Department of Occupational Therapy Works

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https://hdl.handle.net/1805/5215

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Browsing Department of Occupational Therapy Works by Author "Belkiewitz, Johnna"

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    Application of a Model of Family-Centered Harm Reduction in Community-Based Programming
    (WMU, 2023) Belkiewitz, Johnna; Wilburn, Victoria G.; Larson, Sydney; Schrader, Kate; Occupational Therapy, School of Health and Human Sciences
    Coupling high substance use disorder rates with the effects of the COVID-19 pandemic, our nation faces a growing mental health crisis and a shortage of adequately trained mental and behavioral health providers. As occupational therapists work toward recognition as qualified providers in this practice area, we must ensure that future therapists can meet client needs. Traditional mental and behavioral health educational practices in occupational therapy use a model of harm reduction that minimizes negative outcomes for a select subset of the population engaging in specific “high-risk” behaviors, such as individuals engaging in substance use and sexual activity. Expanding our understanding of the harm reduction model and incorporating a more holistic trauma-informed care lens can better ensure beneficence for all clients. To do this, educational institutions must train students to identify harm in all of its contexts, such as the household dysfunction of cohabitating with a family member with substance use disorder, and apply practical treatments for addressing the impacts of dynamic family systems through occupation-based interventions. This paper illustrates a family-centered harm reduction model and offers a community-based educational intervention that allows occupational therapy students to gain valuable trauma-informed care practice skills through hands-on experiences.
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    Gender as Occupation: The "Doing" of Authentic Expression and Reciprocally Affirming Care for Transgender Individuals
    (WMU, 2023) DeRolf, Annie; Belkiewitz, Johnna; Wasmuth, Sally; Occupational Therapy, School of Health and Human Sciences
    The current predominant view of gender as binary, alongside limited training of affirmative care practices, is severely and negatively impacting transgender and gender diverse (TGD) people. This paper urges the re-conceptualization of gender as an occupation, suggesting that gender is a doing that allows for positive identity development, roles, habits, and routines. Doing gender facilitates meaning-making and the ability to engage in other occupations. However, occupational injustices rooted in discrimination, stigma, and/or implicit biases impede TGD people’s ability to engage in the doing of gender and other occupations. Articulation of conceptual guidelines and interventions to support TGD people’s ability to do gender and other occupations is a critical area of need in occupational therapy literature and practice. In accordance with the profession’s ethical mandate to promote occupational justice, it is critical that occupational therapists become educated and involved in providing affirmative services to support occupational participation for this population.
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    Measuring Impact: A Collaborative Community Project to Measure Peace Building
    (IUPUI, 2022-06-22) Belkiewitz, Johnna; Flores, Jessica; Hernandes, Jocelyne; Prentice, Alex; Smith, Rachel; Batts, Dountonia; Garcia Wilburn, Victoria; Occupational Therapy, School of Health and Human Sciences
    Peace is a prerequisite for creating an environment in which all people have the capacity to live safe and productive lives and to engage in meaningful activities and occupations; however, creating caring communities and measuring the impacts of peace is a challenge. To address this concern, nonprofit organizations strive to promote equity and justice by engaging in both direct service and advocacy work. One local nonprofit, the Peace Learning Center, works to promote peace in the Indianapolis community through a variety of innovative educational and advocacy programs, including equity learning, restorative practices, social emotional learning, and family learning. Uniquely, occupational therapists engaging in community-based work provide a lens through which key environmental factors, such as peace, are viewed as vital in consideration of the context surrounding a person and provide a perspective of how peace can affect the tasks and performance in which people are able to engage. Through a semester-long collaborative partnership, Indiana University occupational therapy doctoral candidates and the Peace Learning Center conceptualized peace and created implementable tools for measuring the impacts of the nonprofit’s efforts on peace building in the Indianapolis community. The following outlines the evaluative process that the student group performed and provides replicable tools and recommendations for surveying peace building impacts in K-12 restorative justice programming. By implementing these peace-measuring assessments, the Peace Learning Center will be able to gather both qualitative and quantitative data about perceived safety, violence, and peace from youth and parents in the communities that the organization serves. Recognizing the need for program evaluation, occupational therapy students have provided the Peace Learning Center with vital outcome measures that can lead to program remodeling, content recreation, and improved training, resources and follow up for facilitators, all within the profession’s scope of practice in the community-based realm.
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    Protocol for evaluating external facilitation as a strategy to nationally implement a novel stigma reduction training tool for healthcare providers
    (BMC, 2022-08-12) Wasmuth, Sally; Belkiewitz, Johnna; Bravata, Dawn; Horsford, Caitlin; Harris, Alex; Smith, Carlton; Austin, Charles; Miech, Edward; Occupational Therapy, School of Health and Human Sciences
    Background: Identity Development Evolution and Sharing (IDEAS) is a theatre-based intervention for reducing healthcare provider stigma. IDEAS films are created by collecting narratives from people who have experienced discrimination and healthcare inequity, partnering with professional playwrights to create theatrical scripts that maintain the words of the narratives while arranging them into compelling storylines involving several interviews, and hiring professional actors to perform and record scenes. IDEAS implementation requires a moderator to establish a respectful learning environment, play the filmed performance, set ground rules for discussion, and moderate a discussion between healthcare providers who viewed the film and invited panelists who are members of the minoritized population being discussed. IDEAS' impact on provider stigma is measured via pre/post Acceptance and Action Questionnaire - Stigma (AAQ-S) data collected from participating providers. The objectives of this manuscript are to provide narrative review of how provider stigma may lead to healthcare inequity and health disparities, describe the conceptual frameworks underpinning the IDEAS intervention, and outline methods for IDEAS implementation and implementation evaluation. Methods: This manuscript describes a hybrid type 3 design study protocol that uses the Consolidated Framework for Implementation Research (CFIR) to evaluate external facilitation, used as an implementation strategy to expand the reach of IDEAS. CFIR is also used to assess the impact of characteristics of the intervention and implementation climate on implementation success. Implementation success is defined by intervention feasibility and acceptability as well as self-efficacy of internal facilitators. This manuscript details the protocol for collection and evaluation of implementation data alongside that of effectiveness data. The manuscript provides new information about the use of configurational analysis, which uses Boolean algebra to analyze pathways to implementation success considering each variable, within and across diverse clinical sites across the USA. Discussion: The significance of this protocol is that it outlines important information for future hybrid type 3 designs wishing to incorporate configurational analyses and/or studies using behavioral or atypical, complex, innovative interventions. The current lack of evidence supporting occupational justice-focused interventions and the strong evidence of stigma influencing health inequities underscore the necessity for the IDEAS intervention.