Profile of occupational therapy services in non‐urban settings: A global scoping review

Abstract

Introduction: Regional, rural, and remote people represent nearly half the world's population yet experience disproportionally higher disease, mortality, and disability rates, coupled with limited healthcare access. Occupational therapy has committed to occupational justice, yet no descriptive framework of services provided by occupational therapists in non-urban locations exists. Understanding current non-urban service practices will provide a basis for non-urban service development and research to reduce this inequity. Methods: Four databases were systematically searched for publications describing non-urban occupational therapy services, from any country, written in English, French, Portuguese, or Spanish, from 2010 to 2020. Publications were screened against criteria for inclusion, and data were identified using an extraction tool and presented in a frequency table, on a map, and in a searchable supporting information Table S1.Results: Only 117 publications were included discussing services provided to populations across 19 countries. They were mostly published in English (98%) and about populations from English-speaking countries (70%). Included publications discussed individualist services (65%), for defined age groups (74%), and for people with specific medical diagnoses (58%). Services were commonly provided in the client's community (56%), originating from urban locations (45%) where the provider travelled (26%) or contacted clients using telehealth (19%). Individual 1:1 enabling strategies were most described (59%), including remediation (34%), compensation (9%), or education (7%). Community enablement strategies were infrequently described (14%), focused primarily on transformation to improve existing service delivery (9%), with some redistributive justice (3%), and one community development strategy (1%). Exploratory research services accounted for the remaining studies (27%). Differences were noted between Global North and South approaches. Conclusion: Globally, occupational therapy has limited focus on non-urban services and favours individualist rehabilitative strategies provided by

Supporting the needs of pre‐ and primary school children in rural Victoria: Multidisciplinary views and experiences

“…Professionals identified a shortage of both support for teachers and access to allied health services for children as a common issue, which has similarly been described throughout rural and regional Australia 14 . In rural areas where resources are limited and access to individualist early intervention is scarce, a proposed solution is community‐level enablement strategies 15 . Community development and health promotion actions exemplify enablement strategies to empower communities to identify their own solutions.…”

Extension, austerity, and emergence: Themes identified from a global scoping review of non‐urban occupational therapy services

“…Data were collected using the Joanna Briggs Institute scoping review process (Peters et al, 2020 ). A protocol was peer reviewed and published (Hayes et al, 2021 ), and the detailed method described in Hayes et al ( 2022 ).…”

“…Publications reporting student experiences/placements, recruitment, professional development access, or perspectives of being a rural occupational therapist were excluded. The overall search results, PRISMA diagram, geographic and temporal distribution and services provided, clients served, and methods of both provision and access are described in detail in Hayes et al ( 2022 ).…”

“…Data were collected using the Joanna Briggs Institute scoping review process (Peters et al, 2020). A protocol was peer reviewed and published (Hayes et al, 2021), and the detailed method described in Hayes et al (2022). In summary, four databases, MEDLINE (Ovid), CINAHL (EBSCOhost), Emcare, and ProQuest Nursing & Allied Health were searched for publications discussing occupational therapy services provided to non-urban populations across the globe, from January 2010 to September 2020, in English, Spanish, French, and Portuguese languages.…”

“…Examining and challenging these perceptions require raising non‐urban practice visibility (World Health Organisation, 2021 ). Our scoping review of more than a decade of literature identified relatively few publications describing occupational therapy services in non‐urban spaces, with the majority of these published about populations in the United States, Australia, South Africa, and Canada (Hayes et al, 2022 ). Further, publications tended to discuss services stratified by age groups and diagnoses, focussed primarily on individualist rehabilitation, and provided by occupational therapists who lived remotely from the community served (Hayes et al, 2022 ).…”