Importance: Care partners report that they are unprepared to manage the care of their loved one during the predischarge rehabilitation process and at the time of transition from hospital to home. Objective: To link, classify, and describe care partner–reported problems using the International Classification of Functioning, Disability and Health (ICF) to explore care partner experiences during the predischarge rehabilitation process. Design: We linked meaningful concepts collected during problem-solving training implemented with care partners of patients with sudden-onset conditions to the ICF using a standardized linking technique. Setting: Health care institution. Results: Care partner–reported problems were linked to 13 of the 30 ICF chapters. Activities and participation was most frequently addressed, followed by body functions. Care partners most commonly reported problems in the areas of emotional function, major life areas, self-care, domestic life, interpersonal relationships, and sleep functions. Conclusions and Relevance: The ICF can be used to examine and describe care partners’ health-related experiences. Care partners experience myriad problems related to activities and participation, body functions, environmental factors, and personal health before the care recipient’s initial discharge from the hospital. What this Article Adds : Care partners’ problems early in the rehabilitation process are complex and interrelated. The ICF can serve as a framework for a systematic approach to identifying care partner needs, as it has for patients with a variety of diagnoses.

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. We developed a mobile app to facilitate self-management behaviour among individuals with spinal cord injury (SCI) to help them improve their management of secondary conditions. The purpose of this study was to explore user expectations of the mobile app intervention to inform its adoption. This presentation will inform practitioners about a technology-based approach to promoting self-care and the unique mobile self-management app expectations and needs of people living with SCI. Primary Author and Speaker: W. Ben Mortenson Contributing Authors: Gurkaran Singh, Ethan Simpson, Megan McGillivray, Jared Adams, and Bonita Sawatzky

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Lymphedema affects 65% of women with breast cancer. Self-management programs (SMPs) are used to manage lymphedema. The study explored the effect of the Remotivation Process on the motivation of 12 women to perform a SMP every day. It was provided through a telehealth platform. Analysis showed significant changes in motivation and outcome measures. This study found that the Remotivation Process is a potentially useful OT intervention to address the motivational needs of women with lymphedema. Primary Author and Speaker: Kaye Rubio Contributing Authors: Patricia Bowyer, Sherry Hite, Vidya Pingale, Wyona Freysteinson, Gayle Hersch, and Christine Raber

Date Presented 04/13/21 The Pediatric Evaluation of Disability Inventory–Computer Adaptive Test-ASD (PEDI): Responsibility Scale targets limitations in managing daily life tasks. Adolescents (ages 14–22) with autism spectrum disorder without intellectual disability (N = 125) performed below expectations based on their intellectual level on the PEDI. Eighty-six percent of youth demonstrated borderline or significant delays in management of life tasks. If unaddressed, this challenge may create significant barriers to success in work and independent living. Primary Author and Speaker: Elizabeth Munsell Additional Authors and Speakers: Joshua Wenig, Hannah Cooper Contributing Authors: Alexandra Gunther, Julie Russell, Jordan McNamee, and Samantha Martel

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The audience will learn about a researcher–stakeholder collaboration to create a mobile health (mHealth) self-management intervention for individuals with stroke. This paper will demonstrate a systematic process to apply adaptation and implementation frameworks to generate a feasible, appropriate, and acceptable mHealth self-management intervention. Primary Author and Speaker: Ryan J. Walsh Additional Authors and Speakers: Olivia Depaul Contributing Authors: Carolyn Baum, Ginger E. Nicol, Katie Keenoy, Michelle Klein, and Alex Wong

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The purpose of this study was to evaluate the current literature that exists for telehealth interventions for chronic disease self-management within the scope of OT. This scoping review will benefit the OT profession by furthering the body of evidence on telehealth self-management interventions while also promoting the continuation of research on telehealth to complement developing technologies and practices. Primary Author and Speaker: Elizabeth B. Albritton Additional Authors and Speakers: Josephine Fish, Jeffrey Henkel, Shelby Lee, Rachel Luttrell, and Rachel Rackleff Contributing Authors: Pamalyn Kearney, Teal Benevides

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Chronic pain is a debilitating condition that disrupts engagement in meaningful occupations. Self-efficacy may be a protective factor in reducing pain-related disability and promoting effective chronic pain management. After participating in the 8-week Merging Yoga and Self-Management Skills program, dyads with chronic pain reported increased self-efficacy of varying degrees. Significant improvement in self-efficacy related to physical function was reported. Primary Author and Speaker: Charla Kinkel Contributing Authors: Arlene Schmid, Christine A. Fruhauf, Karen Atler, and Haylee A. Candray

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. We completed a pilot study of an 8-week Merging Yoga and Occupational Therapy for Parkinson's Disease program (MY-OT for PD). MY-OT for PD was a fall-risk self-management program that merged community-based yoga and group OT. Participants served as their own controls during the pilot study. During the intervention period (as compared with the control period), participants experienced reduced self-reported falls, improved fall management and prevention, and improved balance. Primary Author and Speaker: Laura A. Swink Contributing Authors: Brett Fling, Julia L. Sharp, Christine A. Fruhauf, Karen Atler, and Arlene Schmid

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Celiac disease is a chronic condition, treated by a strict lifelong gluten-free diet. Children and adolescents with celiac disease face ongoing challenges of making daily dietary choices. As children grow, they need to become more involved in the decision-making process and take on self-management responsibilities. OTs have an important role in promoting self-management of celiac disease and the decision-making process during the transition years from adolescence to young adulthood. Primary Author and Speaker: Sonya Meyer Contributing Authors: Elena Lionetti, Carlo Catassi

Prolonged symptoms from the novel coronavirus disease 2019 (COVID-19), otherwise known as long COVID, postacute sequelae of COVID-19 (PASC), or post-COVID syndrome, are affecting an increasingly high number of patients after severe, moderate, and mild acute COVID-19 infections. Using evidence-based practice strategies, this case report describes occupational therapy evaluation and treatment approaches, plan of care, and associated outcomes for one client experiencing long COVID symptoms in the outpatient setting.

Importance: Chronic conditions often cause functional impairments in activities of daily living (ADLs) and rest and sleep, leading to decreased independence and self-efficacy. Objective: To aid occupational therapy practitioners in making informed decisions regarding self-management interventions to improve ADLs and rest and sleep for community-dwelling adults with chronic conditions. Data Sources: We identified literature published from 1995 to 2019 through searches of the Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, and OTseeker. Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to abstract and assess data quality and validity. The review followed American Occupational Therapy Association Evidence-Based Practice Project methodology. Studies addressing self-management interventions for community-dwelling adults ages 18 and older with chronic cardiovascular disease, Type 2 diabetes, heart disease, hypertension, chronic respiratory problems, or kidney disease were included. Findings: Fifteen articles met inclusion criteria and were categorized into ADLs and sleep. Strong evidence supports education to improve diabetic foot self-care. Low evidence addresses exercise and education to improve ADLs for people with heart disease and chronic obstructive pulmonary disease. Moderate evidence supports mind–body self-care education to enhance sleep. Conclusions and Relevance: Occupational therapy practitioners working with adults with diabetes are encouraged to routinely offer education that includes discussion of risk factors and daily foot inspections and hygiene. When addressing sleep, education that addresses sleep hygiene, nutrition, relaxation techniques, and physical activity should routinely be provided to adults with chronic conditions. Further research is needed to understand the dosage needed. What This Article Adds: This systematic review supports the role of occupational therapy in providing self-management interventions to address ADLs and sleep for adults with diabetes and other chronic conditions.

Importance: Self-management programs (facilitated by mobile devices) may improve health and prevent secondary complications for older adults with diabetes. However, older adults may have difficulties using mobile devices because of neuropathy or cognitive dysfunction. Objective: To identify sensorimotor and cognitive abilities associated with touchscreen tablet app performance to support self-management of diabetes in older adults. Design: Cross-sectional study. Setting: Outpatient Center for Successful Aging With Diabetes. Participants: Forty-five older adults with Type 2 diabetes. Outcomes and Measures: Dexterity (Purdue Pegboard Test), touch sensation (Semmes–Weinstein monofilaments), pinch strength (pinch gauge), cognition (Montreal Cognitive Assessment), and executive functioning (Trail Making Test) were assessed. Two apps were then used: Dexteria and SuCare. Demographic data, prior mobile device use, and diabetes severity (hemoglobin A1C [HbA1C]) were collected. Results: Age and HbA1C accounted for 29.8% and 9.7%, respectively, of the total variance of Dexteria performance time (dominant hand). Dexterity (dominant hand) accounted for an additional 5.4% of the total variance of 45.1%, F(4, 40) = 10.021, p < .001. Prior mobile device use, age, and diabetes severity accounted for 6.4%, 11.8%, and 26.4%, respectively, of the total variance of SuCare performance time. Executive functioning and dominant-hand dexterity accounted for an additional 9.5% and 9.4%, respectively, of the total variance of 61.0%, F(5, 39) = 14.75, p < .001. Conclusions and Relevance: Beyond age and diabetes severity, executive functioning and dominant-hand dexterity contributed to app performance, highlighting the importance of diabetes self-management. These findings may help determine suitable candidates for tablet use for self-management. What This Article Adds: App performance is explained by the executive functioning and dexterity of older adults with Type 2 diabetes. These factors, in addition to age and diabetes severity, should be taken into consideration by occupational therapy practitioners in future mobile self-management programs.

Importance: This study lays the groundwork for a self-management program run by occupational therapy practitioners for parents with spinal cord injury or disease (SCI/D). Objective: To develop and implement the Parenting Self-Management Program with people with SCI/D and evaluate the potential impact on knowledge, self-efficacy, and participation. Design: A mixed-methods approach was used to develop (Phase 1) and implement and evaluate (Phase 2) a pilot group intervention for parents with SCI/D. Setting: Community-based occupational therapy settings. Participants: Phase 1 participants were professionals working in the field of disability and SCI/D (n = 11) and experienced parents with SCI/D (n = 9). Phase 2 participants were people with SCI/D who were newly injured or inexperienced in parenting (n = 10). All participants were paid volunteers. Intervention: The 4-wk Parenting Self-Management Program was piloted with 10 parents with SCI/D. Participants attended a weekly program with other parents with SCI/D led by occupational therapists in which they received parenting resources and presentations and set weekly goals. Outcomes and Measures: The General Self-Efficacy Scale, a modified version of the Participation Survey/Mobility, and open-ended questions regarding parents’ participation in parenting tasks were administered during Phase 2. Results: Significant increases (p < .05) in perceived knowledge were found for the topics of emergency preparedness, home modifications, adapted equipment, fatigue management, pain management, and community resources among Phase 2 participants. Conclusions and Relevance: A self-management approach combined with pertinent resources for parents with SCI/D yielded positive outcomes. What This Article Adds: This research demonstrates that a self-management structure for a specific population (people with SCI/D) in combination with a targeted occupation (parenting) and delivered through group occupational therapy services, improved client outcomes.

Importance: The prevalence of low vision increases with age. Low vision has detrimental effects on older adults’ independence. Objective: To identify the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in daily activities for older adults with low vision. Data Sources: Literature published between 2010 and 2017 was searched in CINAHL, Cochrane Databases, MEDLINE, OTseeker, and PsycINFO. Study Selection and Data Collection: The authors screened and appraised studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Studies were eligible if the participants’ mean age was 55 yr or older, the level of evidence was Level III or higher, the intervention was within the scope of occupational therapy practice, and the outcome measures assessed the performance of daily activities. Findings: Fourteen studies met the review criteria. Three intervention themes were identified: low vision rehabilitation services (n = 6), self-management approach (n = 6), and tango (n = 2). Moderate evidence was found for low vision rehabilitation services. Low evidence was found for using the self-management approach or adding the self-management approach to existing low vision rehabilitation services. Low evidence was found for tango. Conclusion and Relevance: This systematic review supports the use of low vision rehabilitation services as an effective approach. Occupational therapy practitioners are encouraged to be part of multidisciplinary teams that offer comprehensive low vision evaluations and multicomponent services. What This Article Adds: Low vision rehabilitation that offers multidisciplinary services, including occupational therapy, is effective in promoting independence among older adults with low vision.

Postconcussion syndrome (PCS) affects physical, cognitive, and emotional functioning. Existing reviews of interventions to address PCS are limited to psychological and rehabilitation interventions and to child and adolescent populations. We conducted a systematic review integrating current evidence about interventions for adults with PCS. The inclusion criteria were intervention studies of adults (ages ≥18 yr) with PCS that evaluated recovery from PCS symptoms and focused on functional outcomes; 10 studies met the criteria. Included studies demonstrated medium to high levels of evidence and investigated psychotherapy, counseling, social support, self-management strategies, individualized rehabilitation, hyperbaric oxygen interventions, and group-based cognitive–behavioral therapy. Outcomes included reduced postconcussion symptoms, improved cognitive function, enhanced quality of life, and increased community integration. The evidence supports psychotherapy, counseling, and social support interventions as being beneficial for cognitive and emotional functions in adults with PCS.

OBJECTIVE. We examined the effectiveness of interventions within the scope of occupational therapy to improve the performance of instrumental activities of daily living (IADLs) for community-dwelling older adults. METHOD. We searched and examined the literature (2008 through 2016) using four electronic databases. Fourteen studies met the inclusion criteria and were critically appraised and synthesized. RESULTS. Analysis revealed four thematic areas: cognitive, self-management, prevention, and home-based multidisciplinary rehabilitation interventions. Strong evidence supports the use of tailored, multidisciplinary, home-based care programs to support older adults to maintain IADL improvements over time and the use of cognitive interventions to improve memory, executive function, functional status, and everyday problem solving. In addition, strong evidence indicates that tailored home-based preventive sessions were beneficial to mediate functional disability and satisfaction with performance. CONCLUSION. Evidence supports tailored interventions designed to enhance IADL performance. More studies are needed that focus on IADLs specifically and that use IADLs in their interventions.

OBJECTIVE. This systematic review examined the effectiveness of health promotion, management, and maintenance interventions within the scope of occupational therapy to improve occupational performance and quality of life (QOL) and decrease health care utilization for community-dwelling older adults. METHOD. Thirty-eight articles representing 36 studies were included in the review. Articles were published 2008–2015 and described studies of participants with a mean age of 65 or older who were living in the community. RESULTS. Strong evidence supports the use of group, individual, or a combination of group and individual interventions to improve occupational performance. Group interventions were also effective at improving QOL. The evidence was insufficient that any of these interventions decreased health care utilization. CONCLUSION. Addressing health promotion, management, and maintenance is within the scope of occupational therapy practice and has been shown to improve occupational performance and QOL for older adults. Implications for practice and future research are discussed.

This systematic review examines the evidence for the effectiveness of interventions within the scope of occupational therapy that address leisure engagement and social participation among community-dwelling older adults. Eleven Level I, 1 Level II, 1 Level III, and 1 Level IV studies met inclusion criteria. Included articles addressed two themes: interventions supporting social participation and interventions supporting leisure engagement. Strong evidence supports leisure education interventions to enhance leisure engagement, and moderate evidence supports chronic disease self-management programs to support leisure engagement. Mixed evidence exists for community-based group interventions and electronic gaming to support social participation. Routine use of leisure education and chronic disease self-management programs to enhance leisure engagement and selective use of community-based groups and electronic gaming to support social participation are recommended.

As children and youth with diabetes grow up, they become increasingly responsible for controlling and monitoring their condition. We conducted a scoping review to explore the research literature on self-management interventions for children and youth with diabetes. Eleven studies met the inclusion criteria. Some of the studies reviewed combined the participant population so that children with Type 1 as well as children with Type 2 diabetes were included. The majority of the studies focused on children age 14 yr or older and provided self-management education, self-management support, or both. Parent involvement was a key component of the majority of the interventions, and the use of technology was evident in 3 studies. The findings highlight factors that occupational therapy practitioners should consider when working with pediatric diabetes teams to select self-management interventions.

OBJECTIVE. In this study, we investigated whether older adults with low vision (LV) from age-related macular degeneration (AMD) demonstrated lower functional health literacy than older adults without LV. METHOD. Fifty adults with AMD were matched with adults without LV on age, gender, education, and income. We measured visual acuity, contrast sensitivity, and reading speed and administered the Test of Functional Health Literacy in Adults (TOFHLA) using two test time conditions, standard and unlimited, to measure health literacy levels. RESULTS. The group with LV had considerably lower TOFHLA scores for both time conditions (p < .001) and took notably longer to complete the test (p < .001). Poorer acuity correlated with lower TOFHLA scores in the group with LV. CONCLUSION. Older adults with LV may take longer to read and understand health information, which has important implications for providing health education to support self-management. Modifying components of the reading task may facilitate reading performance and understanding of health education materials.