State of the Journal, 2015

As 2015 ends, AJOT remains a well-regarded occupational therapy and rehabilitation journal. It is the most highly ranked occupational therapy journal, according to Journal Citation Reports (JCR), and ranks 22nd out of 65 journals indexed in the Rehabilitation subsection of the Social Science Division of JCR on the basis of the 2-yr impact factor (1.532).

As shown in Table 1, manuscript submissions to AJOT continue to increase, and the acceptance rate also increased to 40.9% (103) out of 250 submissions. AJOT is truly a global publication, with manuscripts received from 23 countries (compared with 17 in 2014), including the United States, Argentina, Australia, Brazil, Canada, China (mainland and Hong Kong), Greece, India, Iran, Ireland, Israel, Italy, Japan, Jersey, Korea, Norway, Pakistan, Singapore, South Africa, and Spain.

The majority of articles published in AJOT continue to be research articles, consistent with the mission of the journal to be a primary outlet for the evidence that supports occupational therapy practice. Table 2 provides a breakdown of published research articles by type of study. This year, the definitions of these study types were altered to reflect the great variety of studies that have been submitted to the journal and to attempt to eliminate some of the overlap among categories.

• Effectiveness studies examine the effects, efficacy, or effectiveness of a therapy intervention or educational pedagogy and range from case studies or other N-of-1 trials to large randomized controlled trials.

• Instrument development studies are those that involve the development of assessment tools or therapy tools (e.g., new technology) and include studies about tool construction, psychometric properties, and ease of use.

• Basic research studies establish relationships between conditions and occupational limitations, determine the prevalence or incidence of conditions or client factors within a condition, determine predictors of outcomes, develop taxonomies, and test and build theories. They also include occupational science and research with animal models.

• Professional issues studies assess therapist knowledge or skills and examine practices that affect therapy delivery.

• Health services studies describe health care practice and utilization of occupational therapy services, disparities in utilization of health care services, and access to health care services.

• Systematic reviews include literature reviews, meta-analyses, and scoping reviews that use systematic methods to locate and select appropriate literature and critique the literature.

The greatest proportion of articles published in AJOT in 2015 describe effectiveness and basic research studies supporting occupational therapy intervention. This statistic is in keeping with the journal’s mission to be one of the primary outlets for dissemination of evidence for occupational therapy practice and is encouraging because the profession is in critical need of evidence to support the efficacy and effectiveness of occupational therapy interventions for its stakeholders (i.e., clients and families, insurers, legislators, and other health professionals). However, caution is warranted: More than 65% of effectiveness studies (n = 25) were at the lower levels of evidence, in which the risk of bias is relatively high. Of the 34.2% of effectiveness studies at Level I (n = 13), in which risk of bias is reduced, only 4 were randomized clinical trials; the remainder were systematic reviews.

Of concern is that these statistics indicate either that insufficient Level I occupational therapy intervention effectiveness studies are being conducted or that such studies are being published in journals other than AJOT. Although publication in other professions’ journals or interdisciplinary journals is important exposure for occupational therapy, publication in occupational therapy journals drives other professionals and researchers to access occupational therapy literature and emphasizes the uniqueness of occupational therapy in solving the problems of people with disabilities or other conditions.

In 2015, the most commonly addressed practice areas in research articles were (1) rehabilitation, disability, and participation and (2) children and youth (see Table 2). Other practice areas were not well represented, although several articles could have been dually categorized. For example, articles by Hildebrand (2015) and Bixby, Davis, and Ott (2015) were categorized as rehabilitation, disability, and participation but could also have been placed into the mental health and productive aging categories, respectively. This year, the second year of the education supplement, saw an increase in the number of unsolicited education research articles submitted.

Twenty-eight (28.8%) of the 97 research articles were funded by specific funding mechanisms in 2015 (Table 3). We saw a small increase in federally funded research, which suggests that occupational therapy researchers are increasingly funded by some of the most competitive research grants in the United States. However, the small number of “other federal agency”–funded research articles suggests that researchers are not taking advantage of some excellent funding mechanisms, such as those of the Department of Veterans Affairs and the National Science Foundation. In addition, few articles were funded by U.S. foundations, another excellent source of research funding. It is likely that health care reforms that emphasize the importance of distal health outcomes, such as participation, healthy life habits for managing chronic conditions, and life satisfaction, will drive funders to increasingly value the importance of developing effective occupational therapy interventions that support these outcomes. Therefore, occupational therapy researchers should see even greater amounts of federally funded research awards in the next several years.

In keeping with the goals of increasing the quality and quantity of articles published and improving the visibility of occupational therapy research, we can point to the following accomplishments since the start of 2015:

• Sixty-nine reviewers were added to the roster of AJOT reviewers, including reviewers from Canada, the United Kingdom, Australia, and several Asian countries. In general, this increase has eased reviewer workload and shortened the review process.

• The AJOT Editorial Board held a workshop at the American Occupational Therapy Association (AOTA) Annual Conference & Expo in Nashville to provide potential authors with information about the publishing process and tips for higher quality writing. The goal was to foster the submission of manuscripts that need less revision before publication.

• The AJOT Editorial Board agreed to adopt additional publishing guidelines: STROBE (von Elm et al., 2007) for cohort and case-controlled studies and STARD (Bossuyt et al., 2003) for diagnostic accuracy.

• AJOT has joined other major rehabilitation and disability journals in a collaborative initiative to enhance clinical research reporting standards through adoption of mandatory reporting guidelines (Chan, Heinemann, & Roberts, 2014). As a result, effective January 1, 2016, authors of manuscripts reporting on clinical trials must register those trials with ClinicalTrials.gov or a similar non-U.S. registry for the manuscript to be considered for publication. Registering trials on such sites increases the transparency of trial design and implementation, resulting in less risk of bias and higher quality evidence. The editorial collaborative believes that the adoption of such requirements will hasten an increase in the quality of rehabilitation and related research. Additional information is available in the most recent AJOT author guidelines (AOTA, 2015), available at http://ajot.aota.org/article.aspx?articleid=2442689.

• AJOT moved to continuous publishing this year. Articles are now published online as soon as production activities are completed, which is typically months sooner than the article is available in print format.

• As this article went to press, AJOT was implementing a pay-per-article option so that people without a subscription can still access articles. Increased access to AJOT articles is intended to widen the scope of readership and facilitate increased citations.

• AJOT introduced an immediate open access option whereby authors may pay a fee to publish their articles in an open-access format. Most AJOT articles are available only to subscribers and AOTA members for the first 5 years after publication.

• AJOT published three special issues in 2015: one on occupational therapy and stroke, one on autism, and a special issue honoring the legacy of Jane Case-Smith. Two of these special issues were a collaboration between AJOT and AOTA’s Evidence-Based Practice Project (Lieberman & Scheer, 2002). In addition, AJOT published three online supplements. Supplement 1 contains the research abstracts from the 2015 AOTA Annual Conference & Expo, a new feature that is intended to further disseminate the research presented at the conference and help increase the research profile of the profession. Supplement 2 is the second edition of the special issue on occupational therapy education, and Supplement 3 is the annual AOTA official documents supplement.

AJOT’s goal is to remain the premier research journal for the occupational therapy profession and to increase the relevance of occupational therapy literature for other related professions and researchers. To maintain this status, AJOT is using several strategies.

First, despite AJOT continuing to be the top-ranked occupational therapy journal, its 2014 impact factor declined slightly from its 2013 level (Table 4). A journal’s impact factor is based on the number of research articles published that are cited in other indexed journals and is also dependent on the total number of research articles published in a volume. To achieve the goal of increasing AJOT’s impact factor to at least 2, we are taking the following approach:

• Continue to focus on high-quality studies that are more likely to be cited by other authors, including systematic reviews on topics relevant to occupational therapy

• Encourage submission of manuscripts describing research in new and underrepresented areas of practice in the literature, such as primary care and mental health

• Solicit manuscripts from studies with a low risk of bias (Level I evidence methodology) from researchers known to be conducting such studies

• Publish a greater number of articles. Because the number of articles that can be published in AJOT is limited by the costs of print publication, this will be accomplished by placing more articles online and requiring shorter articles.

Another way of raising AJOT’s profile is by asking AJOT authors to refrain from emphasizing the occupational therapy profession and its role in their manuscripts. In doing so, the articles, and occupational therapy, are more likely to be of interest to researchers and practitioners in other professions. The fact of being published in an occupational therapy journal advertises the relevance of an article’s topic to occupational therapy, so authors should focus on the topic’s relevance to occupational engagement. For example, a manuscript about the efficacy of sleep hygiene for obtaining quality sleep should talk only about sleep hygiene and not why occupational therapy practitioners should be involved in teaching sleep hygiene habits.

Two exceptions to this general rule are made. The first is that the section “Implications for Occupational Therapy Practice” will continue to appear at the end of each research article. This section allows authors to specifically link the topic of the manuscript to the occupational therapy profession. The second exception occurs for manuscripts whose topic is the profession of occupational therapy itself, describing the behavior, knowledge, or skills of occupational therapy practitioners or occupational therapy pedagogy. AJOT reviewers are being educated about this mandate so that they do not ask authors to tie the article directly to the occupational therapy profession in the body of the manuscript.

Other steps rounding out the effort to raise AJOT’s profile include encouraging researchers in other disciplines of relevance to occupational therapy to submit to AJOT. In addition, AJOT will continue to publish special issues on critical topics in occupational therapy and in collaboration with AOTA’s Evidence-Based Practice Project.

An important opportunity for the journal is the occupational therapy profession’s centennial in 2017. AJOT needs to reflect this important occasion for the profession; therefore, the AJOT Editorial Board will be planning AJOT’s contributions to the celebration. Members of the profession and others with interesting ideas are welcome to submit their ideas to AJOT’s editor-in-chief at [email protected].

Changes to the AJOT Editorial Board in the past year included Susan Murphy, MJ Mulcahey, and Ashwini Rao stepping down as Associate Editors and the addition of Stephen Page, Lisa Daunhauer, and Tracey Jirikowic in those roles. AOTA staff and I extend our thanks to all the associate editors for the hours of dedicated service they have devoted to AJOT. We also thank the reviewers who have taken the time to provide their valuable feedback to authors submitting manuscripts to AJOT.