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Occupational Therapies and Human Well-Being

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 July 2015) | Viewed by 88128

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Dr. Wendy Stav

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Occupational Therapy Department, College of Health Care Sciences, Nova Southeastern University, 3200 S. University Drive, Ft. Lauderdale, FL 33328, USA

Special Issue Information

Dear Colleagues,

Occupational therapists have long practiced and conducted research on the premise that environments and contexts influence occupational engagement in humans and subsequently have an effect on the health of individuals, organizations and populations. The importance of the relationships between the constructs of occupation, environment, context and health warrant increased understanding of the influence that environments and contexts have on occupational engagement and health. This special issue is devoted to research focused on the role of environments and contexts in health as addressed in occupational therapy with individuals, organizations, communities and populations. Manuscripts presenting original research on either basic or applied topics (or a combination of these) relating to occupation, environments and health will be considered. An inclusive range of environments and contexts including physical, social, institutional and organizational environments as well as cultural, personal, temporal, political and virtual contexts are encouraged.

Dr. Wendy Stav
Guest Editor

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Keywords

occupational therapy
occupation
environment
context
engagement and participation
health
well-being
health promotion

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Published Papers (10 papers)

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Research

11 pages, 677 KiB

Open AccessArticle

Focusing on the Environment to Improve Youth Participation: Experiences and Perspectives of Occupational Therapists

by Dana Anaby, Mary Law, Rachel Teplicky and Laura Turner

Int. J. Environ. Res. Public Health 2015, 12(10), 13388-13398; https://doi.org/10.3390/ijerph121013388 - 23 Oct 2015

Cited by 39 | Viewed by 9665

Abstract

The environment plays a key role in supporting children’s participation and can serve as a focus of intervention. This study aimed to elicit the perceptions and experiences of occupational therapists who had applied the PREP approach—Pathways and Resources for Engagement and Participation. PREP is a novel 12-week intervention for youth with physical disabilities, aimed at improving participation in leisure community-based activities by modifying aspects of the environment. Using a qualitative post-intervention only design, 12 therapists took part in individual semi-structured interviews, in which the therapists reflected on their experience using PREP to enable participation. A thematic analysis was conducted. Four themes emerged from the data; two of which were informative in nature, describing elements of the PREP intervention that target multi-layered composition of the environment and use strategies that involve leveraging resources and problem solving. The two remaining themes were reflective in nature, illustrating a new take on the Occupational Therapy role and re-positioning the concept of participation in therapy practices. Results emphasize aspects of the environment that can serve as effective targets of intervention, guided by the PREP approach. Findings can broaden the scope and focus of occupational therapy practice by redefining views on participation and the environment. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

21 pages, 753 KiB

Open AccessArticle

Adaptive Strategies and Person-Environment Fit among Functionally Limited Older Adults Aging in Place: A Mixed Methods Approach

by Laura L. Lien, Carmen D. Steggell and Susanne Iwarsson

Int. J. Environ. Res. Public Health 2015, 12(9), 11954-11974; https://doi.org/10.3390/ijerph120911954 - 23 Sep 2015

Cited by 42 | Viewed by 11723

Abstract

Older adults prefer to age in place, necessitating a match between person and environment, or person-environment (P-E) fit. In occupational therapy practice, home modifications can support independence, but more knowledge is needed to optimize interventions targeting the housing situation of older adults. In response, this study aimed to explore the accessibility and usability of the home environment to further understand adaptive environmental behaviors. Mixed methods data were collected using objective and perceived indicators of P-E fit among 12 older adults living in community-dwelling housing. Quantitative data described objective P-E fit in terms of accessibility, while qualitative data explored perceived P-E fit in terms of usability. While accessibility problems were prevalent, participants’ perceptions of usability revealed a range of adaptive environmental behaviors employed to meet functional needs. A closer examination of the P-E interaction suggests that objective accessibility does not always stipulate perceived usability, which appears to be malleable with age, self-perception, and functional competency. Findings stress the importance of evaluating both objective and perceived indicators of P-E fit to provide housing interventions that support independence. Further exploration of adaptive processes in older age may serve to deepen our understanding of both P-E fit frameworks and theoretical models of aging well. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

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17 pages, 708 KiB

Open AccessArticle

Improving Personal Characterization of Meaningful Activity in Adults with Chronic Conditions Living in a Low-Income Housing Community

by Carrie A. Ciro and Patsy Smith

Int. J. Environ. Res. Public Health 2015, 12(9), 11379-11395; https://doi.org/10.3390/ijerph120911379 - 11 Sep 2015

Cited by 14 | Viewed by 5250

Abstract

Purpose: To understand how adults living in a low-income, public housing community characterize meaningful activity (activity that gives life purpose) and if through short-term intervention, could overcome identified individual and environmental barriers to activity engagement. Methods: We used a mixed methods design where Phase 1 (qualitative) informed the development of Phase 2 (quantitative). Focus groups were conducted with residents of two low-income, public housing communities to understand their characterization of meaningful activity and health. From these results, we developed a theory-based group intervention for overcoming barriers to engagement in meaningful activity. Finally, we examined change in self-report scores from the Meaningful Activity Participation Assessment (MAPA) and the Engagement in Meaningful Activity Survey (EMAS). Results: Health literacy appeared to impact understanding of the questions in Phase 1. Activity availability, transportation, income and functional limitations were reported as barriers to meaningful activity. Phase 2 within group analysis revealed a significant difference in MAPA pre-post scores (p =0.007), but not EMAS (p =0.33). Discussion: Health literacy should be assessed and addressed in this population prior to intervention. After a group intervention, participants had a change in characterization of what is considered healthy, meaningful activity but reported fewer changes to how their activities aligned with their values. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

15 pages, 750 KiB

Open AccessArticle

Factors Associated with Community Participation among Individuals Who Have Experienced Homelessness

by Feng-Hang Chang, Christine A. Helfrich, Wendy J. Coster and E. Sally Rogers

Int. J. Environ. Res. Public Health 2015, 12(9), 11364-11378; https://doi.org/10.3390/ijerph120911364 - 10 Sep 2015

Cited by 12 | Viewed by 8564

Abstract

Community participation is an important goal for people who have experienced homelessness. The aim of this study was to use the International Classification of Functioning, Disability and Health (ICF) as a framework to examine factors associated with community participation among people who are homeless or recently housed through housing programs. Participants (n = 120) recruited from six housing placement and search programs completed measures of community participation (including productivity, social and leisure, and community-services-use domains), psychiatric and physical symptoms, functional limitations, and a demographic form. Multiple regression analyses were used to identify predictors of overall community participation and subdomain scores. Results suggested that cognitive and mobility limitations, relationship status, and housing status significantly predicted both overall participation and participation in productivity and social and leisure subdomains. Participants who were housed through housing programs, who had cognitive and mobility limitations, and who were single showed less community participation. The findings suggest that activity limitations and environmental and personal factors may need to be addressed in efforts to enhance community participation in this population. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

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16 pages, 184 KiB

Open AccessArticle

Environmental Restrictors to Occupational Participation in Old Age: Exploring Differences across Gender in Puerto Rico

by Elsa M. Orellano-Colón, Gail A. Mountain, Marlene Rosario, Zahira M. Colón, Sujeil Acevedo and Janiliz Tirado

Int. J. Environ. Res. Public Health 2015, 12(9), 11288-11303; https://doi.org/10.3390/ijerph120911288 - 10 Sep 2015

Cited by 8 | Viewed by 6252

Abstract

Many older adults face challenges that prevent them from accomplishing common daily activities such as moving around, home maintenance, and leisure activities. There is still a need to examine and understand how environmental factors impact daily participation across gender. This study sought to make a qualitative comparison of gender differences regarding environmental barriers to participation in daily occupations from the perspectives of older adults who live alone in Puerto Rico. Twenty-six Hispanic older adults, 70 years or older participated in this study. We used a descriptive qualitative research design in which researchers administered an in-depth interview to each participant. The results elucidated that women were more likely than men to experience restricted participation due to lack of accessibility of the built environment and transportation systems. The findings could help with the development of tailored, occupation-based, preventive interventions that address gender specific environmental barriers and promote greater participation among both women and men. Further research is required to explore whether these environmental barriers to occupational participation remain consistent across living situations, socioeconomic status and ethnicity. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

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17 pages, 705 KiB

Open AccessArticle

“An Environment Built to Include Rather than Exclude Me”: Creating Inclusive Environments for Human Well-Being

by Natasha A. Layton and Emily J. Steel

Int. J. Environ. Res. Public Health 2015, 12(9), 11146-11162; https://doi.org/10.3390/ijerph120911146 - 8 Sep 2015

Cited by 19 | Viewed by 10127

Abstract

Contemporary discourses which challenge the notion of health as the “absence of disease” are prompting changes in health policy and practice. People with disability have been influential in progressing our understanding of the impact of contextual factors in individual and population health, highlighting the impact of environmental factors on functioning and inclusion. The World Health Organization’s (WHO) more holistic definition of health as “wellbeing” is now applied in frameworks and legislation, and has long been understood in occupational therapy theory. In practice, however, occupational therapists and other professionals often address only local and individual environmental factors to promote wellbeing, within systems and societies that limit equity in population health and restrict inclusion in communities. This paper presents an in-depth analysis of the supports and accommodations identified by a cohort of individuals (n-100) living with disability. A range of environmental facilitators and barriers were identified in peoples’ experience of “inclusive community environs” and found to influence inclusion and wellbeing. The roles and responsibilities of individuals, professionals, and society to enact change in environments are discussed in light of these findings. Recommendations include a focus on the subjective experience of environments, and application of theory from human rights and inclusive economics to address the multiple dimensions and levels of environments in working towards inclusion and wellbeing. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

13 pages, 1076 KiB

Open AccessArticle

Integration in the Vocational World: How Does It Affect Quality of Life and Subjective Well-Being of Young Adults with ASD

by Eynat Gal, Efrat Selanikyo, Asnat Bar-Haim Erez and Noomi Katz

Int. J. Environ. Res. Public Health 2015, 12(9), 10820-10832; https://doi.org/10.3390/ijerph120910820 - 2 Sep 2015

Cited by 30 | Viewed by 7633

Abstract

This study aimed to assess whether the perception of quality of life (QOL) and subjective well-being (SWB) of young adults with autism spectrum disorders (ASD) is affected by participation in a comprehensive program. Participants included 25 young adults with ASD who participated in the “Roim Rachok Program” (RRP), where they were trained to become aerial photography interpreters. Following the training period, they served in a designated army unit where they practiced their newly acquired profession. The participants filled out two questionnaires, (a) Quality of Life (QOL-Q) and (b) Personal Well-being Index (PWI), at three points of the intervention: (a) before the course, (b) at the end of the course, and (c) six months after integrating in the designated army unit. Wilcoxon signed ranks tests were used to assess the differences between the reported QOL and SWB at the three points of time. The results suggest that there were no significant differences at the end of the course, compared to its beginning. However, there were significantly improved perception of QOL and SWB during the period between the end of the course and six months after starting work. The results of this study highlight the importance of tailored vocational programs that are adapted to the unique needs and strengths of individuals with ASD. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

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14 pages, 656 KiB

Open AccessArticle

Experience of Multisensory Environments in Public Space among People with Visual Impairment

by Gavin R. Jenkins, Hon K. Yuen and Laura K. Vogtle

Int. J. Environ. Res. Public Health 2015, 12(8), 8644-8657; https://doi.org/10.3390/ijerph120808644 - 23 Jul 2015

Cited by 33 | Viewed by 8732

Abstract

This qualitative study explored the role of sensory characteristics embedded in the built environment and whether they support or hinder people with visual impairment in their use of public spaces. An online survey link was e-mailed to the presidents and committee members of each state’s chapters and associations of the National Federation of the Blind in the United States, resulting in 451 direct invitations to participate. Written responses of the survey questions from 48 respondents with visual impairment were analyzed. Three main themes: Barriers, Supporters, and Context-Dependence emerged from the respondents’ experience of multisensory characteristics within the built environment. The four subthemes subsumed in Barriers were: (1) Population specific design, (2) Extreme sensory backgrounds, (3) Uneven ground surfaces and objects, and (4) Inconsistent lighting. For Supporters, respondents provided specific examples of various sensory characteristics in built environments, including audible cues and echoes, smells, tactile quality of the ground surface, and temperature. Context-Dependence referred to the effects of sensory characteristics embedded in public spaces depending on one’s vision condition, the proximity to the sensory cues and the purpose of the activities one was performing at that moment. Findings provide occupational therapy practitioners an in-depth understanding of the transactional relationship between embedded sensory characteristics in the built environment, occupations, and people with visual impairment in order to make appropriate modifications or removal of barriers that affect occupational performance and engagement. Suggestions for occupational therapists as well as architects, designers, planners, policy makers/legislators related to functional sensory cues in the design of built environments were provided to increase accessibility in the use of public spaces by people with visual impairment. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

15 pages, 668 KiB

Open AccessArticle

Working with Policy and Regulatory Factors to Implement Universal Design in the Built Environment: The Australian Experience

by Helen Larkin, Danielle Hitch, Valerie Watchorn and Susan Ang

Int. J. Environ. Res. Public Health 2015, 12(7), 8157-8171; https://doi.org/10.3390/ijerph120708157 - 15 Jul 2015

Cited by 30 | Viewed by 7210

Abstract

Built environments that are usable by all provide opportunities for engagement in meaningful occupations. However, enabling them in day to day design processes and practice is problematic for relevant professions. The purpose of this phenomenological study was to gain greater understanding of the policy and regulatory influences that promote or hinder the uptake of universal design in built environments, to inform better future design. Focus groups or telephone interviews were undertaken with 28 key building industry and disability stakeholders in Australia. Four themes were identified: the difficulties of definition; the push or pull of regulations and policy; the role of formal standards; and, shifting the focus of design thinking. The findings highlight the complexity of working within policy and regulatory contexts when implementing universal design. Occupational therapists working with colleagues from other professions must be aware of these influences, and develop the skills to work with them for successful practice. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

21 pages, 796 KiB

Open AccessArticle

The Effect of Engagement in Everyday Occupations, Role Overload and Social Support on Health and Life Satisfaction among Mothers

by Michal Avrech Bar and Tal Jarus

Int. J. Environ. Res. Public Health 2015, 12(6), 6045-6065; https://doi.org/10.3390/ijerph120606045 - 28 May 2015

Cited by 43 | Viewed by 12185

Abstract

One of the founding assumptions underlying the health professions is the belief that there is a strong relationship between engagement in occupations, health, and wellbeing. The ability to perform everyday occupations (occupational performance) has a positive effect on health and wellbeing. However, there is also conflicting evidence indicating that participation in multiple roles or in certain occupations may lead to poorer health. Therefore, there is a need to better understand this relationship. The purpose of the present study was to examine three possible theoretical models to explain mothers’ health and life satisfaction from the perspective of their occupational performance, their role load, and their social support. 150 married mothers, ages of 25–45, who had at least one child between the ages of one to ten years, participated in the study. Data were collected by using seven self-report questionnaires. The models were analyzed using Structural Equation Modeling. The results show that social support has a direct effect on mothers’ physical health and life satisfaction and an indirect effect, mediated through the occupational performance variables, on mothers’ mental health and life satisfaction. Role overload does not affect mothers’ health and life satisfaction. These results suggest that mothers could benefit from health programs that help them manage their occupational routines. Such programs should focus on improving the mother’s occupational performance and adapting her social environment to fit her occupational needs. Full article

(This article belongs to the Special Issue Occupational Therapies and Human Well-Being)

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