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Background: Evidence indicates occupational therapy (OT) services can address the unmet needs of individuals experiencing homelessness (IEH) to promote health, engagement in meaningful activities, and independent living skills. Additionally, student-run free clinics (SRFCs) are an effective method for developing clinical skills while providing needed services for the community. Based on the available evidence, a student-run OT clinic was developed in partnership with a local homeless services agency. The objective of this pilot study was to evaluate the services established in an OT SRFC in a homeless population to determine the initial effectiveness of the clinic for students and clients. It was hypothesized that the SRFC would increase student perceived clinical skills and provide mutual benefit to clients. Methods: Participants of this SRFC included 17 OT students (n=10 doctoral students, n=7 masters students) and 70 IEH since its opening in Fall 2018. OT students developed and implemented evidenced-based group and individual interventions designed to address health, wellness, and quality of life for the homeless population. Student skills competency, confidence, and client satisfaction were regularly evaluated through survey. Mann-Whitney U tests were used to determine statistical differences. Results: Results indicate that clients are satisfied with clinic services, students’ engagement, and some positive changes in independent living skills. Students reported statistically significant improvement in competency of professional behaviors (p

During the coronavirus disease 2019 (COVID-19) pandemic, health care practitioners’ primary focus has been on its physical consequences. Yet, the emotional strain of the pandemic exposed the mental health needs of survivors and society as a result of forced changes in occupational choices, habits, and roles. These forced changes caused a collective confusion, fear, loss, and grief. This column focuses on occupational therapy’s critical contributions to supporting society’s mental health and wellness. Occupational therapy has a unique opportunity to provide interventions to address population-wide mental health and wellness, targeted prevention of mental health concerns for people at risk, and intensive intervention for people with COVID-19–induced mental health diagnoses.

Importance. Nonsanctioned occupations are those deemed socially unacceptable, unhealthy, or illegal, yet they hold meaning for individuals. A gap in occupational therapy evaluation and intervention to address a broader perspective on occupations prompted the adaptation of the Activity Card Sort tool to explore participation in nonsanctioned occupations. Methods. Develop a new version of the Activity Card Sort-Advancing Inclusive Participation to include occupations experienced by the homeless population, including nonsanctioned occupations. This study occurred in two phases: (1) tool development (item selection, content expert review, line development drawing, and assessment of content validity) and (2) tool use to determine face validity. Participants were selected through a convenience sample at a local homeless shelter and academic institution. Participants experiencing homelessness (phase 1: N=13, phase 2: N=10) were required to be seeking services at the homeless shelter, while nonhomeless participants (phase 2: N=30) worked full-time, resided with a significant other, and had personal transportation. Results. An assessment of 76 occupations, corresponding line drawings, and follow-up questions was created. An initial construct validity study demonstrated differences between occupational participation of those who are homeless and nonhomeless in the areas of social engagement, nonsanctioned occupations, work and education, and home management. Both groups reported previous, current, or desired engagement in the occupations identified in the assessment. Conclusions and relevance. The purpose of this study was to create an inclusive assessment for use in the homeless population and complete a construct validity study of the assessment tool. Although the results indicated some differences in the frequency with which occupations were performed, the results demonstrated that all individuals participate in occupations that many not contribute to their health and wellness. This initial work supports the future development of a tool that is inclusive of all occupations to obtain a holistic picture of an individual’s participation.

The American healthcare system has undergone significant changes in the past few years due to government and corporate-level changes. As healthcare requirements continue to shift, occupational therapists must continue to assert their role or risk losing relevancy. Therefore, educational programs must prepare students to meet the populations’ shifting healthcare needs through agile curricula which focus less on isolated skills and more on broad areas of impact. To determine essential content comprising a ‘metacurriculum’ for occupational therapy education of the future, nine articles were analyzed using Bloom’s Taxonomy (revised) to code each document into knowledge, skills, and behaviors. Major themes were identified across all documents. Through the coding analysis eleven themes were identified: population health, developing life-long learners, advocacy (at government and individual level), interprofessional collaboration, generation of evidence and translational science, diversity and inclusion, psychosocial concerns, aging, wellbeing and preventative care, contemporary issues and informatics. The themes can serve as an outline for academic programs to continue to evolve their curricula to ensure that practitioners are fully prepared to address the global issues that will manifest during their careers in occupational therapy.