State of the Journal, 2023

As 2023 comes to a close, I find myself now in my second 3-yr term as the Editor-in-Chief of the American Journal of Occupational Therapy (AJOT). I am thankful for the opportunities this position has provided me over the past 3 yr: opportunities to work with some amazing authors and editors, opportunities to read so many intriguing research articles, and opportunities to constantly learn and grow in the field of academic publishing.

One of my primary goals for my first term as editor was to expand the ways in which AJOT disseminated and translated research findings for use in practice. The outcomes of this goal are seen in the AJOT Authors & Issues YouTube series, now entering its third season, and in the AJOT Instagram account, which in just 1 yr has posted 27 article summaries and amassed more than 700 followers. Although not as visible to readers, AJOT now has a more systematic communications plan with better integration with the American Occupational Therapy Association’s (AOTA’s) communications team, allowing for promotion of AJOT content across all AOTA platforms. I hope that as these outlets continue to gain traction, we will see a faster and more natural translation of research findings into practice, thereby improving the overall evidence base for the profession.

Another goal for my first term included improving the speed, transparency, and experience of the peer-review process for both authors and reviewers. To that end, AJOT has added more than 65 new reviewers in the past 3 yr, including reviewers with expertise in key areas, such as implementation science, occupational justice and equity, critical review methodology, psychometric analyses, and rehabilitation engineering (among many others). New reviewer resources have been added to the AJOT website, and several of our ad hoc reviewers have transitioned into official reviewer roles. In 2022, AJOT also transitioned to a more efficient online submission system, ScholarOne, which has substantially decreased the time from manuscript submission to first decision and acceptance and has improved the overall submission and peer-review experience.

We have also worked to increase student engagement with AJOT, mentoring six AJOT student representatives over the past 3 yr. Student volunteers have helped to write research briefs and profiles for the AJOT Instagram account, served on the AJOT Diversity, Equity, and Inclusion (DEI) Committee, and written scripts and conducted interviews for the AJOT Authors & Issues series. As we continue to mentor students, clinicians, and junior researchers into the AJOT fold, we hope to develop a pipeline for people to stay connected with the journal throughout their careers and move into leadership positions.

Entering my second term as AJOT Editor-in-Chief feels more daunting in some ways than entering my first term. This apprehension stems primarily from the looming challenges (and opportunities) that artificial intelligence (AI) poses to the publishing world. As noted by Michael Upshall (2019), head of business development at UNSILO, AI is a “disruptive technology” (p. 3); it will absolutely change the way things are done. As someone who can be (admittedly) slow to change, I am feeling the pressure to make rapid decisions about how and when AI can and should be used in relation to AJOT. There is certainly the side of me that wants to say “nope” to any use of AI and continue doing things the way they have always been done, but obviously I would be a terrible leader if I took that stance. The world is changing, and as the leading occupational therapy journal in the world, AJOT has to stay ahead of the curve.

With that in mind, I see several opportunities for the use of AI at AJOT. First and foremost, emerging AI platforms, such as ChatGPT, a large language model that generates humanlike text, as well as existing AI editing tools, such as Grammarly, have the potential to level the playing field for authors who use English as a second language. Many high-impact health and medical journals, such as AJOT, require articles to be written in English for peer review or publication. For non-native English speakers, English grammar, syntax, spelling, and professional jargon can all create barriers to publishing what would otherwise be solid research (Telich-Tarriba, 2023; Zohny et al., 2023). Although AI cannot be listed as an author or coauthor of a manuscript (because AI tools are not human and cannot assume responsibility for the validity or originality of the generated work; Hartel, 2023), it can be used judiciously to enhance a manuscript before submission for peer review. These tools can also be used advantageously by native English speakers, who can save time and effort editing their drafts and direct more of their efforts toward the development of novel interventions, complex research designs, and sophisticated analyses. Given that AI is available to everyone, native and non-native English speakers alike, it could create greater equity in the publishing arena. As we move in this direction, authors will need to include a statement in their AJOT submission that discloses how AI was used in the preparation of their work and to take responsibility for the content of the publication (Telich-Tarriba, 2023). Our updated Author Guidelines spell out AJOT’s policy on the use of generative AI.

With the opportunities that AI offers to authors, we must also consider the threats it presents. First, it is fairly well accepted that AI systems can be developed with, or learn, biases, including political, racial, and gender biases (Meetoo & Rylance, 2018). This is because AI receives its information from human sources that are, in many ways, biased themselves (Motoki et al., 2023). Most health-related journals have only just begun to strive for bias-free language and reduction of bias in medical reporting, so the greater use of AI presents another threat to these efforts. Second, AI systems, such as ChatGPT, present a threat of disseminating inaccurate, incomplete, or harmful text if authors do not validate the accuracy of AI-generated content (Leveridge, 2023); furthermore, AI cannot currently evaluate the quality of the content it draws from and cannot adequately cite (Zohny et al., 2023). In fact, ChatGPT has been known to “hallucinate” (a machine learning term) citations, making them seem legitimate and real when they are, in fact, fabricated (Welborn, 2023). Although we would hope authors would be vigilant about checking their articles for accuracy, editorial teams will also need to be more aware of an uptick in trustworthiness issues and prevent false information from being disseminated. Without this fortification of knowledge, there is a risk that trust in the journal could be undermined and standards of scholarly publishing as a whole could be questioned.

Finally, there is the potential for us to consider greater use of AI in our peer review and publishing processes. Our online submission platform, ScholarOne, already uses an AI-based plagiarism checker, and our article composition partner uses an AI tool that automates the process of comparing and matching in-text citations with their references. Are there other ways in which AI can help to enhance the speed or accuracy of peer review and publishing? Could AI be incorporated early in the review process to ensure that submitted manuscripts align with the journal’s scope and mission, or could AI be used, as suggested by Heaven (2018), to identify statistical errors or inconsistencies? Personally, I am interested in how AI can help us digest research articles into manageable snapshots (brief reports or lay summaries) of information that can help with translation of findings into practice. Although I do not see AI replacing the editorial team, I am interested to see how AI can be used moving forward to support editors and associate editors in doing their job. For now, our role at AJOT will be to keep up with current trends, communicate our expectations to stakeholders, and be transparent in our decision-making processes regarding the use of AI.

The year 2023 was busy and exciting for the journal. In February 2023, we published a special section, “Mental Health Needs for Clients With Autism,” which was guest edited by Dr. Anne Kirby, Dr. Claudia Hilton, and Lisa Morgan. Published in Volume 77, Issue 2, this collection of articles highlights the needs of the autism community with regard to mental health services and the role occupational therapists can play in addressing those needs. The guest editorial for this special issue highlights the state of the science in this field and current gaps in knowledge. We are also in the process of preparing two new AJOT special issues for Volume 78. The first of these issues, “Recovery After Neurological Injury,” will be guest edited by Dr. Amit Sethi, Dr. Jaclyn Stephens, Dr. Michelle Woodbury, and Dr. Sook-Lei Liew and published in Volume 78, Issue 2 (March/April 2024). The second special issue will be titled “Play in Occupational Therapy” and will be guest edited by Dr. Heather Kuhaneck, Dr. Anita Bundy, and an international team of play researchers; this issue is slated for publication in Volume 78, Issue 3 (May/June 2024).

In 2023, we also continued the AJOT Authors & Issues interview series, which can be accessed through our YouTube channel as well as through the AJOT website. Since the series launched in December 2021, we have published 23 interviews with AJOT authors, tallying more than 6,000 views. Topics covered in the 2023 Authors & Issues sessions are listed in Table 1. The most-watched episodes were related to addressing microaggressions in occupational therapy education; using Ayres Sensory Integration^® to address play in autistic children; and using practice-based inquiry to enact occupation-centered, justice-oriented practice in an acute mental health setting. Each article featured in the series is also available through Open Access on the AJOT website, making translation into practice even more accessible.

We have also maintained, and added features to, our AJOT Instagram account (ajoteditor) and AJOT website. Our Instagram account features two monthly research briefs, editor spotlights, viewer polls, recaps of our Authors & Issues series, and opportunities to direct-message the Editor-in-Chief. Through this social media platform, we hope to engage readers in new ways and to make the work we publish more accessible for clinicians to translate into practice. Since its launch in August 2022, the AJOT Instagram account has accumulated more than 700 followers. Redesigned in 2021, the AJOT website continues to make finding relevant information faster and easier for users, including access to full-text articles, clinical practice guidelines, resources for potential reviewers and authors, AOTA INSPIRE conference abstracts, and article special collections. Three new collections were added in 2023 on (1) DEI, (2) functional cognition, and (3) AOTA Practice Guidelines.

One of our goals for 2023 was to closely examine our Author Guidelines and copyediting policies and help ensure that information on race, gender, disability, and so forth is written and presented in ways that do not, intentionally or unintentionally, perpetuate biases. As part of this process the AJOT DEI Committee recommended resources for the editorial team to read and a Bias-Free Language statement has been added to our Author Guidelines. In addition, Dr. Khalilah R. Johnson (AJOT Associate Editor) and I (AJOT Editor-in-Chief) presented on bias-free research reporting at the 2023 AOTA Education Summit in Denver, Colorado, and will conduct an expanded short course on the topic at the 2024 AOTA INSPIRE in Orlando, Florida. The goal of promoting equity and justice in our practices and procedures will be a continual process and commitment. We are also proud of the strides we have made as a journal and of our ongoing efforts to promote DEI in the occupational therapy community.

A journal impact factor (JIF) is a frequency measure that reflects the number of times, on average, articles have been cited in a specific time period. The 2- and 5-yr JIF scores are the most frequently reported and are used to rank journals in terms of significance. The calculation is determined by dividing the number of times articles were cited in the given period (i.e., 2 or 5 yr) by the number of articles published in the journal. Editorials and opinion-based articles (e.g., the AJOT “The Issue Is” column) are not included in this calculation. AJOT’s 2-yr impact factor increased from 2.813 in 2021 to 2.900 in 2022 (Journal Citation Reports [JCR], 2023). Its 5-yr impact factor fell for the second year in a row from 3.596 to 3.100 (see Table 2). The top 10 most-cited articles contributing to AJOT’s 2-yr impact factor are listed in Table 3. Of these 10 articles, 4 were review articles.

JCR ranks journals in various categories on the basis of their JIF as well as other factors, such as citation and article counts, publisher information, and subject categories. Among all the ranked journals (N = 73) in the category of rehabilitation, AJOT made a big jump up from a rank of 14 to a rank of 8. Within the rehabilitation category, AJOT is also first among all occupational therapy journals worldwide.

CiteScore is another journal evaluation metric based on citations recorded in the Scopus database. CiteScore 2022 is the number of citations in 2019–2022 for articles published in 2019–2022, divided by the number of articles published in 2019–2022 (Scopus, 2022). In 2023, AJOT’s CiteScore increased from 2.7 to 2.8, placing the journal in the 76th percentile of occupational journals. Although our CiteScore increased, this ranking is lower than our 2022 ranking, which was in the top 89% of all occupational journals.

Between January 1, 2023, and September 1, 2023, AJOT had 351 total submissions (229 original, 122 revised), putting us on track to match the 452 total submissions (311 original, 141 revised) in 2022. Acceptance rates for the journal have remained stable over the past 5 yr, ranging from 24% to 30% (Table 4). AJOT received submissions this year from all over the world, representing a journal-high record of 31 different countries. Outside of the United States, Taiwan (n = 6), Israel (n = 4), Canada (n = 3), Australia (n = 3), and Spain (n = 3) had the highest number of accepted articles for 2023. Other countries with articles accepted in AJOT in 2023 include Cyprus, France, Italy, Japan, Qatar, Romania, Switzerland, and Turkey. Acceptance rates were slightly higher for U.S. authors (33.0% of accepted articles) than for international authors (26.7% of accepted articles); however, this gap is smaller than in previous years.

AJOT published Volume 77 in 2023, which included six regular issues and two supplements. In the regular issues, 107 research articles and 23 nonresearch articles (e.g., editorials, “The Issue Is” features, and clinical practice guidelines) were published. Of the 107 research articles published, 18.7% were instrument development or psychometric studies, 24.3% were effectiveness studies, 14.0% were critical literature reviews (e.g., systematic or scoping reviews), 18.7% were qualitative or exploratory in nature, and 20.0% were classified as basic articles focused on establishing relationships between conditions and occupational limitations, prevalence or incidence of conditions or client factors, predictors of outcomes, or taxonomies. A full breakdown of the types of articles published in 2023, including the evidence levels for these articles, is presented in Table 5.

After showing a steady increase over the past 5 yr, the number of funding sources identified for work published in AJOT dropped from 47 sources identified in Volume 76 (2022) to 34 sources identified in Volume 77 (2023). Although the number of studies funded by the National Institutes of Health (NIH) rose slightly (n = 8 vs. n = 6), the number of studies funded by foundations dropped by more than half (n = 6 vs. n = 13). In addition, for the first time in 5 yr, no state agencies were identified as funding sources for articles published in AJOT. International funding sources continue to make up about one-third of all funding sources identified in AJOT publications, which is commensurate with the number of articles authored by international authors. A full listing of funding sources is presented in Table 6.

The masked peer-review process is at the core of the journal’s ability to critique the rigor and trustworthiness of submitted articles. All submissions are screened for appropriateness by the Editor-in-Chief, then distributed to an associate editor for screening, soliciting reviewers, and working with authors and reviewers throughout the peer-review process. A minimum of two peer reviewers are solicited to evaluate the rigor and acceptability of the article for AJOT. From January 1, 2023, through September 1, 2023, our team solicited 660 reviewers, 430 of whom accepted our review request (65.2% acceptance rate). On average, authors submitting their articles to AJOT can expect to have a first decision within 25 days; articles making it through the review process are generally accepted within a 3-mo time frame (time from initial submission to final decision, including revisions and re-reviews; see Table 7 for details).

AJOT continues to set a high bar for publishing rigorous research in the profession. As we move into 2024, we want to consider how we can also help to drive the work that needs to be conducted in the field. With this in mind, in 2024 we will reinitiate publishing State of the Science (SoS) articles, which provide a brief narrative review of the state of the occupational therapy literature in a broad area of practice with the goal of creating a road map for researchers who are interested in conducting new and innovative research in this area. As such, we will be inviting groups of authors to submit SoS articles that help to outline where the state of the research is in a specific area of practice and to provide recommendations for what work needs to be done to move the profession forward in this area.

In 2024, we will continue to host monthly AJOT Authors & Issues sessions to help bridge the gap between research and practice and to make featured articles available through open-access platforms. We will also continue to post research briefs and editor spotlights on our Instagram account and include more polls to help engage followers.

Each of these initiatives continues to support our overarching goal of helping to translate occupational therapy research into practice. In summary, our editorial board has outlined the following specific goals for the 2024 volume year:

• ▪ Reinitiate the State of the Science articles.

• ▪ Update AJOT Author Guidelines and include policies on the use of AI and bias-free language.

• ▪ Hire new associate editors to replace those who have rotated off the board.

• ▪ Publish special issues on recovery after neurological injury and play in occupational therapy.

• ▪ Solicit articles for our new special issues (2025) on DEI and feeding practices in occupational therapy.

• ▪ Promote engagement with the journal through the AJOT Instagram account.

• ▪ Host monthly AJOT Authors & Issues discussions.

While maintaining its position as the most-cited occupational therapy journal in the world, AJOT continues to be more than just a repository for research. Our efforts to translate research into practice and promote best practices in research reporting make our journal a valuable resource for the profession of occupational therapy. We believe in our product and its value, and we are committed to publishing and promoting peer-reviewed research that is trustworthy so that occupational therapy professionals can make evidence-based decisions to inform their work.