Browsing by Author "Occupational Therapy, School of Health and Human Sciences"
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Item Adverse Childhood Experiences and Mental Health Conditions Among Multiracial Adolescents(Taylor & Francis, 2021) Weller, Bridget E.; Conrad, Joseph K.; Wilburn, Victoria G.; Ramamonjiarivelo, Jo; Gladden, Jessica; Occupational Therapy, School of Health and Human SciencesThe relationships between adverse childhood experiences (ACEs) and mental health conditions have received much attention in the literature. A particularly well-documented type of ACE is household dysfunction. However, compared to monoracial youth, little is known about the relationship between this type of ACE and mental health outcomes among multiracial adolescents. Objective The objective of this study was to verify the factor structure of the household dysfunction type of ACE using data from the National Survey of Children’s Health (NSCH), and then examine whether household dysfunction (measured as a latent construct) was associated with mental health conditions among multiracial adolescents. Design We used cross-sectional data collected in 2016 from caregivers who completed the NSCH and analyzed data from a subpopulation of adolescents (12–17) who reported more than one race (n = 1,231). Mplus 8.4 was used to conduct confirmatory factor analysis and probit models from a structural equation modeling framework. Results Results from this study indicated that the household dysfunction type of ACE, as a latent construct, had good model fit and was significantly associated with depression [standardized coefficient [B] = .50, 95% confidence interval [CI] .36, .65], anxiety [B = .61, 95% CI .48, .73], behavior problems [B = .58, 95% CI .44, .72], and ADHD [B = .54, 95% CI .38, .69] for multiracial adolescents. Conclusions Household dysfunction may result in adolescents being separated (physically or emotionally) from their caregivers, which may hinder adolescents’ ability to establish or maintain one of the most important relationships needed to promote racial/ethnic identity development and mental health. Implications for advancements in theory and NSCH are presented.Item 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 SciencesCoupling 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.Item Applying the Ecological Model of Human Performance and the SlutWalk Movement to Support those Affected by Rape Culture in the Context of Occupational Therapy(WMU, 2023) Klukken, Angela; Wasmuth, Sally; Occupational Therapy, School of Health and Human SciencesImproving the occupational lives of others is at the heart of occupational therapy practice. Advocacy for clientele is central to this improvement, both at individual and structural levels. We argue that interventions in the Ecological Model of Human Performance (EHP) and the social movement theSlutWalk can offer increased opportunity for occupational therapists to address the harmful implications for clients affected by sexual assault and rape culture. In addition, through the principles of the EHP and the SlutWalk, we propose that occupational therapists can have a hand in eradicating the culture that facilitates and tolerates sexual violence. This paper highlights the barriers women and sexual assault survivors may face to equitable occupational participation, where occupational therapists may establish/restore, alter, create, prevent, and adapt intervention approaches in the client’s context to elicit optimal engagement in meaningful activity.Item Bridging the Humanities and Health Care With Theatre: Theory and Outcomes of a Theatre-Based Model for Enhancing Psychiatric Care via Stigma Reduction(APA, 2022-12-22) Wasmuth, Sally; Pritchard, Kevin T.; Belkiewitz , Johnna; Occupational Therapy, School of Health and Human SciencesObjective: This article describes the rational, methods, implementation, and effectiveness of Identity Development Evolution and Sharing (IDEAS), an evidence-supported, narrative theater-based training that reduces stigma among health care providers to increase health care equity in psychiatric rehabilitation. Method: The IDEAS model has been used to reduce provider bias toward patients. From May 2017 to January 2020, we interviewed people from three patient groups who have been harmed by stigma, including Black women, transgender, and gender-diverse people, and people with substance use disorders. These interviews informed the creation of three theatrical scripts that were performed by professional actors for audiences of health care providers from January 2020 to May 2022. The performances aimed to raise conscious awareness of implicit provider biases and to provide a reflective opportunity to ameliorate these biases. The purpose of IDEAS is to improve experiences in health care settings such as psychiatric rehabilitation of patients from groups who have been harmed by stigma. We used paired-samples t tests to compare pre/postprovider stigma, measured via the Acceptance and Action Questionnaire-Stigma (AAQ-S). Results: Sociodemographic factors for providers who viewed IDEAS were similar across all three performances. IDEAS significantly decreased AAQ-S scores (t = 11.32, df = 50, M = 13.65, 95% confidence limit: [11.32, 15.97], p < .0001). Conclusions and implications for practice: IDEAS reduces provider stigma to support positive clinical encounters with diverse patient populations. These findings are relevant for psychiatric rehabilitation settings, which seek to establish positive rapport between providers and patients.Item Comparing Narrative-Informed Occupational Therapy in Adult Outpatient Mental Health to Treatment as Usual: A Quasi-Experimental Feasibility Study with Preliminary Treatment Outcomes(Taylor & Francis, 2021) Wasmuth, Sally; Wilburn, Victoria G.; Hamm, Jay A.; Chase, Anthony; Occupational Therapy, School of Health and Human SciencesThis paper describes implementation of narrative-informed occupation-based service delivery in outpatient community mental health that addresses (1) the need for outcome data on occupational therapy in this setting, (2) an ongoing mental health provider shortage, and (3) a need for innovative approaches to supporting mental health. We found a significant improvement from baseline to post-intervention in occupational participation. Dose of occupational therapy was significantly related to improvements in roles, habits, values, long-term goals, social environment, and readiness for change. This study supports future, larger effectiveness studies of narrative-informed occupation-based intervention delivered by occupational therapists in outpatient community mental health.Item Considerations for Occupational Therapists in Developing Community-Level Interventions for Youth with High Adverse Childhood Experiences (ACEs)(Western Michigan University, 2022) Wilburn, Victoria G.; Huber, Megan E; Senter, Denise; Stoll, Hannah B.; Occupational Therapy, School of Health and Human SciencesDrug misuse likely contributes to the over 30,000 children in foster care and to the 24.2% of children who have experienced two or more adverse childhood experiences (ACEs). Twenty-five percent of children are living in poverty, with nearly half of those living in single-parent households. Among the national guidelines to preventing ACEs are connecting youth with positive activities and providing family relationship enhancement opportunities. We believe the profession of occupational therapy can help contribute to the mental and behavioral health care workforce in a greater capacity than is currently used. Many children are not afforded the opportunity to engage in novel leisure pursuits that are essential for positive mental health function and well-being. Occupational therapists can assist in creating a culture of health and equity for youth by harnessing the power of play and leisure to promote self-healing communities.Item Current State, Needs, and Opportunities for Wearable Robots in Military Medical Rehabilitation and Force Protection(MDPI, 2024) Cooper, Rory A.; Smolinski, George; Candiotti, Jorge L.; Satpute, Shantanu; Grindle, Garrett G.; Sparling, Tawnee L.; Nordstrom, Michelle J.; Yuan, Xiaoning; Symsack, Allison; Lee, Chang Dae; Vitiello, Nicola; Knezevic, Steven; Sugar, Thomas G.; Schneider, Urs; Kopp, Verena; Holl, Mirjam; Gaunaurd, Ignacio; Gailey, Robert; Bonato, Paolo; Poropatich, Ron; Adet, David J.; Clemente, Francesco; Abbas, James; Pasquina, Paul F.; Occupational Therapy, School of Health and Human SciencesDespite advances in wearable robots across various fields, there is no consensus definition or design framework for the application of this technology in rehabilitation or musculoskeletal (MSK) injury prevention. This paper aims to define wearable robots and explore their applications and challenges for military rehabilitation and force protection for MSK injury prevention. We conducted a modified Delphi method, including a steering group and 14 panelists with 10+ years of expertise in wearable robots. Panelists presented current wearable robots currently in use or in development for rehabilitation or assistance use in the military workforce and healthcare. The steering group and panelists met to obtain a consensus on the wearable robot definition applicable for rehabilitation or primary injury prevention. Panelists unanimously agreed that wearable robots can be grouped into three main applications, as follows: (1) primary and secondary MSK injury prevention, (2) enhancement of military activities and tasks, and (3) rehabilitation and reintegration. Each application was presented within the context of its target population and state-of-the-art technology currently in use or under development. Capturing expert opinions, this study defines wearable robots for military rehabilitation and MSK injury prevention, identifies health outcomes and assessment tools, and outlines design requirements for future advancements.Item Discovering Provider Awareness of Mobility Assistive Technologies and Clinical Guidelines- A Comparative Analysis with Consumer Responses(Wolters Kluwer, 2024) Lee, Chang Dae; Peterson, Sara; Joseph, James; McKernan, Gina; Cooper, Rosemarie; Koontz, Alicia M.; Dicianno, Brad E.; Cooper, Rory A.; Occupational Therapy, School of Health and Human SciencesObjective: This study aims to enhance the accessibility and quality of mobility-assistive technology by investigating and bridging knowledge gaps between mobility-assistive technology providers and consumers with ambulatory limitations. Design: A survey was conducted among mobility-assistive technology providers in the United States, consisting of sections on awareness, knowledge importance and desire, and knowledge sources. The responses were compared to data collected from consumers in a previous study. Results: A total of 144 mobility-assistive technology providers participated, with 60% having received academic or professional training in relevant fields. Analysis revealed significant knowledge gaps between providers and consumers, particularly in assistive technology assessment tools and knowledge sources. Moderate gaps were also observed in areas such as clinical practice guidelines, desired mobility-assistive technology information, and knowledge sources. However, the gaps in other areas were relatively small. Conclusions: This study highlights the knowledge gaps between mobility-assistive technology providers and consumers, hindering the optimal utilization and fulfillment of user needs. Providers possess valuable information that consumers may lack, positioning them as primary knowledge sources. Addressing these gaps through targeted interventions, improved communication channels, and enhanced education can enhance the utilization of mobility-assistive technology and improve outcomes for individuals with ambulatory limitations.Item 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 SciencesThe 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.Item The implications of desk arrangement on social interaction in a third grade classroom(Taylor & Francis, 2018) Wilburn, Victoria G.; Wasmuth, Sally; Fehr, Callie; Brokamp, Kristen; Shupe, Mallory; Hursey, Brianna; Ross, Katie; Nelson, Jessica; Occupational Therapy, School of Health and Human SciencesNumerous studies have illustrated that participation in occupations—defined as meaningful life activities—is essential to wellness (AOTA, 2014). Social interaction is an important area of occupational participation for children in their roles as students (AOTA, 2014). Classroom design can impact student social participation; however, there is a lack of current research focused on effects of classroom design on social interaction for all students. Rather, research has examined factors affecting social participation of certain subgroups of students in the classroom, such as those with chronic illness or deafness (Martinez, Carter & Legato, 2011; Martins & Gaudiot, 2012). While literature provides information about various subpopulations, in this paper we emphasize that social participation based on classroom design can facilitate or inhibit overall occupational participation for all children in the role of student.