State of the Journal, 2021

It has been just over 1 year since I wrote my first State of the Journal report. In July 2020, I stepped into a new role as the Editor-in-Chief of the American Journal of Occupational Therapy (AJOT) in the midst of a worldwide health crisis as well as a period of national social and political turmoil. Over the next few months, we saw occupational therapy practitioners work with masses of critically ill patients; advocate across multiple contexts; and fear for the safety of their patients, their students, their families, and themselves. In early 2021, many in the profession began to have hope as a vaccine became available for the prevention of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hope also came in the form of greater discourse around racial issues in the United States, changes to support persons of color at multiple levels, and election to office of the country’s first female vice president (as well as the first African-American and first Asian-American vice president).

Now, as we enter the final season of 2021, our brief respite from fear and uncertainty appears to be over. Around the world, genetic variants of SARS-CoV-2 have emerged, causing severe illness in those who are unvaccinated and even breakthrough infections in those who are vaccinated. In the United States, safety has also become politicized, and disinformation campaigns have led to underprotection among nearly half of the population. Moreover, COVID-19 continues to highlight social and racial injustice and health inequity, with many racial and ethnic minority groups being disproportionately affected by the virus (Centers for Disease Control and Prevention, 2021).

As the flagship journal of the occupational therapy profession, AJOT exists to help fulfill the mission of the American Occupational Therapy Association (AOTA), which is to advance occupational therapy practice, education, and research. To fulfill this mission, AOTA strives to help occupational therapy professionals understand the events that shape the lives of practitioners and clients and publishes peer-reviewed research so that practitioners can make informed, evidence-based decisions. To that end, in July 2021, AJOT published a supplemental issue on COVID-19 featuring cases from multiple practice settings and clients from across the lifespan. The journal has also published or accepted independent research articles related to COVID-19 treatment, telehealth, and other practice issues that have arisen because of SARS-CoV-2.

AJOT has also been committed to serving as a platform for professional issues related to diversity, equity, inclusion, and justice. This issue features one such article, titled “Be Heard—We’re Listening: Emerging Issues and Potential Solutions From the Voices of BIPOC Occupational Therapy Students, Practitioners, and Educators” (Salvant et al., 2021). Other recent publications include The Issue Is column “Increasing Racial and Ethnic Diversity Within Occupational Therapy Education” (Brown et al., 2021) and the research article “Supporting Occupational Justice of Transgender and Gender Nonconforming People by Wasmuth et al., (2021).

This State of the Journal report is an opportunity to look back at what AJOT has done well over the past year and the challenges we have faced. It is also an opportunity to look ahead to how we can continue to serve the profession and expand our impact.

In 2021, AJOT accomplished many of the goals it set for the calendar year. We recruited 40 new, research-trained official reviewers from diverse professional, ethnic, and racial backgrounds who have been providing quality peer reviews for the journal. We also implemented an open and transparent process for recruiting new associate editors to the journal and welcomed three new AJOT editorial board members in March: Lenin Grajo, Khalilah R. Johnson, and Matthew Malcolm. The addition of new reviewers and the expansion of our board have helped expedite our review process and reduce the time from submission to acceptance by about 3 weeks.

As we enhance the speed of the review process, we are also continuing to raise the standards of research published in AJOT. In February 2021, we implemented new author guidelines that require the submission of a Consolidated Standards of Reporting Trials (CONSORT) checklist with all clinical trial manuscripts (Schulz et al., 2010) and a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist with all systematic and scoping review articles (Page et al., 2021). Authors are now also required to complete a presubmission checklist (available at https://research.aota.org/ajot/pages/authorguidelines) to ensure they have met all formatting guidelines before the manuscript is considered, reducing the administrative burden on editorial staff and reviewers. The presubmission checklist also requires authors of research with a person or sample of people from minoritized or historically marginalized communities to attest that they have referenced these individuals with culturally sensitive, appropriate language and to include a positionality statement that acknowledges potential author biases that might influence the equitable presentation of data related to social, ethnic, or cultural variables. These practices are in line with those of other top journals in the country and were developed by the AJOT Diversity, Equity, and Inclusion Committee.

During 2021, the AJOT production team and guest editors have been busy working on a special issue on health services research, which will be published in the January/February 2022 issue (Volume 76, Issue 1). This special issue is the first for our profession and will serve to guide policy decisions, improve patient safety, and help professionals understand how to deliver optimal care to clients. We are also proud of the two special issues published in 2021, which focused on neurodiverse populations (Volume 75, Issue 3) and disability studies (Volume 75, Issue 4). Special issues require significant coordination, and we are appreciative of the guest editors and reviewers who have devoted their time and energies to these endeavors.

This year we worked to translate research findings into practice through dissemination of systematic reviews, Evidence Connection articles, and conference abstracts. We are also working with AOTA to promote AJOT articles through the Association’s social media platforms, journal clubs, and podcasts.

We are thrilled that the new AJOT website launched this fall! The new website (at https://research.aota.org/ajot) makes current occupational therapy research easy to find and includes new features such as AJOT special collections, reviewer resources, and conference abstracts. Users can also sign up to receive alerts when new issues are available or when an article is published in their areas of interest.

As we move forward as a journal, we will continue to set goals for raising research standards in the profession and meeting the needs of AJOT authors, readers, and reviewers. Our success as a journal can be viewed in many ways, including our ability to meet our goals and our ranking against other journals in the world. The next section looks at how AJOT stacks up against other rehabilitation journals using standardized journal metrics.

The journal impact factor (JIF) is a metric used across multiple countries and disciplines to rank a journal’s prestige. The numerical JIF score is based on the number of times AJOT articles were cited within the latest 2-yr or 5-yr period. AJOT’s 2-yr impact factor increased from 2.231 in 2019 to 2.246 in 2020 (Journal Citation Reports, 2021). Similarly, our 5-yr impact factor increased from 3.220 to 3.776 (Table 1). With 6,437 citations in 2020, AJOT is ranked No. 1 among occupational therapy journals in North America and No. 2 among occupational therapy journals worldwide (Journal Citation Reports, 2021). Of the most cited AJOT articles, six were systematic reviews and two were scoping reviews.

CiteScore is a journal evaluation metric based on citations recorded in the Scopus database. CiteScore 2020 is the number of citations in 2017–2020 for articles published in 2017–2020, divided by the number of articles published in 2017–2020 (Scopus, 2021). This year, AJOT’s CiteScore increased from 2.5 to 2.6, placing our journal in the 88th percentile of occupational journals, maintaining its rank of 3rd of 21 journals. Interestingly, the top two ranked journals, Journal of Occupational Rehabilitation (CiteScore = 4.4) and Physical and Occupational Therapy in Pediatrics (CiteScore= 2.9), are not specific to occupational therapy practice.

Analysis of website usage allows us to gauge how stakeholders are accessing AJOT articles and interacting with our online platform. According to Google Analytics, the number of visits to the AJOT website increased from 689,538 in 2019 to 891,700 in 2020, a 29.32% increase. As of July 31, 2021, we were on track to surpass our total number of both users and visits for 2021.

Between January 1, 2021, and September 1, 2021, AJOT received 280 submissions, on par with the number of submissions during the same time frame in 2020 (N = 274; submission and acceptance rates for 2016 to 2021 are presented in Table 2). Like our overall readership, AJOT authors originate from around the world. In 2021, 57.0% of AJOT manuscript submissions had corresponding authors based in the United States, and 43.0% had international authors representing 22 other countries. AJOT receives the most international submissions from the Republic of Korea (4.9%), Australia (4.9%), Japan (3.7%), and Israel (3.3%). Although generally commensurate with submission statistics, U.S. authors do have a slightly higher acceptance rate (65.3% of accepted papers) compared with international authors (34.7% of accepted papers).

Volume 75 of AJOT was published in calendar year 2021 and included six regular issues and three supplements, one of which was devoted to the topic of COVID-19. The regular issues contained 91 research articles and 14 nonresearch articles (e.g., editorials, The Issue Is columns). Of the 91 research articles, just under one-quarter (22.0%) were systematic or scoping reviews. The proportion of qualitative research studies published increased by 15.5% over 2020; many were published in the AJOT special issue on neurodiverse populations (Issue 3) and the special issue on disability studies (Issue 4). Since 2018, AJOT has seen a reduction in the number of effectiveness studies published. Trends in research types over the past 5 years can be seen in Table 3.

In 2021, 32 articles described either effectiveness studies or systematic reviews of effectiveness studies, compared with 39 articles in 2020. Of these 32 articles, 59.4% provide Level 1 evidence, the highest percentage in recent years. The proportion of Level 2 studies increased by 13% over the previous year. These increases suggest that although fewer effectiveness studies were published, those that made it through the review process are of higher quality than in recent years.

These trends in quality may be related to increased research funding from the National Institutes of Health (NIH) and other U.S. foundations and associations (Table 4). In 2021, 12 AJOT articles reported funding from NIH, compared with only 8 in 2020. Similarly, the number of foundation grants doubled to 8 in 2021. As occupational therapy researchers continue to increase their competitiveness for external research awards, we expect to see a greater number of clinical research articles submitted to and published in the journal.

The success of AJOT is highly dependent on the work of our volunteer board (associate editors) and official reviewers. By September 1, our team had solicited 660 reviews, and 430 review requests were accepted (65.2% acceptance rate). Although the rate of declined review requests remained relatively steady at 34.8%, the editorial team met its overarching goal to reduce the time from manuscript submission to acceptance by approximately 3 weeks. In total, authors submitting their papers to AJOT can expect to have a first decision in less than 8 wk; papers 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 rereviews; see Table 5).

AJOT began publication in 1947, and with the completion of Volume 75 at the end of 2021, we mark 75 years of publication. This is an exciting time for the journal. Our new website allows us to provide more features, more resources, and more interaction with our readers, so our focus for 2022 is reader engagement. Over the next year, we will study how users interact with the site and solicit feedback on what can be improved. We are looking forward to all of the ways we can continue to serve our users in the virtual format.

We are also in the process of transitioning to a new manuscript submission management system on the ScholarOne platform, a reliable tool with which many of our authors are familiar. Although change is always hard, my hope is that this new system will make the submission and peer review processes easier and faster for authors, editors, and reviewers. The new manuscript submission system should be online by the time this article is published.

We are also excited to launch an online discussion series, AJOT: Authors & Issues. On the release of each new issue, the AJOT editorial board will select one or two articles to feature and take a deep dive into the content through a discussion with the authors and invited guests. Discussion recordings will then be posted to AOTA’s CommunOT online discussion board for AOTA members’ viewing and response. Authors and AJOT editors will moderate the online discussion and answer questions for 1 week. This series is an important step toward meeting our goal of engaging readers and creating more scholarly discussion around research and professional issues in occupational therapy.

Meeting our goals for engagement in 2022 will also include exploring ways to get occupational therapy students more involved with the journal and continuing to expand our pool of qualified reviewers and associate editors. Opportunities to engage with the journal will be promoted on the AJOT website and shared through AOTA social media platforms.

In 2022, AJOT will stay committed to its key mission to publish peer-reviewed research so that occupational therapy professionals can make informed, evidence-based decisions about best practice. We will continue to prioritize articles that help occupational therapy practitioners decide which interventions to use, what therapeutic dosing will bring the best results, how to use intervention approaches in ways that are inclusive and unbiased, and how to choose assessment tools that are reliable and valid and that reflect changes in occupational performance outcomes.

In summary, our editorial board has outlined the following specific goals for the 2022 volume year:

• Promote the new AJOT website and its features.

• Successfully transition to a new manuscript submission management system.

• Launch our new AJOT: Authors & Issues series.

• Publish a special issue on health services research and prepare a new special issue on mental health in autism.

• Continue to increase our pool of qualified official reviewers, including those from diverse backgrounds.

• Increase student engagement with AJOT.

AJOT continues to be the top-ranked occupational therapy journal in North America and has seen its impact factor rise for the second year in a row, with the highest 5-yr impact factor in the journal’s history. As turmoil associated with COVID-19, climate crises, and racial inequities continues to plague the world, AJOT will remain committed to publishing rigorous, peer-reviewed research so that occupational therapy professionals can make informed, evidence-based decisions about best practices across a variety of contexts.