BACKGROUND Although there is a need for gender-specific health care, especially within the contex... more BACKGROUND Although there is a need for gender-specific health care, especially within the context of vocational rehabilitation for youth with disabilities, clinicians, trainees, and community service providers commonly report lacking training in gender-sensitive approaches. Therefore, an educational tool designed for clinicians working with youth, that addresses how to approach such issues, could help clinicians to augment the care they provide. OBJECTIVE The objective of our study was to conduct a pilot evaluation of an educational simulation for health care and service providers focusing on gender-sensitive approaches within the context of supporting youth with disabilities in vocational rehabilitation. METHODS We conducted a survey from May to September 2021 to assess the relevance of the simulation content, preliminary perceived impact on gender-sensitive knowledge and confidence, and open-ended feedback of a web-based gender-sensitive educational simulation. A total of 12 health care providers from a variety of professions who had experience working with youth in the context of vocational rehabilitation participated in the survey (11 women and 1 man). RESULTS Most participants reported that the content of the simulation was relevant and comprehensive. The majority of participants reported that the simulation helped to increase their perceived knowledge or understanding of the topic, changed their perceived understanding of their intervention or approach, and informed their perceived confidence. Our qualitative findings from the open-ended questions highlighted three main themes: (1) relevance of the simulation content, (2) perceived impact for clinical practice (ie, gender-sensitive language and communication and building rapport with patients), and (3) perceived impact on organizational processes (ie, practices, policy, and privacy). CONCLUSIONS Our educational simulation shows preliminary potential as an educational tool for service providers working with youth who have a disability within the context of vocational rehabilitation. Further research is needed to assess the impact of the tool with larger samples.
Work-a Journal of Prevention Assessment & Rehabilitation, Apr 10, 2022
BACKGROUND: Peer-led workplace mental health training programs informed by the principles of cont... more BACKGROUND: Peer-led workplace mental health training programs informed by the principles of contact-based education have shown promising results, but research evidence largely focuses on measuring outcomes for service recipients with little attention to the experiences of peer educators in delivering these interventions. OBJECTIVE: To gain in-depth knowledge about the opportunities and challenges experienced peer educators recruited to lead a mental health literacy training program for healthcare workers. METHODS: An interpretive description approach was used to explore the experiences of peer educators in providing a structured two-day “Beyond Silence” workplace mental health training program. Peer educators were healthcare workers with personal mental health experience, who completed an additional leadership training. Semi-structured telephone interviews were conducted with seven peer educators. Data collection and analysis was concurrent and iterative, employing inductive analysis. RESULTS: Four overarching themes captured the key opportunities and challenges faced by peer educators: 1) the art and science of providing mental health literacy training, 2) power of personal stories, 3) competence as a journey or a destination and 4) the dual role of educator and advocate. CONCLUSIONS: Recommendations are provided for recruitment, training, and support for peer educators. Future research could focus on longitudinal evaluation of engagement and sustainability of peer educators in this role.
The concept of social capital may shed light on challenges experienced by employees with mental h... more The concept of social capital may shed light on challenges experienced by employees with mental health conditions (MHC) in sustaining employment. This article presents findings from a qualitative descriptive study exploring the concept of workplace social capital and its impact on how employees with MHC negotiate workplace accommodations. The findings reveal that social capital consists of various elements that impact how accommodations are negotiated in the workplace; some are dynamic and can be built, rebuilt, and spent such as employee self-confidence, reputation, and likeability. Future research is needed to explore how social capital can be developed to facilitate the accommodation process.
BACKGROUND Perspectives of individuals with acquired brain injury (ABI) regarding inpatient rehab... more BACKGROUND Perspectives of individuals with acquired brain injury (ABI) regarding inpatient rehabilitation experiences can inform patient-centered care; however, these voices are under-represented in the literature. PURPOSE To explore the experiences, needs, and preferences of patients from an ABI inpatient rehabilitation program in Ontario. METHODS Using an interpretive description approach, we interviewed 12 participants and analyzed the transcripts inductively to generate themes. FINDINGS We identified three major themes: (1) Life Rerouted - participants felt their lives diverted due to ABI, with rehabilitation seen as a way to return to pre-injury life, (2) Autonomy within Rehab highlighted the perceived importance of personal autonomy in decision-making within rehabilitation, and (3) Life (and Recovery) Go On reflected an ongoing recovery process after discharge - leading to mixed emotions. An overall message, "re-establishing personal identity is important to the recovery process," reflected theories of biographical disruption and relational autonomy. IMPLICATIONS Our findings provide a patient perspective for clinicians and administrators to consider. We found that ABI was significantly disruptive to personal identity - resulting in tensions in autonomy while attempting to reclaim a sense of identity. We suggest counseling services and strategies supporting post-injury adjustment, along with ways for rehabilitation professionals to enhance patient autonomy where possible.Implications for rehabilitationSustaining an ABI can significantly disrupt personal identity and sense of autonomy - especially as persons occupy the role of "patient" while in inpatient rehabilitation.Psychological support is recommended to address the impacts of ABI on patients' sense of identity, as well as on family members.Strategies of support might include, providing formal psychotherapy, as well as creating opportunities for patients and family members to discuss the changes they are experiencing, and to establish their personal narratives (e.g., through writing or art) or peer mentorship programs between discharged and current patients.Clinicians can enhance patient autonomy by increasing opportunities for communication with patients about choice; educating patients and family members on the rehabilitation team's decision-making process, and other methods that increase communication and provide consistent up-to-date information to patients and their family members.
Background. Competency in ethical decision making is a criterion for ethical practice, and it is ... more Background. Competency in ethical decision making is a criterion for ethical practice, and it is expected to advance with ongoing professional development. However, research exploring continuing competency needs of occupational therapists regarding ethical decision making is limited. Purpose. The purpose of this study was to explore potential gaps and directions for development related to continuing competency in ethical decision making from the perspective of practicing occupational therapists. Method. Interpretive description informed secondary data analysis of professional narratives from a grounded theory study regarding ethical decision making. In-depth interviews were conducted with a purposive sample of 18 occupational therapists. Data analyses focused on identifying gaps and future directions regarding continuing competency. Findings. Two main themes regarding gaps were identified: “I didn’t have the knowledge” and “I don’t have anybody.” Education, tool development, and eth...
Background. The Do-Live-Well (DLW) framework was first published in 2015 and aimed to fill a theo... more Background. The Do-Live-Well (DLW) framework was first published in 2015 and aimed to fill a theoretical gap in the health promotion literature related to the links between occupational patterns and health. However, the extent of uptake and use of the framework since publication is unknown. Purpose. To explore and reflect on the adoption and application of DLW in the literature. Method. Citation content analysis of two seminal DLW publications was conducted from 2015 to November 2022 across six databases. Findings. Seventeen citations directly applied DLW to inform research ( n = 10), practice ( n = 5) and knowledge translation ( n = 2). Implications. The findings highlight uptake of the framework in a range of settings, and how it can inform an occupation-based understanding of health and well-being. Ongoing knowledge dissemination, development of practice tools, and research to update evidence and examine relevance are needed to further advance the utility and application of the f...
BackgroundThe COVID-19 pandemic has disrupted everyday rehabilitation research. Many academic ins... more BackgroundThe COVID-19 pandemic has disrupted everyday rehabilitation research. Many academic institutions have halted in-person human research including rehabilitation sciences. Researchers are faced with several barriers to continuing their research programs. The purpose of this perspective article is to report the results of an interdisciplinary workshop aimed at understanding the challenges and corresponding strategies for conducting rehabilitation research during the COVID-19 pandemic.MethodsTwenty-five rehabilitation researchers (17 trainees and eight faculty) attended a 2-h facilitated online workshop in to discuss challenges and strategies they had experienced and employed to conduct rehabilitation research during the COVID-19 pandemic.ResultsRehabilitation researchers reported challenges with (1) pandemic protocol adjustments, (2) participant accessibility, and (3) knowledge dissemination, along with corresponding strategies to these challenges. Researchers experienced disr...
Background. Recent changes in the Canadian regulatory landscape have prompted reflections on the ... more Background. Recent changes in the Canadian regulatory landscape have prompted reflections on the role and scope of occupational therapy in the provision of psychotherapy. Purpose. To document how psychotherapy has been explored in occupational therapy literature. Method. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines by searching eight databases (e.g., Medline, AMED, CINAHL, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Sociological s, and ProQuest Dissertations & Theses). Articles included at the full-text stage were subjected to a narrative synthesis. Findings. A total of 207 articles met the criteria for inclusion, spanning 93 years. 47.3% of these articles represented non-empirical literature, with only 14% representing effectiveness studies, suggesting that this body of literature remains in an early stage of development. Implications. Occupational therapists have bee...
In Canada, and internationally, there is an increased demand for patient engagement in health car... more In Canada, and internationally, there is an increased demand for patient engagement in health care research. Patients are being involved throughout the research process in a variety of roles that extend beyond the traditional passive participant role. These practices, referred to collectively as 'patient engagement', have raised questions about how to engage patients in the research process. Specifically, researchers have noted a lack of theory underpinning patient engagement and are looking for guidance on how to select patients and engage patients throughout the research process. In this commentary, we draw on qualitative research perspectives to generate theoretical and methodological ideas that novice or experienced researchers can apply to facilitate patient engagement in research. Despite the recent advancements in patient engagement in health care research, there is limited research evidence regarding the best strategies for developing and supporting research partners...
Objective: This study sought to evaluate whether a contact-based workplace education program was ... more Objective: This study sought to evaluate whether a contact-based workplace education program was more effective than standard mental health literacy training in promoting early intervention and support for healthcare employees with mental health issues. Method: A parallel-group, randomised trial was conducted with employees in 2 multi-site Ontario hospitals with the evaluators blinded to the groups. Participants were randomly assigned to 1 of 2 group-based education programs: Beyond Silence (comprising 6 in-person, 2-h sessions plus 5 online sessions co-led by employees who personally experienced mental health issues) or Mental Health First Aid (a standardised 2-day training program led by a trained facilitator). Participants completed baseline, post-group, and 3-mo follow-up surveys to explore perceived changes in mental health knowledge, stigmatized beliefs, and help-seeking/help-outreach behaviours. An intent-to-treat analysis was completed with 192 participants. Differences were...
PURPOSE Given the steady rise in HIV incidence among South Asian women in Canada their health-rel... more PURPOSE Given the steady rise in HIV incidence among South Asian women in Canada their health-related challenges and disability are not well understood. Our aim was to understand the "lived experiences" of disability among South Asian women living with HIV in Southern Ontario, Canada. METHODS We conducted a qualitative study using an interpretive phenomenological approach. We recruited immigrant South Asian women living with HIV in Ontario and conducted one-on-one semi structured interviews. Following the first interview, participants were invited to participate in a second interview. Interviews were audio recorded and transcribed verbatim. RESULTS Eight participants completed the first interview; six completed a second interview (14 interviews total). The mean age of participants was 47.1 years (standard deviation (sd) = 5.8) and mean length of time since HIV diagnosis was 15.1 years (sd = 6.7). We identified two overarching themes, "experiencing disability" and...
ABSTRACT Occupational identity is a central concept within occupational science and exploration o... more ABSTRACT Occupational identity is a central concept within occupational science and exploration of how the occupational identity of mother is shaped by having a child with a disease is an important consideration within this field. Currently up to 550 million people worldwide experience food allergy (Fiocchi, Sampson, Bahna, & Lack, 2011). The majority are children and the disease has been shown to create significant disruption across their occupational repertoire. It has also been suggested that the occupations of mothers of children with food allergy may be affected, however there is a paucity of scientific inquiries into this claim. The purpose of this study was to explore how mothers of children with food allergy represent their mothering occupations. Discourse analysis was used to analyze text of three on-line blogs (356 posts) written by mothers of children with food allergy. Four occupational identities emerged from the data: mothers as change managers, mothers as allergy moms, mothers as warriors, and mothers as advocates. These findings reflect researcher interpretation of how mothers’ occupations were discursively represented following occupational disruption due to food allergy. This study advances the scholarship of food allergy and occupational science by providing the first known exploration of occupations relating to mothering a child with food allergy.
BACKGROUND Although there is a need for gender-specific health care, especially within the contex... more BACKGROUND Although there is a need for gender-specific health care, especially within the context of vocational rehabilitation for youth with disabilities, clinicians, trainees, and community service providers commonly report lacking training in gender-sensitive approaches. Therefore, an educational tool designed for clinicians working with youth, that addresses how to approach such issues, could help clinicians to augment the care they provide. OBJECTIVE The objective of our study was to conduct a pilot evaluation of an educational simulation for health care and service providers focusing on gender-sensitive approaches within the context of supporting youth with disabilities in vocational rehabilitation. METHODS We conducted a survey from May to September 2021 to assess the relevance of the simulation content, preliminary perceived impact on gender-sensitive knowledge and confidence, and open-ended feedback of a web-based gender-sensitive educational simulation. A total of 12 health care providers from a variety of professions who had experience working with youth in the context of vocational rehabilitation participated in the survey (11 women and 1 man). RESULTS Most participants reported that the content of the simulation was relevant and comprehensive. The majority of participants reported that the simulation helped to increase their perceived knowledge or understanding of the topic, changed their perceived understanding of their intervention or approach, and informed their perceived confidence. Our qualitative findings from the open-ended questions highlighted three main themes: (1) relevance of the simulation content, (2) perceived impact for clinical practice (ie, gender-sensitive language and communication and building rapport with patients), and (3) perceived impact on organizational processes (ie, practices, policy, and privacy). CONCLUSIONS Our educational simulation shows preliminary potential as an educational tool for service providers working with youth who have a disability within the context of vocational rehabilitation. Further research is needed to assess the impact of the tool with larger samples.
Work-a Journal of Prevention Assessment & Rehabilitation, Apr 10, 2022
BACKGROUND: Peer-led workplace mental health training programs informed by the principles of cont... more BACKGROUND: Peer-led workplace mental health training programs informed by the principles of contact-based education have shown promising results, but research evidence largely focuses on measuring outcomes for service recipients with little attention to the experiences of peer educators in delivering these interventions. OBJECTIVE: To gain in-depth knowledge about the opportunities and challenges experienced peer educators recruited to lead a mental health literacy training program for healthcare workers. METHODS: An interpretive description approach was used to explore the experiences of peer educators in providing a structured two-day “Beyond Silence” workplace mental health training program. Peer educators were healthcare workers with personal mental health experience, who completed an additional leadership training. Semi-structured telephone interviews were conducted with seven peer educators. Data collection and analysis was concurrent and iterative, employing inductive analysis. RESULTS: Four overarching themes captured the key opportunities and challenges faced by peer educators: 1) the art and science of providing mental health literacy training, 2) power of personal stories, 3) competence as a journey or a destination and 4) the dual role of educator and advocate. CONCLUSIONS: Recommendations are provided for recruitment, training, and support for peer educators. Future research could focus on longitudinal evaluation of engagement and sustainability of peer educators in this role.
The concept of social capital may shed light on challenges experienced by employees with mental h... more The concept of social capital may shed light on challenges experienced by employees with mental health conditions (MHC) in sustaining employment. This article presents findings from a qualitative descriptive study exploring the concept of workplace social capital and its impact on how employees with MHC negotiate workplace accommodations. The findings reveal that social capital consists of various elements that impact how accommodations are negotiated in the workplace; some are dynamic and can be built, rebuilt, and spent such as employee self-confidence, reputation, and likeability. Future research is needed to explore how social capital can be developed to facilitate the accommodation process.
BACKGROUND Perspectives of individuals with acquired brain injury (ABI) regarding inpatient rehab... more BACKGROUND Perspectives of individuals with acquired brain injury (ABI) regarding inpatient rehabilitation experiences can inform patient-centered care; however, these voices are under-represented in the literature. PURPOSE To explore the experiences, needs, and preferences of patients from an ABI inpatient rehabilitation program in Ontario. METHODS Using an interpretive description approach, we interviewed 12 participants and analyzed the transcripts inductively to generate themes. FINDINGS We identified three major themes: (1) Life Rerouted - participants felt their lives diverted due to ABI, with rehabilitation seen as a way to return to pre-injury life, (2) Autonomy within Rehab highlighted the perceived importance of personal autonomy in decision-making within rehabilitation, and (3) Life (and Recovery) Go On reflected an ongoing recovery process after discharge - leading to mixed emotions. An overall message, "re-establishing personal identity is important to the recovery process," reflected theories of biographical disruption and relational autonomy. IMPLICATIONS Our findings provide a patient perspective for clinicians and administrators to consider. We found that ABI was significantly disruptive to personal identity - resulting in tensions in autonomy while attempting to reclaim a sense of identity. We suggest counseling services and strategies supporting post-injury adjustment, along with ways for rehabilitation professionals to enhance patient autonomy where possible.Implications for rehabilitationSustaining an ABI can significantly disrupt personal identity and sense of autonomy - especially as persons occupy the role of "patient" while in inpatient rehabilitation.Psychological support is recommended to address the impacts of ABI on patients' sense of identity, as well as on family members.Strategies of support might include, providing formal psychotherapy, as well as creating opportunities for patients and family members to discuss the changes they are experiencing, and to establish their personal narratives (e.g., through writing or art) or peer mentorship programs between discharged and current patients.Clinicians can enhance patient autonomy by increasing opportunities for communication with patients about choice; educating patients and family members on the rehabilitation team's decision-making process, and other methods that increase communication and provide consistent up-to-date information to patients and their family members.
Background. Competency in ethical decision making is a criterion for ethical practice, and it is ... more Background. Competency in ethical decision making is a criterion for ethical practice, and it is expected to advance with ongoing professional development. However, research exploring continuing competency needs of occupational therapists regarding ethical decision making is limited. Purpose. The purpose of this study was to explore potential gaps and directions for development related to continuing competency in ethical decision making from the perspective of practicing occupational therapists. Method. Interpretive description informed secondary data analysis of professional narratives from a grounded theory study regarding ethical decision making. In-depth interviews were conducted with a purposive sample of 18 occupational therapists. Data analyses focused on identifying gaps and future directions regarding continuing competency. Findings. Two main themes regarding gaps were identified: “I didn’t have the knowledge” and “I don’t have anybody.” Education, tool development, and eth...
Background. The Do-Live-Well (DLW) framework was first published in 2015 and aimed to fill a theo... more Background. The Do-Live-Well (DLW) framework was first published in 2015 and aimed to fill a theoretical gap in the health promotion literature related to the links between occupational patterns and health. However, the extent of uptake and use of the framework since publication is unknown. Purpose. To explore and reflect on the adoption and application of DLW in the literature. Method. Citation content analysis of two seminal DLW publications was conducted from 2015 to November 2022 across six databases. Findings. Seventeen citations directly applied DLW to inform research ( n = 10), practice ( n = 5) and knowledge translation ( n = 2). Implications. The findings highlight uptake of the framework in a range of settings, and how it can inform an occupation-based understanding of health and well-being. Ongoing knowledge dissemination, development of practice tools, and research to update evidence and examine relevance are needed to further advance the utility and application of the f...
BackgroundThe COVID-19 pandemic has disrupted everyday rehabilitation research. Many academic ins... more BackgroundThe COVID-19 pandemic has disrupted everyday rehabilitation research. Many academic institutions have halted in-person human research including rehabilitation sciences. Researchers are faced with several barriers to continuing their research programs. The purpose of this perspective article is to report the results of an interdisciplinary workshop aimed at understanding the challenges and corresponding strategies for conducting rehabilitation research during the COVID-19 pandemic.MethodsTwenty-five rehabilitation researchers (17 trainees and eight faculty) attended a 2-h facilitated online workshop in to discuss challenges and strategies they had experienced and employed to conduct rehabilitation research during the COVID-19 pandemic.ResultsRehabilitation researchers reported challenges with (1) pandemic protocol adjustments, (2) participant accessibility, and (3) knowledge dissemination, along with corresponding strategies to these challenges. Researchers experienced disr...
Background. Recent changes in the Canadian regulatory landscape have prompted reflections on the ... more Background. Recent changes in the Canadian regulatory landscape have prompted reflections on the role and scope of occupational therapy in the provision of psychotherapy. Purpose. To document how psychotherapy has been explored in occupational therapy literature. Method. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines by searching eight databases (e.g., Medline, AMED, CINAHL, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Sociological s, and ProQuest Dissertations & Theses). Articles included at the full-text stage were subjected to a narrative synthesis. Findings. A total of 207 articles met the criteria for inclusion, spanning 93 years. 47.3% of these articles represented non-empirical literature, with only 14% representing effectiveness studies, suggesting that this body of literature remains in an early stage of development. Implications. Occupational therapists have bee...
In Canada, and internationally, there is an increased demand for patient engagement in health car... more In Canada, and internationally, there is an increased demand for patient engagement in health care research. Patients are being involved throughout the research process in a variety of roles that extend beyond the traditional passive participant role. These practices, referred to collectively as 'patient engagement', have raised questions about how to engage patients in the research process. Specifically, researchers have noted a lack of theory underpinning patient engagement and are looking for guidance on how to select patients and engage patients throughout the research process. In this commentary, we draw on qualitative research perspectives to generate theoretical and methodological ideas that novice or experienced researchers can apply to facilitate patient engagement in research. Despite the recent advancements in patient engagement in health care research, there is limited research evidence regarding the best strategies for developing and supporting research partners...
Objective: This study sought to evaluate whether a contact-based workplace education program was ... more Objective: This study sought to evaluate whether a contact-based workplace education program was more effective than standard mental health literacy training in promoting early intervention and support for healthcare employees with mental health issues. Method: A parallel-group, randomised trial was conducted with employees in 2 multi-site Ontario hospitals with the evaluators blinded to the groups. Participants were randomly assigned to 1 of 2 group-based education programs: Beyond Silence (comprising 6 in-person, 2-h sessions plus 5 online sessions co-led by employees who personally experienced mental health issues) or Mental Health First Aid (a standardised 2-day training program led by a trained facilitator). Participants completed baseline, post-group, and 3-mo follow-up surveys to explore perceived changes in mental health knowledge, stigmatized beliefs, and help-seeking/help-outreach behaviours. An intent-to-treat analysis was completed with 192 participants. Differences were...
PURPOSE Given the steady rise in HIV incidence among South Asian women in Canada their health-rel... more PURPOSE Given the steady rise in HIV incidence among South Asian women in Canada their health-related challenges and disability are not well understood. Our aim was to understand the "lived experiences" of disability among South Asian women living with HIV in Southern Ontario, Canada. METHODS We conducted a qualitative study using an interpretive phenomenological approach. We recruited immigrant South Asian women living with HIV in Ontario and conducted one-on-one semi structured interviews. Following the first interview, participants were invited to participate in a second interview. Interviews were audio recorded and transcribed verbatim. RESULTS Eight participants completed the first interview; six completed a second interview (14 interviews total). The mean age of participants was 47.1 years (standard deviation (sd) = 5.8) and mean length of time since HIV diagnosis was 15.1 years (sd = 6.7). We identified two overarching themes, "experiencing disability" and...
ABSTRACT Occupational identity is a central concept within occupational science and exploration o... more ABSTRACT Occupational identity is a central concept within occupational science and exploration of how the occupational identity of mother is shaped by having a child with a disease is an important consideration within this field. Currently up to 550 million people worldwide experience food allergy (Fiocchi, Sampson, Bahna, & Lack, 2011). The majority are children and the disease has been shown to create significant disruption across their occupational repertoire. It has also been suggested that the occupations of mothers of children with food allergy may be affected, however there is a paucity of scientific inquiries into this claim. The purpose of this study was to explore how mothers of children with food allergy represent their mothering occupations. Discourse analysis was used to analyze text of three on-line blogs (356 posts) written by mothers of children with food allergy. Four occupational identities emerged from the data: mothers as change managers, mothers as allergy moms, mothers as warriors, and mothers as advocates. These findings reflect researcher interpretation of how mothers’ occupations were discursively represented following occupational disruption due to food allergy. This study advances the scholarship of food allergy and occupational science by providing the first known exploration of occupations relating to mothering a child with food allergy.
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Papers by Sandra Moll