Uncovering the obstacles: creating a typology of contextual factors that affect participation
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Increasingly, disability related literature recognizes the environment as an important factor in the participation in roles and in engagement in activities for individuals with disabilities; which would naturally make the environment an important concern for occupational therapists (Hammel et al., 2015). The language and methods to describe and analyze the characteristics of the environment that support or limit client participation in occupations are not as well developed in occupational therapy (Whiteneck & Djickers, 2009). This is an important gap in our practice that must be addressed. Guided by Person-Environment-Occupation Theory (Baptiste, 2017), this project attempted to address this need by developing a typology of terms for contextual factors that affect participation. It was completed with the belief that providing the terminology will increase the attention provided to these factors in practice. Environmental interventions can be more universal, are often less expensive, and change the focus from the individual’s deficits to how society can be more just and inclusive. We created the typology using a scoping review methodology to identify source literature and by searching through the selected literature for the environmental and contextual terms describing factors that impact participation. The resulting typology is divided into four areas with twelve categories of terms and 54 total terms. It aligns with the International Classification of Function (WHO, 2001) and the performance factors in the Occupational Therapy Practice Framework (AOTA, 2014). The typology is designed and meant for use across OT practice areas, in OT education, research and scholarship. This will require wide spread dissemination. A dissemination plan based on Diffusion of Innovations Theory (Rogers ,2010) starts by refining the typology with the guidance of assessment from stakeholders. After this refinement process, the typology will be introduced via outreach to occupational therapy programs, publications, and conference presentations. Widely used, this typology has the potential to expand the scope of occupational therapy and to make our interventions more effective in improving and increasing participation for more people.
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