The health professions are confronted with external pressures to assure the public of the continuing competence of health care providers and internal pressures for self-regulation. This article describes the forces driving continuing competence, the difficulty defining the scope of professional competencies for experienced practitioners, the difficulty creating valid measures to evaluate continuing competence, and the need for shared responsibility and collaboration among regulatory boards, professional associations, and specialty certification programs. The article presents findings from the Study of Professions, which was based on literature review, document review, and telephone interviews with key informants from 13 regulated health professions.

The role of occupational therapy in prevention has received much discussion but relatively little empirical testing and model building. Because of the evidence linking stress and illness, the life stress process has become a popular area of investigation. More importantly, a role strain model can provide a theoretical guide to occupational therapy practice due to the central importance of adaptive behavior and social competence. To illustrate, the maternal stress study is presented as an example of prevention research that examines the relationship between maternal stress and child psychopathology. Risk factors are identified as the first step in reliable case finding and the design of preventive interventions. Such model building can help occupational therapists develop prevention services for vulnerable populations.

The relation of familial and school-based risk factors to socioemotional and learning problems was studied in a sample of Hispanic children in Head Start programs. Socioemotional problems were found to relate most strongly to school-based solitary play, negative peer interaction, and maternal reports of child temperament, while associated learning problems related most strongly to school-based attention span. Significant gender interaction was also identified. Results support use of a culturally sensitive ecological model for assessing child behavior and hold implications for further research.

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