To promote active and healthy ageing, it is important to foster social
participation. Although well positioned to do so, few community occupational
therapists intervene to address social participation, and no review of
promising and current practices is available. This study synthesised
knowledge on community occupational therapy practices fostering older
adults' social participation.
Method
A scoping review involved searches in eight databases using 49 keywords.
Studies were selected by two reviewers and content-analysed following PRISMA
guidelines.
Results
Of the 32 selected studies, most involved descriptive
(n = 11; 34%), randomised controlled trial
(n = 9; 28%) or quasi-experimental
(n = 7; 22%) designs, and were conducted mainly in the USA
(n = 8; 25%), Canada (n = 6; 19%) and
Sweden (n = 6; 19%). Twenty promising practices combined
multi-component interventions (n = 11; 55%), or involved
group (n = 5; 25%) or individual (n = 4;
20%) sessions. Promising practices improved participation in social
activities (n = 13; 65%), social interactions
(n = 6; 30%), self-rated health
(n = 6; 30%) and quality of life (n = 6;
30%), and reduced health-care costs (n = 4; 20%). Facing
organisational and systemic barriers, current practices rarely incorporated
these possibilities.
Conclusion
Efforts to foster older adults' social participation appear to be
cost-effective but need to be further incorporated into practice. Research
should engage community stakeholders in implementing these
possibilities.
AmagasaSFukushimaNKikuchiH,
et al.(2017) Types of social
participation and psychological distress in Japanese older adults: A
five-year cohort study. PLoS One12(4): e0175392. doi:
10.1371/journal.pone.0175392.
2.
ArkseyHO'MalleyL
(2005) Scoping studies: Towards a methodological
framework. International Journal of Social Research
Methodology8(1): 19–32.
doi: 10.1080/1364557032000119616.
3.
AshcroftR
(2014) Inadequate performance measures affecting
practices, organizations and outcomes of Ontario's family health
teams. Healthcare Policy10(1):
86–96.
4.
CamdenCSwaineBLevasseurM
(2013) Did waiting times really decrease
following a service reorganization? Results from a retrospective study in a
pediatric rehabilitation program in Québec.
Disability and Rehabilitation35(9): 719–724.
doi: 10.3109/09638288.2012.705948.
5.
CarrierAFreemanALevasseurM,
et al.(2015) Standardized referral
form: Restricting client-centered practice?.
Scandinavian Journal of Occupational Therapy22(4): 283–292.
doi: 10.3109/11038128.2015.1019922.
6.
CarrierALevasseurMFreemanA,
et al.(2016) Reddition de compte et
optimisation de la performance: Impacts sur le choix des interventions
ergothérapiques. [Impact of accountability and performance optimization on
the choice of occupational therapy interventions].
Santé Publique28(6):
769–780.
7.
CiroCASmithP
(2015) Improving personal characterization of
meaningful activity in adults with chronic conditions living in a low-income
housing community. International Journal of
Environmental Research and Public Health12(9):
11379–11395. doi:
10.3390/ijerph120911379.
8.
ClarkFAzenSPCarlsonM,
et al.(2001) Embedding
health-promoting changes into the daily lives of independent-living older
adults: Long-term follow-up of occupational therapy
intervention. Journals of Gerontology Series B:
Psychological Sciences and Social Sciences56B(1):
P60–P63.
9.
ClarkFAzenSPZemkeR,
et al.(1997) Occupational therapy
for independent-living older adults: A randomized controlled
trial. JAMA278(16):
1321–1326. doi:
10.1001/jama.1997.03550160041036.
10.
ClarkFJacksonJCarlsonM,
et al.(2012) Effectiveness of a
lifestyle intervention in promoting the well-being of independently living
older people: Results of the Well Elderly 2 randomised controlled
trial. Journal of Epidemiology and Community
Health66(9):
782–790.
11.
CockburnLTrenthamB
(2002) Participatory action research:
Integrating community occupational therapy and research.
Canadian Journal of Occupational Therapy69(1):
20–30.
12.
CraigDG
(2012) Current occupational therapy publications
in home health: A scoping review. American Journal
of Occupational Therapy66(3): 338–347.
doi: 10.5014/ajot.2012.003566.
13.
DawsonDRichardsonJTroyerA,
et al.(2014) An occupation-based
strategy training approach to managing age-related executive changes: A
pilot randomized controlled trial. Clinical
Rehabilitation28(2): 118–127.
doi: 10.1177/0269215513492541.
14.
De
ConinckLBekkeringGEBouckaertL,
et al.(2017) Home- and
community-based occupational therapy improves functioning in frail older
people: A systematic review. Journal of the American
Geriatrics Society65(8): 1863–1869.
doi: 10.1111/jgs.14889.
15.
Di
StefanoMLovellRStoneK,
et al.(2009) Supporting individuals
to make informed personal mobility choices: Development and trial of an
evidence-based community mobility education program.
Topics in Geriatric Rehabilitation25(1):
55–72.
16.
DickensAPRichardsSHGreavesCJ,
et al.(2011) Interventions
targeting social isolation in older people: A systematic
review. BMC Public Health11: 647–647. doi:
10.1186/1471-2458-11-647.
17.
DugowHConnollyDYuenHK
(2012) Exploring impact of independent living
programme on activity participation of elderly people with chronic
conditions. International Journal of Therapy and
Rehabilitation19(3):
154–162.
18.
EklundKSjöstrandJDahlin-IvanoffS
(2008) A randomized controlled trial of a
health-promotion programme and its effect on ADL dependence and
self-reported health problems for the elderly visually
impaired. Scandinavian Journal of Occupational
Therapy15(2):
68–74.
19.
FiliatraultJRichardL
(2005) L'apport des théories des changements
comportementaux aux interventions de prévention et de promotion de la santé
de l'ergothérapeute. The Canadian Journal of
Occupational Therapy72(1):
45–56.
20.
FougeyrollasP
(2010) Le funambule, le fil et la toile.
Transformations réciproques du sens du handicap [The Tightrope Walker, Wire
and Canvas. Reciprocal Transformations of the Meaning of
Disability], Québec, Canada:
Presses de l'Université
Laval.
21.
FuråkerCNilssonK
(2011) The consultative work of occupational
therapists working in municipal healthcare.
Scandinavian Journal of Occupational Therapy18(2): 101–108.
doi: 10.3109/11038121003686179.
22.
GarveyJConnollyDBolandF,
et al.(2015) OPTIMAL, an
occupational therapy led self-management support programme for people with
multimorbidity in primary care: A randomized controlled
trial. BMC Family Practice16: 59–59. doi:
10.1186/s12875-015-0267-0.
23.
Gouvernement du Québec
(2013) Code Des Professions (c.C-26),
Québec, Canada: Éditeur
officiel du Québec.
24.
Graff,
AdangEVernooij-DassenMDekkerJ,
et al.(2008) Community occupational
therapy for older patients with dementia and their care givers: Cost
effectiveness study. BMJ336(7936):
134–138. doi:
10.1136/bmj.39408.481898.BE.
25.
GraffMVernooij-DassenMThijssenM,
et al.(2006) Community based
occupational therapy for patients with dementia and their care givers:
Randomised controlled trial. BMJ333(7580): 1196.
26.
GraffMJLVernooij-DassenMJMThijssenM,
et al.(2007) Effects of community
occupational therapy on quality of life, mood, and health status in dementia
patients and their caregivers: A randomized controlled
trial. The Journals of Gerontology Series A: Biological
Sciences and Medical Sciences62(9):
1002–1009.
27.
GrolRGrimshawJ
(2003) From best evidence to best practice:
Effective implementation of change in patients' care.
Lancet362(9391):
1225–1230.
28.
HayJLaBreeLLuoR,
et al.(2002) Cost-effectiveness of
preventive occupational therapy for independent-living older
adults. Journal of the American Geriatrics
Society50(8):
1381–1388.
29.
Hébert M (2001) Du
quotidien de l'ergotherapie dans les C.L.S.C. du Quebec a l'emergence de
nouveaux savoirs pour la pratique communautaire. (Philosophiae
Doctor (Ph.D.)), Université de Montréal, Montréal, Québec, Canada. (ProQuest
Dissertations and Theses).
30.
HébertMMaheuxBPotvinL
(2002) Théories qui émergent du quotidien de la
pratique communautaire de l'ergothérapie [Theories stemming from day-to-day
practice of community occupational therapy].
Canadian Journal of Occupational Therapy69(1):
31–39.
31.
HolmbergVRingsbergKC
(2014) Occupational therapists as contributors
to health promotion. Scandinavian Journal of
Occupational Therapy21(2): 82–89.
doi: 10.3109/11038128.2013.877069.
32.
Holt-LunstadJSmithTBBakerM,
et al.(2015) Loneliness and social
isolation as risk factors for mortality: A meta-analytic
review. Perspectives on Psychological
Science10(2): 227–237.
doi: 10.1177/1745691614568352.
33.
JacksonJCarlsonMMandelD,
et al.(1998) Occupation in
lifestyle redesign: The well elderly study occupational therapy
program. American Journal of Occupational
Therapy52(5):
326–336.
34.
JacksonJMandelDBlanchardJ,
et al.(2009) Confronting challenges
in intervention research with ethnically diverse older adults: The USC Well
Elderly II Trial. Clinical Trials (London,
England)6(1): 90–101.
doi: 10.1177/1740774508101191.
35.
JohanssonABjörklundA
(2016) The impact of occupational therapy and
lifestyle interventions on older persons' health, well-being, and
occupational adaptation. Scandinavian Journal of
Occupational Therapy23(3): 207–219.
doi: 10.3109/11038128.2015.1093544.
36.
KergoatMJLégaréJ
(2007) Aspects démographiques et
épidémiologiques du vieillissement au Québec. Précis
pratique de gériatrie, Québec,
Canada:
Edisem.
37.
LamarchePPineaultRGauthierJ,
et al.(2011) Availability of
healthcare resources, positive ratings of the care experience and extent of
service use: An unexpected relationship. Healthcare
Policy6(3):
46–56.
38.
LarssonEPadyabMLarsson-LundM,
et al.(2016) Effects of a social
internet-based intervention programme for older adults: An explorative
randomised crossover study. British Journal of
Occupational Therapy79(10): 629–636.
doi: 10.1177/0308022616641701.
39.
LaucknerHMKrupaTMPatersonML
(2011) Conceptualizing community development:
Occupational therapy practice at the intersection of health services and
community. Canadian Journal of Occupational
Therapy78(4): 260–268.
doi: 10.2182/cjot.2011.78.4.8.
40.
LelandNEFogelbergDSleightA,
et al.(2016) Napping and nighttime
sleep: Findings from an occupation-based intervention.
American Journal of Occupational Therapy: Official Publication of
the American Occupational Therapy Association70(4):
7004270010p7004270011–7004270017. doi:
10.5014/ajot.2016.017657.
LevasseurMDesrosiersJSt-Cyr
TribbleD
(2008) Subjective quality-of-life predictors for
older adults with physical disabilities. American
Journal of Physical Medicine and Rehabilitation87(10):
830–841.
43.
LevasseurMLefebvreHLevertM-J,
et al.(2016) Personalized citizen
assistance for social participation (APIC): A promising intervention for
increasing mobility, accomplishment of social activities and frequency of
leisure activities in older adults having disabilities.
Archives of Gerontology and Geriatrics64: 96–102. doi:
10.1016/j.archger.2016.01.001.
44.
LevasseurMRichardLGauvinL,
et al.(2010) Inventory and analysis
of definitions of social participation found in the aging literature:
Proposed taxonomy of social activities. Social
Science and Medicine71(12):
2141–2149.
45.
LiljaMBorellL
(2001) Occupational therapy practice patterns
with older Swedish persons at home. Canadian Journal
of Occupational Therapy68(1):
51–59.
46.
LoganPAGladmanJRAveryA,
et al.(2004) Randomised controlled
trial of an occupational therapy intervention to increase outdoor mobility
after stroke. BMJ329(7479):
1372–1375.
47.
MatuskaKGiles-HeinzAFlinnN,
et al.(2003) Outcomes of a pilot
occupational therapy wellness program for older adults.
American Journal of Occupational Therapy57(2):
220–224.
48.
MitchellRUnsworthCA
(2004) Role perceptions and clinical reasoning
of community health occupational therapists undertaking home
visits. Australian Occupational Therapy
Journal51(1):
13–24.
49.
MoherDLiberatiATetzlaffJ,
et al.(2009) Preferred reporting
items for systematic reviews and meta-analyses: The PRISMA
statement. PLoS Med6(7): e1000097.
50.
MountainGMozleyCCraigC,
et al.(2008) Occupational therapy
led health promotion for older people: Feasibility of the Lifestyle Matters
programme. British Journal of Occupational
Therapy71(10):
406–413.
51.
MulryCMPiersolCV
(2014) The Let's Go program for community
participation: A feasibility study. Physical and
Occupational Therapy in Geriatrics32(3):
241–254.
52.
MurphySLStrasburgDMLydenAK,
et al.(2008) Effects of activity
strategy training on pain and physical activity in older adults with knee or
hip osteoarthritis: A pilot study. Arthritis Care
and Research59(10): 1480–1487.
doi: 10.1002/art.24105.
53.
O'TooleLConnollyDSmithS
(2013) Impact of an occupation-based
self-management programme on chronic disease management.
Australian Occupational Therapy Journal60(1):
30–38.
54.
PapageorgiouNMarquisRDareJ,
et al.(2016) Occupational therapy
and occupational participation in community dwelling older adults: A review
of the evidence. Physical and Occupational Therapy
in Geriatrics34(1): 21–42.
doi: 10.3109/02703181.2015.1109014.
55.
QuickLHarmanSMorganS,
et al.(2010) Scope of practice of
occupational therapists working in Victorian community health
settings. Australian Occupational Therapy
Journal57(2):
95–101.
56.
Ramsey R (2007) The
professional expertise of community-practicing occupational
therapists. (Doctoral studies), University of San Francisco,
San Francisco, CA (3263728).
57.
TownsendEAPolatajkoHJ
(2013) Enabling Occupation II: Advancing an
Occupational Therapy Vision for Health, Well-Being, and Justice Through
Occupation, Ottawa, Canada:
Canadian Association of Occupational
Therapists.
58.
TrenthamBCockburnLShinJ
(2007) Health promotion and community
development: An application of occupational therapy in primary health
care. Canadian Journal of Community Mental
Health26(2):
53–70.
59.
TurcottePLCarrierADesrosiersJ,
et al.(2015) Are health promotion
and prevention interventions integrated into occupational therapy practice
with older adults having disabilities? Insights from six community health
settings in Québec, Canada. Australian Occupational
Therapy Journal62(1): 56–67.
doi: 10.1111/1440-1630.12174.
60.
TurcottePLLarivièreNDesrosiersJ,
et al.(2015) Participation needs of
older adults having disabilities and receiving home care: Met needs mainly
concern daily activities, while unmet needs mostly involve social
activities. BMC Geriatrics15(1): 95.
61.
WalkerMFLeonardi-BeeJBathP,
et al.(2004) Individual patient
data meta-analysis of randomized controlled trials of community occupational
therapy for stroke patients. Stroke35(9):
2226–2232.
62.
WoodRFortuneTMcKinstryC
(2013) Perspectives of occupational therapists
working in primary health promotion. Australian
Occupational Therapy Journal60(3): 161–170.
doi: 10.1111/1440-1630.12031.
ZingmarkMFisherAGRocklövJ,
et al.(2014) Occupation-focused
interventions for well older people: An exploratory randomized controlled
trial. Scandinavian Journal of Occupational
Therapy21(6): 447–457.
doi: 10.3109/11038128.2014.927919.
65.
ZingmarkMNilssonIFisherAG,
et al.(2016) Occupation-focused
health promotion for well older people – A cost-effectiveness
analysis. British Journal of Occupational
Therapy79(3): 153–162.
doi: 10.1177/0308022615609623.
