State of the Journal, 2016

This year, the American Journal of Occupational Therapy (AJOT) experienced an important increase in prestige: For 2015, the journal obtained a 5-year impact factor of 2.113 and a 2-year impact factor of 1.806, the highest ever! AJOT remains the most highly ranked occupational therapy journal according to the 2016 Journal Citation Reports (JCR), moving up in rank from 22nd to 10th of 71 journals indexed in the Social Science Division’s Rehabilitation subsection on the basis of the 2-year impact factor.

The Editorial Board saw some changes this year. Marjorie Scaffa joined the board as associate editor for education manuscripts, replacing Janice Burke, and Mariana d’Amico and Barbara Doucet completed their terms in June. We are extremely appreciative of everyone's efforts on the Editorial Board, and we are happy to announce that Dr. d'Amico and Dr. Doucet will continue with AJOT as reviewers. We welcomed Karen Jacobs and Linda Shriber to the board as associate editors in July.

Table 1 shows manuscript statistics for 2016 compared with the previous 5 years. As of September 2016, 255 manuscripts had been submitted to the journal this calendar year, 76 of which (29.8%) were accepted for publication in either 2016 or 2017 issues. International manuscript submissions have increased: Manuscripts have been received from 30 countries other than the United States, compared with 23 non-U.S. countries in 2015.

Readership of AJOT has also increased; for example, for the month of August 2016, AJOT articles were viewed online 13,983 times, with 9,795 pdf downloads, for a total of 23,778 views; in comparison, in August 2015, articles were viewed 8,841 with 6,957 pdf downloads, for a total of 15,798 views. Between January and August 2016 (this writing), AJOT articles were viewed online 151,881 times, with 110,239 pdf downloads. Most users of the AJOT website are from the United States, the United Kingdom, and Canada, although many other countries are represented. Readership of AJOT has also seen international growth, demonstrating that AJOT is truly a global publication.

Because AJOT’s mission is to be a primary source for dissemination of evidence to support occupational therapy practice, the journal continues to publish primarily research articles. The types of research articles published to date compared with 2015 are provided in Table 2. As in 2015, articles are categorized as follows:

• Effectiveness studies: Research ranging from N-of-1 studies to randomized clinical trials that examined the effect, efficacy, or effectiveness of a therapy intervention or educational pedagogy

• Instrument development and testing studies: Research involving assessment or therapy tool development

• Basic studies: Research that establishes relationships between conditions and occupational limitations, reports the prevalence or incidence of conditions or client factors within a condition, identifies predictors of outcomes, outlines the development of taxonomies, describes the testing and building of theories, explicates occupational science, or describes results of work with animals

• Efficiency: Studies that examine the cost–benefit ratio of occupational or interdisciplinary health care programs/interventions

• Professional issues studies: Research dealing with occupational therapy practitioners’ knowledge or skills or that investigates practices in therapy provision

• Health services studies: Research describing health care practice or utilization of occupational therapy services or that discusses health care utilization disparities

• Systematic reviews: Research including scoping reviews and reviews of intervention effectiveness and basic research.

Consistent with AJOT’s mission, the largest number of studies published measure effectiveness and provide basic knowledge that justifies occupational therapy intervention. This ongoing trend is encouraging because the profession is in critical need of evidence to support the mandate for occupational therapy and the efficacy and effectiveness of occupational therapy interventions for its stakeholders (i.e., clients and families, insurers, legislators, other health professionals). This year saw a slight increase in the number of published effectiveness studies providing Level I and II evidence, suggesting that researchers are conducting more occupational therapy–related research that provides stronger evidence for practice. However, more than half of the intervention effectiveness studies published in AJOT were at lower levels of evidence, and the risk of bias in these studies is relatively high. Nine of the 13 Level I studies were systematic reviews rather than new trials of interventions. The need for high-level occupational therapy intervention research remains considerable, and that research needs to be published in occupational therapy journals. The rising impact factor is encouraging, however, because it reflects the rising prestige of the journal and may entice more researchers to publish high-level research in AJOT.

The most common topic categories of published articles continue to be (1) Rehabilitation, Disability, and Participation and (2) Children and Youth; this pattern is not surprising given the large breadth of these categories. Other topic areas remain poorly represented, although several manuscripts could have been dually categorized. For example, “Simulator Measures and Identification of Older Drivers With Mild Cognitive Impairment” (Vardaki, Dickerson, Beratis, Yannis, & Papageorgiou, 2016) was classified as Productive Aging but could also have been classified as Rehabilitation, Disability, and Participation, whereas “Activities of Daily Living in Survivors of Childhood Brain Tumor” (Demers, Gélinas, & Carret, 2016) was classified under the Children and Youth grouping but could also have been categorized in Health, Wellness, Occupation, and Participation. To reduce publication costs and to better serve educators, the annual education supplement has been discontinued and instead, the journal will seek to publish one or two education manuscripts in each issue, depending on the timing and quality of submitted manuscripts.

Of research articles published through September 2016, 52.8% were supported by specific funding mechanisms (Table 3). 2016 saw a small increase in funding from the major U.S. federal funding agencies, such as the National Institutes of Health (NIH), the Department of Veterans Affairs, and the Centers for Disease Control and Prevention. The number of internationally funded manuscripts increased. However, about half of the published studies represented unfunded research, suggesting that occupational therapy still has significant potential to expand research funding. The continuing emphasis on the importance of occupational participation, healthy life habits for managing chronic conditions, and life satisfaction as major health outcomes should drive funders to place more value on developing effective intervention strategies to obtain these outcomes, leading to greater funding for occupational therapy researchers.

Several accomplishments were achieved this year:

• AJOT welcomed 43 new reviewers. Currently, reviewers come from around the world, including Canada, the United Kingdom, Australia, Hong Kong, Taiwan, and India. The Editorial Board continues to recognize that reviewers are very busy and to keep requests for reviews manageable.

• The AJOT Editorial Board held a workshop in collaboration with the editorial board of OTJR: Occupation, Participation and Health at the AOTA Annual Conference & Expo in April to provide potential authors with information about the publishing process and offer tips for higher quality writing to foster the submission of manuscripts that are more publication ready. The two editorial boards have submitted an abstract for a similar workshop at the AOTA 2017 conference.

• AJOT is part of a multidisciplinary rehabilitation journal group, and as of January 1, 2016, all clinical trials published in AJOT and the other journals must be prospectively registered with Clinicaltrials.gov (or a similar site for international trials not registering with Clinicaltrials.gov) before manuscripts are considered for publication. These journals use NIH’s (2004) definition of clinical trial: “a research study in which one or more human subjects are prospectively assigned to one or more interventions (which may include placebo or other control) to evaluate the effects of those interventions on health-related biomedical or behavioral outcomes.” AJOT authors are encouraged to visit the NIH (2004) website for specific examples to ascertain whether their research study needs to be registered. Researchers who were already recruiting or had finished recruitment or data collection before the January 1 deadline were required to retrospectively register their trials before their manuscripts were considered for publication. Registering a trial on such sites reduces risk of bias and promotes higher quality evidence, hastening an increase in the quality of rehabilitation and related research.

• AJOT continues to award the annual Cordelia Myers AJOT Best Article Award for a high-impact article that describes high-quality research, is timely and highly relevant, and addresses an urgent need for information in the field (at least one author must be an occupational therapist). The article is chosen in a two-step process: A committee first selects one or two articles from each issue that meet these criteria, and a second committee makes the final selection from among these articles. The Best Article Award for 2015 went to Anne V. Kirby, Lauren M. Little, Beth Schultz, and Grace T. Baranek (2015) for “Observational Characterization of Sensory Interests, Repetitions, and Seeking Behaviors.” AJOT will continue to bestow the Cordelia Myers AJOT Best Article Award in the fall of each year.

• AJOT published two special issues in 2016, one on occupational therapy for adults with traumatic brain injury, the result of a collaboration between AJOT and AOTA’s Evidence-Based Practice Project (Lieberman & Scheer, 2002), and the other on pediatric obesity.

• In 2015, AJOT began publication of the research abstracts from the AOTA Annual Conference & Expo in an online supplement, and continued to do so in 2016.

• The AJOT Editorial Board has planned a special section for each issue of the 2017 volume to celebrate AOTA’s Centennial and has disseminated calls for manuscripts. Each Centennial section will have at least two manuscripts dealing with different topics in occupational therapy. In the first issue, the Centennial section will focus on the history of occupational therapy and considerations for the future. Other issues will focus on topics in which occupational therapy has not traditionally been very involved or, after experiencing reduced involvement, is now seeing a need for increased emphasis. These topic areas are cancer treatment; youth-to-adult transitions; health, well-being, and quality of life; and mental health. In the last issue, the Centennial section will focus on occupational therapy internationally.

AJOT’s goals are to remain the premier research journal for the occupational therapy profession and to increase the relevance of occupational therapy literature to related professions and researchers. To reach these goals, AJOT is using the following strategies:

• The Editorial Board will continue to implement policies and make acceptance decisions on the basis of the probability of increasing the journal’s impact factor, while continuing to attempt to represent the breadth of occupational therapy research. Although the increase in 2015 is a step in the right direction, a 2-year impact factor of 2.00 or greater will put AJOT on par with the top journals of the American Speech-Language-Hearing Association and the American Physical Therapy Association (Table 4). Strategies include the following steps:

• ○ Publish systematic reviews, guided by PRISMA standards, on topics relevant to occupational therapy.

• ○ Encourage submission of manuscripts describing studies with low risk of bias (i.e., Level I evidence methodology).

• ○ To make the articles of more interest to other professions, ask AJOT authors to focus their introduction and discussion on the topic of their article rather than on the occupational therapy profession or the reasons occupational therapy needs to be involved in the topic. The relevance of a study to occupational therapy is reflected in its publication in AJOT, and its methodology can include that the intervention was provided in whole or in part by an occupational therapist. Authors should continue to tie the topic’s relevance to occupational engagement and related topics, such as occupational performance, roles, habits, and values, and AJOT continues to require an “Implications for Occupational Therapy Practice” section at the end of each research article.

• ○ Encourage authors to cite relevant AJOT articles published within the past 5 years in addition to relevant articles in other publications.

• AJOT encourages occupational therapy–related manuscript submissions by authors of other disciplines. These authors may need to work with the managing editor on an appropriate “Implications for Occupational Therapy Practice” section.

• Special issues on critical topics in occupational therapy and occupational science, in collaboration with AOTA’s Evidence-Based Practice Project (Lieberman & Scheer, 2002) and as suggested by AJOT authors, have been very popular. Thus, AJOT will continue to plan these special issues. Special issues include articles describing original research as well as systematic reviews (of various kinds) of quantitative research and metasyntheses of qualitative research.

• In line with the increasingly global nature of the journal, the Editorial Board hopes to recruit additional international associate editors.

AJOT continues to be an important journal in occupational therapy around the world, and its prestige is growing. It receives a high number of submissions, and the quality of those submissions is increasing. Over the coming year, AJOT will maintain its goal of publishing quality research that speaks to the breadth and types of research related to occupational therapy.