Browsing by Author "Horsford, Caitlin"

Now showing 1 - 4 of 4
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    Effectiveness of Occupational Therapy Interventions to Promote Social Participation and Quality of Life in Older Adults: A Rapid Systematic Review
    (2021-05-05) Adams, Alexa; Horsford, Caitlin; Jones, Paige; Long, Ryane; Pflugradt, Dana; Chase, Anthony; Department of Occupational Therapy, School of Health and Human Sciences
    This systematic review discusses the evidence of 24 studies to identify the effectiveness of various evidence-based interventions that could be utilized within the scope of occupational therapy (OT), as they aim to improve social participation and health related quality of life in adults over 60 years of age. Older adults often experience difficulty with social engagement, increasing their risk for social isolation which is correlated to decreases in health-related quality of life, functional mobility, as well as increased loneliness, cognitive declines, or other adverse physical and psychological effects. Social participation can facilitate increased health-related quality of life, mitigate loneliness, as well as slow cognitive decline and other adverse physical and psychological effects related to aging and late life transitions. Overall, this review found strong evidence for the effectiveness of physical activity interventions, moderate evidence for the effectiveness of emotional and personal based interventions, and mixed evidence for external support interventions that aim to improve social participation in older adults. Additional research should be conducted to further identify objective aspects (rather than typical subjective aspects) of evidence-based interventions that clinically correlate to increased health-related quality of life and well-being as related to social participation for therapeutic utilization within the domain of occupational therapy for older adults.
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    “Metacognitive Reflection and Insight Therapy” (MERIT) for the Occupational Therapy Practitioner
    (Sage, 2022) Wasmuth, Sally; Horsford, Caitlin; Mahaffey, Lisa; Lysaker, Paul H.; Occupational Therapy, School of Health and Human Sciences
    Background: Metacognitive Reflection and Insight Therapy (MERIT) is a manualized, evidence-based approach that supports occupational participation through its focus on the inter-related constructs of meaning making, positionality, and self-definition (Lysaker et al., 2020). MERIT's core tenets parallel the fundamentals of occupational therapy, making it an ideal guiding methodology for mental health occupational therapy practice. Purpose: We outline key constructs of MERIT and detail how occupational therapy practitioners can apply MERIT to support occupational engagement. Key Issues: Few manualized, evidence-based interventions exist to guide occupational therapy mental health practice (Kirsch et al., 2019). Detailing MERIT and its application in occupational therapy is an important first step in future studies of its feasibility, acceptability, and effectiveness in this context. Implications: MERIT provides a clear methodology for delivering mental health occupational therapy services that is amenable to large-scale hybrid implementation and effectiveness studies, thereby supporting practice and rigour in research.
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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.
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    Supporting Veteran Mental Health Through Metacognitive Reflection and Insight Therapy for the Occupational Therapist (MERIT-OT): A Quality Improvement Doctoral Capstone Project Report
    (2023-05) Horsford, Caitlin; Wasmuth, Sally; Department of Occupational Therapy, School of Health and Human Sciences; Wellington, Miranda
    Background: Veterans are at over 50% higher risk of experiencing mental health crises compared to the general population, negatively impacting occupational engagement and quality of life. With roots in mental health practice, OT is primed to meet these uniquely complex healthcare needs. Research shows improving factors of metacognition through interventions like MERIT-OT can improve self-agency and recovery from mental health crises. However, OT at the IN VA has not yet been utilized within the mental health care teams. For MERIT-OT research to move forward at the IN VA, the barriers and facilitators to implementation at this site needed to be understood. Methods: A DCE student completed a 14-week quality improvement project to support the role of OT in mental health services within the IN VA, eliciting appropriate patient populations to implement MERIT-OT research in the future. Program implementation included OT staff training and advocacy, MERIT-OT resource building, and clinical skills building through mental health group interventions. Data was collected through activity analysis of staff workflow, informal discussion, staff survey, self-assessment journalling of MERIT-OT integration, and pre/post assessment of domiciliary groups. Results: Increased knowledge, access, and the likelihood of OT staff implementation of mental health resources. New OT integration into existing suicide prevention follow-up programs. Deeper understanding of MERIT-OT principles, barriers/ facilitators, and appropriate opportunities for future research. Conclusion: Integration of MERIT-OT within OT’s newly established and growing roles in mental health services at the IN VA healthcare system will improve the quality of care, meet the growing need for mental health professionals, and support rigor and fidelity within the field of mental health OT.