the settlement and integration experiences of immigrants and refugees residing in the Metropolitan area of Vancouver.

Objective: To synthesize and present current knowledge regarding the settlement and integration experiences of immigrants and refugees residing in Vancouver.  Adopting an occupational perspective to analyze existing literature we aim gain insight into factors that enable or limit immigrants and refugees in engaging in meaningful occupations.

Method: A scoping review methodology informed by Arksey and O’Malley’s (2005) six stage approach guided the study. To meet our objective, the identification of relevant studies was systematically completed using search terms related to four categories (population, location, methodology and issue). Study selection was guided by inclusion and exclusion criteria that were applied during title, abstract and full text screenings. Selected articles were then read and relevant data were extracted into a chart.  Finally, charted data were then collated and summarized into key themes.

Results:  In narrowing the focus of the scoping review to a specific geographic area, the findings of this review that is currently being completed will be more transferable to the local community. Adopting an occupational lens to interpret data from interdisciplinary literature will result in findings that can identify a broad range of factors shaping immigrants’ and refugees’ participation in the host community.

Conclusions: Better understanding the experiences of immigrants and refugees as they transition between occupations following relocation will enable the identification of gaps in existing settlement and integration services and in recent research and generate recommendations for moving forward


Evaluating common approaches to improve visibility of mobility device users

Jaquelyn Webber and Jennifer Wuschke

Introduction: Orange flags are frequently recommended as means of increasing wheelchair user visibility; however, some users find them stigmatizing (Mortenson et al., 2005). Recently, a light emitting diode (LED) system has been developed to increase wheelchair user visibility, especially during nighttime conditions. Unfortunately, there is no empirical evidence supporting the use of any of these visibility strategies among wheelchair users.

Objectives: To investigate the effectiveness of four different visibility strategies (i.e., LED lighting system, safety vests, orange flags, or black clothing) for wheelchair users in nighttime and daytime conditions.

Methods: Participants will be shown videos from the driver’s perspective depicting a wheelchair pedestrian waiting to cross the street while using one of the four visibility strategies in isolation during nighttime and daytime. Participants will indicate when they first see the pedestrian at the roadside, if at all. A repeated measures ANOVA test will be performed to determine which strategy allows for the longest reaction distance.

Practice Implications: This study will provide evidence about which visibility strategy is the most effective at increasing wheelchair pedestrian conspicuity.

Conclusions: Results will enable wheelchair users to make informed choices about which visibility strategy to use.


Evaluation of the Smartphone Peer Physical Activity Counseling (SPPAC) Program on Physical Activity among Manual Wheelchair Users with a Spinal Cord Injury: A Mixed Methods Pilot Study​

Rachel Degan and Hanna Kirsten 

Introduction: Physical activity (PA) has numerous physical and mental health benefits. Integrating more PA into everyday life to attain such health benefits can be challenging, especially for individuals with a spinal cord injury (SCI) who use a wheelchair. While there is some evidence for PA programs, less than 50% of people with SCI are active enough to attain the health benefits. Peers and smartphones represent one way for integrating important psychological factors known to influence PA participation.

Objectives: The study aims to determine if the Smartphone Peer Physical Activity Counseling (SPPAC) program improves PA levels in a group of manual wheelchair users with a SCI and explore participants’ thoughts and experiences participating in this program.

Methods: This mixed methods study will recruit 10 community dwelling adults with SCI to participate in a 14-session program. A datalogger will measure PA levels in a single group pretest-posttest design and secondary outcomes will collect information about leisure-time PA, motivation, and satisfaction with PA. A focus group will then be held to determine participants’ experience with the SPPAC program.

Results: It is anticipated that the SPPAC program will improve PA levels, secondary outcome measures, and the use of a peer and technology will be well-received by participants.

Conclusions: This study will help determine if the SPPAC program provides individuals living with a SCI the knowledge and skills to empower them to engage in more PA throughout their everyday occupations in order to promote health and well-being. 


Functional Individualized Cognitive Intervention Program for Persons with Multiple Sclerosis

Cassandra Santos & Nathan Susilo

Introduction: Individuals with cognitive dysfunction due to multiple sclerosis (MS) often experience difficulties in their ability to participate in meaningful occupations. While intervention programs currently exist that treat specific cognitive components, there is no individualized program that focuses on function. The Functional Individualized Cognitive Intervention Program (FICIP) was developed to provide clinicians with a systematic program to address the functional impact of cognitive dysfunction in clients with MS and to provide persons with MS with a comprehensive and individualized intervention program that addresses both the impairments in cognitive domains and in daily function. The program offers modules that include client education, supportive exercises, tangible solutions, and online and community resources.

Objectives: To test the clinical utility, acceptability and feasibility of the FICIP by seeking input from occupational therapy clinicians and persons with MS.

Methods: This ethics approved study targets ten occupational therapy clinicians and seven persons with MS. Clinicians are recruited through purposive recruitment, while persons with MS are recruited through recruitment posters at a local MS clinic. All participants receive a copy of the FICIP and are asked to review the program. Clinicians are encouraged to use the program with an appropriate client in their practice possible. The feedback from clinicians regarding the FICIP’s clinical utility, acceptability and feasibility are gathered through one-to-one interviews. Feedback from persons with MS are gathered through questionnaires and a focus group. Transcripts are coded and analyzed to identify common themes to improve the FICIP.

Results: The FICIP is revised based on feedback from the clinicians and persons with MS who experience cognitive dysfunction on the use, acceptability and feasibility of the program. The FICIP is regarded as an easy to use, individualized, evidence-based, functional program.

Conclusions: The FICIP provides persons with MS who are experiencing cognitive dysfunction with the opportunity to learn about various cognitive impairments, how their abilities to participate in activities are affected, and strategies to overcome these functional difficulties in their everyday lives. The FICIP provides clinicians with an individualized intervention program they are able to use and practice with to improve the function of clients with MS.


Innovative program to support students with disabilities in health professions

Heather Enns and Jessica Towle

Introduction: Health and human service (HHS) students with disabilities often face challenges navigating both academic and clinical aspects of their programs. To help mitigate barriers, we, guided by students with disabilities, have developed DREAM (Disclosure, Rights & Responsibilities, Advocacy, and Accommodations Module), a blended learning program comprised of four online modules and face-to-face workshops. DREAM aims to equip students with the knowledge and skills to navigate their classroom and clinical experiences.

Objectives: To evaluate the effectiveness of DREAM.

Methods: This in-progress mixed methods pre-post study uses quantitative measures and focus groups to evaluate the change in student knowledge, skills, and attitudes after participating in DREAM. Thirty HHS students with disabilities will be invited to participate in the project through engaging  in the online modules and workshops. Measures focus on ascertaining participants’ assertiveness, self-efficacy and advocacy, institutional sense of belonging, and knowledge of accommodations processes. Interviews and focus groups will gather in-depth

feedback from participants on their learning experiences.

Practice Implications: Fieldwork supervisors and faculty will gain insight into strategies that help students overcome challenges and ways to enable student success.  Our evidence on the effectiveness of a blended learning program can also provide post-secondary institutions with tools to become more accessible for students with disabilities.

Conclusions: HHS professions such as occupational therapy value diversity and inclusion, but need to find ways to increase diversity within the professions. Results will increase understanding of how to support students with disabilities and how to develop blended programs for student success.


Investigating the Influence of Peer-Led Wheelchair Training Boot Camp on Satisfaction with Participation, Self-Efficacy and Skill

Emma Davis and Sarah Christie

Effective use of a manual wheelchair (MWC) can support participation in meaningful activities, while ineffective use can limit it. Although effective MWC training programs do exist, research shows few clinicians implement these programs due to lack of time, resources, and knowledge. A cost-effective, time-efficient method is needed to teach MWC skills that improves satisfaction with participation in meaningful activities, increases self-efficacy and improves MWC skills. One proposed method uses principles of Social Learning Theory to deliver MWC skills in a peer-led boot camp. A group of 6 to 10 MWC users will take part in two, 4.5 hour, peer-led MWC skills training sessions. A repeated-measures design with assessments pre-intervention, post-intervention and 4 months post-intervention will be performed to investigate the influence of this intervention.


Mothers’ perspectives on family quality of life

Megan DeLeon and Fiona Roome

Introduction: Inflammatory arthritis (IA) disrupts quality of life and impacts the entire family. The Family Quality of Life Survey (FQLS) is a 25-item inventory designed to measure satisfaction with various aspects of family life (Hoffman et al., 2006; Park et al., 2003). Prior studies of mothers with IA have not considered family quality of life (FQoL).

Objectives: 1. to describe how perceptions of FQoL differ among mothers with and without IA, and 2. to identify key predictors of FQoL.

Methods: We analyze data from a larger cross-sectional survey of 342 women (n= 190 IA; 152 without). This analysis is limited to describing and predicting FQoL. Potential predictors are health status (e.g., pain, fatigue), parenting (e.g., task ability, sense of competence), social support, and demographic characteristics. T-tests will be applied to examine differences between groups on the FQoL total scores and five separate domains (Family Interaction, Parenting, General Resources, Health & Safety, and Support for People with Disabilities). Multiple regression will be used to identify salient health, parenting, social, and demographic predictors of FQoL with the combined sample.

Results: Data analysis is in progress. FQLS was completed by 335 women. Participants ranged in age from 21 to 60 (mean = 42) and typically had two children <21 at home (range = 1 to 6 children).

Conclusion: This analysis has potential to elucidate factors associated with FQoL when the mother has a chronic illness thereby informing and advancing innovative occupational therapy practices aimed at helping women sustain valued roles within their families.


Occupational therapist and psychiatric inpatient experiences of sensory modulation rooms.

Aman Rangi and Nicole Chan

Introduction: Sensory modulation rooms are environments that utilize different sensory stimuli to modulate an individual’s arousal levels. Such rooms promote self-soothing strategies in times of acute distress, as well as reduce the use of coercive measures such as seclusion and restraints. Recently, sensory modulation rooms have been introduced to acute psychiatric units. Opportunity exists to understand how sensory modulation rooms can be used to enhance the treatment experience and health outcomes of patients receiving care in this setting.

Objectives: To evaluate client and occupational therapist experiences regarding the use of sensory modulation rooms in an acute urban psychiatric setting.

Methods: Two graduate students will conduct semi-structured interviews with ten clients and five occupational therapists regarding their experiences of the sensory modulation rooms located on three acute inpatient units in a large urban tertiary care hospital We will use thematic analysis to find common subthemes and explore the data.

Practical Implications: Information regarding the experiences of sensory modulation rooms is essential to contribute to the reinforcement of recovery-oriented and trauma-informed mental health practices in acute inpatient settings. Our findings can be used to help inform and enhance current healthcare delivery, specifically the role of occupational therapy to promote the use of ensory modulation rooms in this setting.


Outcomes from an Arts-Based Psychosocial Rehabilitation Program

Graeme Hughes-Lauer and Alana Marshall

RATIONALE: Program evaluation is fundamental to evidence-based practice. Psychosocial rehabilitation (PSR) programs help people with mental health issues achieve recovery, but may fail to demonstrate recovery in their program evaluations because recovery outcomes are multi-faceted, dynamic and difficult to measure. A combination of individualized, occupation-focused measures and standardized tools anchored in psychosocial recovery philosophy may help capture intervention effects.

OBJECTIVES: To evaluate recovery in an arts-based, community out-patient PSR program serving adults with persistent mental illness.

METHODS: Independent evaluators (not involved in program delivery) employed a pre-/post-test design to measure occupational performance and a repeated-measures design to track recovery from mental illness.  Occupational performance and satisfaction with performance was measured using the Canadian Occupational Performance Measure (COPM) at baseline and two years. Recovery was measured with a new recovery outcome measure, routinely administered at beginning and end of each 12-week set of art classes over a period of one year. Evaluators used chart reviews to extract data and map outcome trajectories. Paired t-tests will be used to assess changes in COPM scores and repeated measures ANOVA to assess changes in psychosocial recovery scores.

RESULTS: Chart reviews are in progress. It is anticipated that COPM scores will be available for 20-25 clients and recovery scores for 80-100 clients.

CONCLUSIONS: Adequate recovery measures are instrumental in providing evidence of PSR program efficacy. This program evaluation integrates findings from an individualized, occupation-focused outcome measure and a new, theoretically robust measure of psychosocial recovery to demonstrate outcomes from an arts-based psychosocial rehabilitation intervention.


Outdoor recreation among wheeled mobility users: Perceived barriers and facilitators

Ashley Menzies and Carolyn Mazan

Introduction:  Participation in outdoor recreation is associated with improvements in physical, mental, and emotional health (Beringer, 2004).  Individuals with impairments affecting mobility, particularly wheelchair users, face physical, social, and environmental barriers to participate in outdoor recreation (Burns, Paterson, & Watson, 2009).  Although a number of formal programs exist to enable outdoor recreation, these programs are often oversubscribed and may not offer participants with opportunities to participate more spontaneously (James, Shing, Mortenson, Mattie, & Borisoff, 2017).

Objectives:  1) To explore the experiences and impact of participation in outdoor recreation activities by wheelchair users with an emphasis on more informal activities; and 2) to identify perceived barriers and facilitators to participation in outdoor recreation activities.

Methods: This interpretive description study (Thorne, 2016) will conduct semi-structured interviews as the main means of data collection. We will interview 12-20 wheelchair users in the Vancouver area.  These data will be analyzed thematically.

Results:  This study will explore barriers and facilitators to participation in outdoor leisure recreation.  This may help identify ways to enhance participation for wheelchair users in informal outdoor recreation activities.

Conclusions:  Expected results of the study include the use of adaptive technology as a facilitator to participation in outdoor recreation, while barriers may include environmental factors such as terrain. We also hope to identify changes that should be made to the built environment in order to facilitate participation and aide in the development of new adaptive devices.


Parent perspectives of power mobility for young children

Kaitlin Pelletier and Jenna Salewski

Introduction: Using power mobility devices with children who have mobility limitations supports development of cognitive, psychosocial and communication skills, while promoting independent mobility and function. However, survey evidence suggests that few infants and preschool children are provided with power mobility experiences.

Objectives: To examine parent impressions of their child’s experience in trialing one of four different early power mobility devices, such as child-size power wheelchairs and ride-on toy cars at home or preschool.

Methods: Following a six-month equipment loan period, consenting parents participated in a semi-structured in-person or telephone interview. Parents were purposefully sampled from a larger quantitative study that included 40 children aged 13 months to six years-of-age with a variety of diagnoses (e.g., cerebral palsy, genetic syndromes, global developmental delay, spina bifida, spinal muscular atrophy). Qualitative, thematic analysis of transcribed interviews will synthesize data from initial coding into overarching themes.

Results: To date, 11 interviews have been completed; our goal is to recruit a sample of 20 parents to ensure representation of the range of ages, diagnoses and environmental settings included in the larger study. Initial findings suggest that parents report benefits as well as challenges, such as environmental barriers and technical difficulties.

Conclusion: Early power mobility loans aim to support early childhood developmental capacity by increasing access to early power mobility devices. Exploring the benefits and challenges of power mobility loans in early childhood through the lived experience of parents of young children with mobility impairments will inform future development of a power mobility loan program.


Recovery needs of young adults receiving Early Psychosis Intervention services

Morgan Nohnychuk and Nicole Nairn

Introduction: Early Psychosis Intervention (EPI) teams are mental health services designed to support young adults with their illness trajectory and recovery. Given that the onset of early psychosis often coincides with junctures of life that entail significant life transitions, there is an important need to understand the priorities of EPI clients so that care can be recovery-oriented and contextualized around what is meaningful to this population.

Objective: The purpose of the study was to understand the recovery and rehabilitation needs of young adults receiving EPI services.

Methods: This study was a prospective survey of young adults accessing EPI services from two urban centers. We asked participants to complete a recovery assessment package, which included a demographic questionnaire and six recovery questionnaires. We summarized the data using descriptive and correlational analyses and used the CHIME framework (Leamy et al., 2011) to organize the findings.

Results: We recruited 61 participants (median age=22 years, IQR=21-26). Males represented 56% of the sample, with 38% reporting to be Caucasian and 37% East Asian. The reported recovery needs included 1) maintaining participation in meaningful activities 2) management of symptoms, self-esteem and stress, and 3) building a healthy support network. The data also suggested that 66% of participants spend less than 15 hours/week in structured time use.

Conclusions: The recovery needs of youth extend beyond disease-specific outcomes. Occupational therapy can play an important role to ensure EPI services are recovery-oriented, client-centered, and contextualized around the needs and priorities of young adults receiving EPI services.
Reference: Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. British Journal of Psychiatry, 199(6), 445-452.


Role for occupational therapy in postpartum depression: A scoping review

Kayla MacKirdy and Randi Weiss

Introduction: Postpartum depression can have a myriad of negative psychological and functional impacts on mothers and their children (O’Hara & McCabe, 2013). In Canada, the majority of women with postpartum depression are either not diagnosed or do not receive treatment (Zauderer, 2009). Occupational therapists are well suited to support women with postpartum depression who experience psychosocial and functional challenges associated with this new role.

Objectives: The objective of this study was to understand the current evidence supporting the role of occupational therapy to enhance the health and quality of life of women with postpartum depression.

Methods: We conducted a scoping review of the literature, searching the CINAHL, MEDLINE, and PsycINFO databases using a list of keywords agreed upon by experts and information librarian specialists.

Results: Our review found a total of 1,731 studies. After screening for inclusion and exclusion criteria, a total of 17 studies were reviewed. Key roles identified include: screening with specialized assessment tools, role preparation, and interventions aimed at returning function and attaining goals. The study also highlighted current gaps in services offered to women with postpartum depression related to occupational deprivation, self-management, and connection to resources.

Conclusions: Considering the negative outcomes of postpartum depression, there is a need for person-centered interventions focused on the needs and priorities of mothers. There is a clear role for occupational therapists in this area, and a strong incentive to develop an evidence base to support an impetus for the expansion of the profession into this field.

References

O’Hara, M. W., & McCabe, J. E. (2013). Postpartum depression: Current status and future directions. Annual Review of Clinical Psychology, 9(1), 379-407.doi:10.1146/annurev-clinpsy-050212-185612

Zauderer, C. (2009). Postpartum depression: How childbirth educators can help break the silence. Journal of Perinatal Education, 18(2), 23-31. doi:10.1624/105812409X426305


Sighted Perspectives on Academic Belonging for Blind People

Minnie Teng and Mary-Lou Brown

Introduction: Belonging has been associated with increased engagement and participation in academic occupations, and well-being. There is lack of research about perceptions of sighted people regarding belonging for people who are blind or partially blind. As sighted people constitute a large proportion of the academic environment, exploring their perceptions may define barriers and facilitators to creating an environment wherein blind people can experience belonging.

Objectives: The purpose of the study is to (1) examine factors that sighted students, staff, faculty, and instructors perceive as facilitating or hindering belonging for blind or partially blind people in academia; and (2) explore the experiences and opinions of sighted students, staff, faculty, and instructors regarding what helps or prevents them from enacting these factors.

Methods: Semi-structured focus groups and interviews will be used to explore perspectives of sighted students, instructors, and staff. Data will be transcribed and coded thematically.

Practice Implications: This study explores the experiences and opinions of sighted people regarding what helps or prevents them from enacting factors that contribute to sense of belonging for people who are blind or partially blind in academia. Results of this study could inform best practices for educators, including those in occupational therapy, with regards to advocating for more inclusive learning opportunities to support belonging for people who are blind or partially blind.

Conclusion: Understanding facilitators and barriers to belonging for blind and partially blind people could result in more successful program planning and influence educational system policies.


Step-Wise Approach for Treating Intention Tremor (SWAT-IT2): Community Application

Philip Yan and Mariah Morris

Introduction: Intention tremor (IT) due to multiple sclerosis (MS) disrupts important activities of daily life. The original Step-Wise Approach for Treating Intention Tremor (SWAT-IT) is an intervention with preliminary evidence suggesting its support for individuals with upper limb IT to function in daily life. The revised SWAT-IT2 has an increased repertoire, improved administration and simplified measurement.

Objectives: (1) Test the clinical utility of SWAT-IT2.  (2) Determine if the SWAT-IT2 impacts patients’ perceptions and satisfaction of function, and self-efficacy.

Methods: 15 community dwelling persons with MS-related upper limb IT will participate in individualized sessions applying the SWAT-IT2 protocol to activities of handwriting, eating, or other participant chosen activity. Questionnaires completed during the intervention session and in the 1-week follow-up session will include: demographic and medical status questionnaires, the Multidimensional Assessment of Tremor (MAT) and daily questionnaires targeting participant perceived changes due to the techniques in function, satisfaction of function, and self-efficacy. One month after the intervention, a follow-up telephone session will be conducted and the MAT and the questionnaires re-administered. Analysis includes descriptive statistics to characterize the population and nonparametric statistics to analyze the pre-post intervention trends for client perceived function, satisfaction and self-efficacy with the SWAT-IT2.

Results: Participants are expected to be satisfied with the techniques, incorporate them into daily activities, and report improved self-efficacy in completing their chosen activity one month post intervention.

Conclusions: This study adds to the literature surrounding non pharmacological, non-invasive interventions for MS-related IT by providing a feasible and effective intervention protocol that targets functional activities.


The Recovery Continuum: Mapping Occupational Therapy and Peer Navigation Services in Mental Health

Catherine Lloyd and Bex Stanke

Introduction: Improving access to mental health services in Canada is a priority. The Canadian Personal Recovery Outcome Measure (C-PROM) is a person-centred measure of recovery designed to connect people to mental health services and guide clinical care. The C-PROM has 30 items that describe recovery needs from low to high. The structure of the C-PROM offers an opportunity to standardize and coordinate care delivered to clients across different disciplines.

Objective: To use the C-PROM to describe the types of services that occupational therapy and peer navigation provide to people with psychiatric disabilities.

Methods: We will use purposive sampling to recruit 10-20 community occupational therapists and 10-20 peer navigators working in a mental health setting. In two focus groups, we will ask participants to use the C-PROM to describe the types of assessments and interventions used to support the recovery needs. We will use constant-comparison analysis of data to generate and organize themes.

Practice Implications: The projected outcome of this project will be a preliminary map of occupational therapy and peer navigation services delivered in community mental health settings. This is an essential step toward exposing occupational therapy and peer navigation services to clients, families, clinicians, and stakeholders to ensure the right clients receive occupational therapy and peer navigation at the right time.

Conclusions: There is an identified need for client-centered care to direct services informed by the principles of recovery. This study will generate a deeper understanding of occupational therapy and peer navigation services that contribute to community mental health and the impact on outcomes for people with psychiatric disabilities.


Transitions to Emerging Practice From an Occupational Perspective

Trisha Vaquera and Jenna Cunningham

INTRODUCTION: Recent work in transitions in the occupation literature resulted in a model that describes predictable life transitions from an occupational perspective (P-TOP II). Career transitions are a common predictable life transition; however the transition from traditional occupational therapy practice to emerging practice has not yet been studied from an occupational perspective nor with a focus on transition.

OBJECTIVES: This study’s objectives are to: 1) determine if the current definition of “emerging practice” applies to therapists in the Canadian context, from the therapists’ perspective; 2) describe the features of transition experienced by occupational therapists who move from traditional practice to an emerging practice; 3) assess the fit of this transition to the P-TOP II model.

METHODS:  This study takes an exploratory approach. Occupational therapists who self-identify as participating in the transition into emerging practice will be recruited from the provincial regulatory college database and invited to complete an online survey. Up to ten therapists who indicate an interest will also participate in a semi-structured interview. Surveys will be summarized using descriptive statistics and interviews will be thematically analyzed in order to understand the transition.

RESULTS:  Results will establish a definition of emerging practice appropriate to the Canadian context and enrich the understanding of transition to emerging practice areas from an occupational perspective. Perspective about the P-TOP II model will support its further revision from an occupational perspective.

CONCLUSION: This study supports a nuanced understanding of life transitions from an occupational perspective and provides a Canadian perspective of emerging occupational therapy practice.


Up on the Hill: The Experiences of Adaptive Snow Sports

Michelle Stevens and Olga Mavritsakis

Introduction: Literature supports the benefits of involvement for persons with disabilities (PWD) in competitive snow sports, such as skiing, snowboarding, and sit-skiing. However, there is limited evidence exploring the impact of adaptive snow sports for recreational purposes.

Objectives: This study will explore the experiences of individuals with disabilities participating in recreational adaptive snow sport programs, the perceived benefits and barriers to participation, and will provide health-care professionals with the impact adaptive snow sports have in the lives of PWD.

Methods: This study will recruit 15 past or present participants from recreational adaptive snow sport programs through purposive sampling. Data will be collected through semi-structured interviews and/or informal observations through the use of GoProTM footage and photography. Data will be transcribed verbatim and a thematic data analysis will be conducted.

Results: This study anticipates to better understand the experiences of PWD participating in adaptive snow sport programs and to explore the impact of these programs on their participants.

Conclusion: Participating in recreational adaptive snow sports is an understudied area and may be an alternative outlet for PWD as a way for them to connect with a community. Results from this study may inform adaptive snow sport programming and provide clinicians with evidence supporting the value of such programs.


Volunteer Mentorship to assist Persons with Physical Disabilities

Randall Haime and Martin Middleton

Introduction. This exploratory study is a part of a larger project that is evaluating the efficacy of a community-based program in achieving employment goals for people with physical disabilities. Preliminary findings from this project suggest that issues have emerged related to obtaining and retaining volunteer mentors.

Objectives. The purpose of this study is to a. examine barriers and facilitators of the formal volunteer mentor-protégé relationship; b. determine common criteria for mentoring relationships that are perceived to be successful; and c. provide salient recommendations to mentorship programs.

Method. Using purposive sampling, 15 participants from formal mentorship programs will be recruited. A comparatively equal number of mentors (with or without a physical disability) and protégés (with a physical disability) will be individually interviewed. Thematic analysis will be used to capture global areas to better understand the perceptions and practicalities of mentoring relationships.

Practice Implications. Many people with physical disabilities are unable to reach employment goals, often for reasons unrelated to their condition (Turcotte, 2014). With a growth in employment mentorship programs, the findings from this study will foreground the issues and nuances of the mentoring relationship to be considered as well as proactively managed, to better support people with physical disabilities.

Conclusions. Employment programs, support measures and services are not widely accessed by people with disabilities (Prince, 2014). Understanding the issues around mentoring relationships will inform the development of mentorship programs and ultimately better assist people with physical disabilities in achieving goals.

Reference List

Prince, M. J. (2014). Locating a window of opportunity in the social economy: Canadians with disabilities and labour market challenges. Canadian Journal of Nonprofit and Social Economy Research, 5(1), 6.

Turcotte, M., Canadian Government EBook Collection, & Statistics Canada. (2014). Persons with disabilities and employment. Ottawa: Statistics Canada = Statistique Canada.